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Ahmad A, Khan M, Osman SM, Haassan AM, Javed MH, Ahmad A, Rauf A, Luque R. Benign-by-design plant extract-mediated preparation of copper oxide nanoparticles for environmentally related applications. Environ Res 2024; 247:118048. [PMID: 38160981 DOI: 10.1016/j.envres.2023.118048] [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: 10/03/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
A facile, cost-competitive, scalable and novel synthetic approach is used to prepare copper oxide (CuO) nanoparticles (NPs) using Betel leaf (Piper betle) extracts as reducing, capping, and stabilizing agents. CuO-NPs were characterized using various analytical techniques, including Fourier-transform infrared (FTIR) spectroscopy, ultraviolet-visible (UV-Vis) spectroscopy, scanning electron microscopy (SEM), X-ray diffraction (XRD), high-resolution transmission electron microscopy (HRTEM), as well as photoluminescence (PL) measurements. The activity of CuO-NPs was investigated towards Congo red dye degradation, supercapacitor energy storage and antibacterial activity. A maximum of 89% photodegradation of Congo red dye (CR) was obtained. The nanoparticle modified electrode also exhibited a specific capacitance (Csp) of 179 Fg-1. Furthermore, the antibacterial potential of CuO NPs was evaluated against Bacillus subtilis and Pseudomonas aeruginosa, both strains displaying high antibacterial performance.
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Affiliation(s)
- Awais Ahmad
- Departamento de Quimica Organica, Universidad de Cordoba, Edificio Marie Curie (C-3), Ctra Nnal IV-A, Km 396, E14104, Cordoba, Spain.
| | - Mariam Khan
- School of Applied Sciences and Humanity (NUSASH), National University of Technology, Islamabad, 44000, Pakistan
| | - Sameh M Osman
- Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Ahmad M Haassan
- Faculty of Engineering and Technology, Future University in Egypt, New Cairo, 11835, Egypt
| | - Muhammad Hassan Javed
- Sustainable Development Study Centre, Government College University, Lahore, 54000, Pakistan
| | - Anees Ahmad
- Sustainable Development Study Centre, Government College University, Lahore, 54000, Pakistan
| | - Abdul Rauf
- Sustainable Development Study Centre, Government College University, Lahore, 54000, Pakistan
| | - Rafael Luque
- Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Str., 117198, Moscow, Russian Federation; Universidad ECOTEC, Km 13.5 Samborondón, Samborondón EC092302, Ecuador
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2
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Iyizoba-Ebozue Z, Fatimilehin A, Kayani M, Khan A, McMahon M, Stewart S, Croney C, Sritharan K, Khan M, Obeid M, Igwebike O, Batool R, A-Hakim R, Aghadiuno T, Ruparel V, O'Reilly K. Unveiling Disparities: Exploring Differential Attainment in Postgraduate Training Within Clinical Oncology. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00118-3. [PMID: 38582627 DOI: 10.1016/j.clon.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 04/08/2024]
Abstract
AIMS Differential attainment (DA) in post graduate medical training is a recognised challenge and refers to unexplained variation across groups when split by several protected characteristics. The Royal College of Radiology is committed to fostering diversity, inclusivity, and equality with the goal of narrowing existing gaps and improving training outcomes. MATERIALS AND METHODS This was a mixed methods study aiming to understand the causes of DA with view to helping the RCR develop strategies to address this. A cross-sectional survey was completed by 140 clinical oncology trainees in September 2022. Trainees and trainers (17 and 6 respectively) from across England, Scotland, Wales and Northern Ireland, took part in focus group and interviews from August to December 2022. Quantitative and qualitative data merged and interpreted. RESULT Results showed international medical graduates and trainees from ethnic minority backgrounds were more likely to encounter challenges. The qualitative findings were used to identify three themes through which these problems could be framed. The trainee as a "space invader," the hidden curriculum of clinical oncology training and the process of navigating and tacking the training journey. CONCLUSION Differential attainment is the product of a complex interplay between the trainee, trainer, and the training environment. Therefore, interventions must be tailored to different people and contexts. At a national level, the RCR can adopt general policies to promote this such as mentorship programmes, protected time for supervision and cultural competency training. Efficacy of proposed interventions for trial and their impact on DA should be evaluated to drive evidence-based changes.
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Affiliation(s)
- Z Iyizoba-Ebozue
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK.
| | - A Fatimilehin
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - M Kayani
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - A Khan
- Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - M McMahon
- Department of Clinical Oncology, Northern Ireland Cancer Centre, Northern Ireland, UK
| | - S Stewart
- Department of Clinical Oncology, University College London Hospital, London, UK
| | - C Croney
- Department of Clinical Oncology, Northern Ireland Cancer Centre, Northern Ireland, UK
| | - K Sritharan
- Department of Clinical Oncology, University College London Hospital, London, UK
| | - M Khan
- Department of Clinical Oncology, Northern Ireland Cancer Centre, Northern Ireland, UK
| | - M Obeid
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - O Igwebike
- Department of Clinical Oncology, Western Park Cancer Centre, Sheffield, UK
| | - R Batool
- Department of Clinical Oncology, The University Hospital Coventry, West midlands, UK
| | - R A-Hakim
- Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - T Aghadiuno
- Department of Clinical Oncology, Velindre Cancer Centre, Cardiff, Wales, UK
| | - V Ruparel
- Department of Clinical Oncology, Aberdeen Royal Infirmary, Aberdeen, Scotland UK
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Kelly K, Kolbeinsson H, Blanck LM, Khan M, Kyriakakis R, Assifi MM, Wright GP, Chung M. Can we let our patients sleep in the hospital? A randomized controlled trial of a pragmatic sleep protocol in surgical oncology patients. J Surg Oncol 2024; 129:827-834. [PMID: 38115237 DOI: 10.1002/jso.27565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Postoperative inpatients experience increased stress due to pain and poor restorative sleep than non-surgical inpatients. OBJECTIVES AND METHODS A total of 101 patients, undergoing major oncologic surgery, were randomized to a postoperative sleep protocol (n = 50) or standard postoperative care (n = 51), between August 2020 and November 2021. The primary endpoint of the study was postoperative sleep time after major oncologic surgery. Sleep time and steps were measured using a Fitbit Charge 4®. RESULTS There was no statistically significant difference found in postoperative sleep time between the sleep protocol and standard group (median sleep time of 427 min vs. 402 min; p = 0.852, respectively). Major complication rates were similar in both groups (7.4% vs. 8.9%). Multivariate analysis found sex and Charlson Comorbidity Index to be significant factors affecting postoperative sleep time and step count. Postoperative delirium was only observed in the standard group, although this did not reach statistical significance. There were no in hospital mortalities. CONCLUSION The use of a sleep protocol was found to be safe in our study population. There was no statistical difference in postoperative sleep time or major complications. Institution of a more humane sleep protocol for postoperative inpatients should be considered.
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Affiliation(s)
- Kathrine Kelly
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Hordur Kolbeinsson
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Lauren M Blanck
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
| | - Mariam Khan
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
| | - Roxanne Kyriakakis
- Division of Colon and Rectal Surgery, Spectrum Health Colon and Rectal Fellowship, Grand Rapids, Michigan, USA
| | - M Mura Assifi
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
| | - G Paul Wright
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
| | - Mathew Chung
- Department of General Surgery, Spectrum Health/Michigan State University College of Human Medicine General, Grand Rapids, Michigan, USA
- Department of Graduate Medical Education, Michigan State College of Human Medicine, Grand Rapids, Michigan, USA
- Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, Michigan, USA
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Khan M, Urban C, Vanwyk A, Everin O, Mitchell N, Chung M, Assifi MM, Wright GP. Utility and costs of surveillance imaging for low- and very low-risk gastrointestinal stromal tumors. Surgery 2024; 175:752-755. [PMID: 38097482 DOI: 10.1016/j.surg.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/27/2023] [Accepted: 10/24/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND There is limited evidence on the optimal surveillance approach in patients with low- and very low-risk gastrointestinal stromal tumors, resulting in inconsistent and arbitrary approaches to surveillance in this population. In this study, we reviewed our institutional approach to surveillance in patients with low- and very low-risk gastrointestinal stromal tumors and the costs associated with detecting recurrence. METHODS We retrospectively reviewed consecutive adult patients treated for low- and very low-risk gastrointestinal stromal tumors at our institution from 2010 to 2019. Data collected included patient and tumor characteristics, surgical management, and postoperative follow-up. Surveillance-related expenses were calculated using estimates of average costs obtained from our institution. A cost analysis was performed to evaluate estimated yearly costs based on the surveillance strategy used. RESULTS There were 60 patients included. The mean age at diagnosis was 63.9 (±12.5) years. The primary tumor was typically in the stomach (73%; n = 44). Computed tomography scan of the abdomen and pelvis with intravenous contrast was the most common surveillance modality (total = 226 scans). No recurrences were identified. Median follow-up duration was 49.0 (interquartile range = 19.5-61.5) months. The mean number of surveillance images per patient was 4 (±2.6). Surveillance imaging was obtained more frequently than just annually in 83% (n = 50) of patients, with an estimated yearly cost of $2,840.77 (interquartile range = $2,273.62-$3,895.92) and no detection of recurrence. CONCLUSION In this study population, patients with low- and very low-risk gastrointestinal stromal tumors underwent frequent imaging studies for surveillance with little yield and at substantial cost. Further multi-institutional studies on practice patterns and outcomes of surveillance are warranted to better inform standardized surveillance recommendations.
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Affiliation(s)
- Mariam Khan
- General Surgery Residency, Corewell Health - Grand Rapids/Michigan State University, Grand Rapids, MI.
| | - Caitlin Urban
- College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Austin Vanwyk
- College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Olivia Everin
- College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Nicole Mitchell
- Office of Research and Education, Corewell Health - Grand Rapids/Michigan State University, Grand Rapids, MI
| | - Mathew Chung
- Division of Surgical Oncology, Corewell Health - Grand Rapids/Michigan State University, Grand Rapids, MI
| | - M Mura Assifi
- Division of Surgical Oncology, Corewell Health - Grand Rapids/Michigan State University, Grand Rapids, MI
| | - G Paul Wright
- Division of Surgical Oncology, Corewell Health - Grand Rapids/Michigan State University, Grand Rapids, MI
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5
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Levine A, Khan M, Kelley JK, Wang S, Devireddy D, Wrubel E, Thompson JL, Hop AM, Chung MH, Wright GP. Timing of mastectomy and the effect on the likelihood of outpatient surgery and cost savings in breast cancer patients. Surgery 2024; 175:671-676. [PMID: 37891061 DOI: 10.1016/j.surg.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Same-day discharge after mastectomy has potential patient- and hospital-level benefits; however, few data are available regarding factors affecting the likelihood of same-day discharge in order to address barriers. We sought to evaluate factors contributing to same-day discharge, focusing on the timing of mastectomy during the operative day. METHODS We conducted a single-institution retrospective review of patients who underwent mastectomies for malignancy over a 3-y time frame. Clinicopathologic variables were collected along with a binary variable for mastectomy start time (morning versus afternoon). Our primary endpoint was rate of same-day discharge. A multivariable logistic regression model was constructed from significant univariate variables to determine independent predictors of same-day discharge. A secondary endpoint was a cost-utility analysis for morning versus afternoon start time, using hospital cost data. RESULTS There were 451 patients included in the analysis. Factors associated with same-day discharge rate included the American Society of Anesthesiologists score, use of a preoperative regional anesthesia block, type of mastectomy performed, individual surgeon variation, and a morning start for the mastectomy. On multivariable analysis, morning start was a strong independent predictor of same-day discharge (odd ratio = 2.83; 95% CI, 1.75-4.60). The cost-utility analysis favored a morning start, with average cost savings of $550 per patient. CONCLUSION Despite patient- and surgeon-specific variations, simple scheduling policies can improve same-day discharge rates after mastectomy, leading to improved hospital bed use and cost reduction.
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Affiliation(s)
- Anna Levine
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI.
| | - Mariam Khan
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Jesse K Kelley
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Susanna Wang
- College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Deepthi Devireddy
- College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Erica Wrubel
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI; Division of Surgical Oncology, Corewell Health West Cancer Center, Grand Rapids, MI
| | - Jessica L Thompson
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI; Division of Surgical Oncology, Corewell Health West Cancer Center, Grand Rapids, MI
| | - Amie M Hop
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI; Division of Surgical Oncology, Corewell Health West Cancer Center, Grand Rapids, MI
| | - Mathew H Chung
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI; Division of Surgical Oncology, Corewell Health West Cancer Center, Grand Rapids, MI
| | - G Paul Wright
- General Surgery Residency Program, Corewell Health-Michigan State University, Grand Rapids, MI; Department of Surgery, College of Human Medicine, Michigan State University, Grand Rapids, MI; Division of Surgical Oncology, Corewell Health West Cancer Center, Grand Rapids, MI
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Noor AE, Fatima R, Aslam S, Hussain A, Nisa ZU, Khan M, Mohammed AAA, Sillanpaa M. Health risks assessment and source admeasurement of potentially dangerous heavy metals (Cu, Fe, and Ni) in rapidly growing urban settlement. Environ Res 2024; 242:117736. [PMID: 38007083 DOI: 10.1016/j.envres.2023.117736] [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: 06/04/2023] [Revised: 10/23/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023]
Abstract
Environmental contamination is a global challenge that impacts every aspect of ecosystem. The contaminants from anthropogenic or industrial trash continually recirculate into the environment, agricultural land, plants, livestock, and ultimately into humans by way of the food chain. After an increase in human and farmland animal deaths from illnesses due to contaminated drinking water, toxic metal water poisoning has remained a global concern. Diverse environmental and enforcement organisations have attempted to regulate the activities that serve as precursors to these heavy metals which have been proven ineffective. These unnecessary metals have severely hampered most biological processes. The presence of hazardous metals, which are harmful at extremely high levels and have a negative effect on the health of living bodies generally degrades the nutritional value of water. In order to evaluate the heavy metals (Cu, Ni, and Fe) toxicity of groundwater in pri-urban areas, the current study was conducted that have been considered as advance solution to tackle climate change which influence coastal ecosystem. Additionally, the impacts of soil and plant (spinach and brassica) contamination from groundwater were evaluated. The heavy metals were examined in the soil and groundwater samples (Pb, Fe and Ni). While Fe concentrations in water samples were found to be high as 1.978 mg/L as compared to Ni and Cu values low. According to WHO guidelines, the mean value of Fe exceeds the limit value. Similarly, Cu had a higher mean value (0.7 mg/L) in soil samples than other metals (Ni and Fe). In comparison to Ni and Cu, the Fe concentrations in spinach and brassica plants samples are greater, at 17.2 mg/L and 3.22 mg/L, respectively. The possible effects of metal poisoning of groundwater and plants on human health have been assessed using the Hazard Quotient (HQ), Evaluated Daily Intake (EDI), and Incremental Life Time Cancer Risk formulas (ILTCR). When drinking Ni-contaminated water, humans are more at risk of developing cancer (0.0031) than Fe and Cu. Metal concentrations in water and brassica showed substantially more scattered behaviour on the plot and no meaningful relationship, although PCA and masked matrix correlation showed a fair association between Ni and Cu in brassica (r2: 0.46) and Fe and Ni in spinach (r2: 0.31). According to the study's findings, it is anticipated that special management and groundwater monitoring will be needed in the examined area to reduce the health risks related to drinking water that has been contaminated with metals.
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Affiliation(s)
- Arsh E Noor
- Department of Environmental Sciences and Engineering, Government College University Faisalabad, Pakistan.
| | - Raqash Fatima
- Department of Environmental Sciences, COMSATS University Islamabad-Vehari Campus, Pakistan
| | - Sadia Aslam
- Department of Botany, Government College University Faisalabad, Pakistan
| | - Afzal Hussain
- Department of Environmental Sciences and Engineering, University of Lahore, Lahore, Pakistan.
| | - Zaib Un Nisa
- Department of Zoology, Government College University, Faisalabad, Pakistan
| | - Mariam Khan
- School of Applied Sciences and Humanity, (NUSASH), National University of Technology, Islamabad, Pakistan
| | - Abdallah A A Mohammed
- Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Mika Sillanpaa
- Department of Biological and Chemical Engineering, Aarhus University, Nørrebrogade 44, 8000, Denmark
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Khan JM, Tahir M, Qamar MF, Naz S, Rauf M, Noreen R, Ayaz MM, Khan M, Ahmad M, Khurshid U, Saeed S, Iqbal MJ, Younas QUA, Hameed Y. Mutations in the bone morphogenetic protein 15 gene causing defective protein secretion in Cholistani infertile sheep. BRAZ J BIOL 2024; 84:e256923. [DOI: 10.1590/1519-6984.256923] [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] [Received: 10/02/2021] [Accepted: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract Naturally occurring mutations in morphogenetic protein 15 (BMP15) are associated with decreased ovulation rate (OR), litter size (LS), and sterility. It is of a great interest to elucidate BMP15 gene in Cholistani sheep breed to uplift socio-economic status and the knowledge of Cholistani sheep breeding in Southern Punjab, Pakistan. In our study, a total of 50 infertile Cholistani sheep aged between 2-6 years and having no blood relation were screened for BMP15 mutations. For this purpose, a high-quality DNA was extracted from the blood of sheep followed by primer designing, Polymerase Chain Reaction (PCR) amplification, DNA sequencing, and in silico analyses. Out of total 50 samples, 9 samples including case 1 (T3), case 2 (T8), case 3 (T17), case 4 (T22), case 5 (T25), case 6 (T33), case 7 (T40), case 8 (T44), and case 9 (T47) were found positive for a variety of already reported and novel BMP15 mutations. Further in silico analyses of the observed mutations have shown the functional impact of these mutations on different characteristics (molecular weight, theoretical PI, estimated half-life, instability index, sub-cellular localization, and 3D confirmation) of the encoded proteins, possibly altering the normal functionality. In a nutshell, findings of this study have confirmed the possible essential role of the BMP15 mutations in the infertility of the Cholistani sheep.
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Affiliation(s)
- J. M. Khan
- Cholistan University of Veterinary and Animal Sciences, Pakistan
| | | | - M. F. Qamar
- College of Veterinary and Animal Sciences, Pakistan
| | - S. Naz
- The Government Sadiq College Women University Bahawalpur, Pakistan
| | - M. Rauf
- Cholistan University of Veterinary and Animal Sciences, Pakistan
| | - R. Noreen
- Government College University Faisalabad, Pakistan
| | - M. M. Ayaz
- Cholistan University of Veterinary and Animal Sciences, Pakistan
| | - M. Khan
- The Islamia University of Bahawalpur, Pakistan
| | - M. Ahmad
- The Islamia University of Bahawalpur, Pakistan
| | - U. Khurshid
- The Islamia University of Bahawalpur, Pakistan
| | - S. Saeed
- The Government Sadiq College Women University, Pakistan
| | | | - Q. U. A. Younas
- Cholistan University of Veterinary and Animal Sciences, Pakistan
| | - Y. Hameed
- The Islamia University of Bahawalpur, Pakistan
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Gilden J, Steenen SA, Brand Kanters ART, Khan M. [Vascular occlusion following profile harmonization of the chin with hyaluronic acid fillers]. Ned Tijdschr Tandheelkd 2023; 130:520-524. [PMID: 38051086 DOI: 10.5177/ntvt.2023.12.23057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
The use of dermal fillers for cosmetic procedures has increased rapidly both worldwide and in the Netherlands in recent years, which has led to an absolute increase in reported side effects and complications. Although most of these complications are mild, serious complications such as vascular occlusion can also occur. In this article, we describe a case of a 35-year-old woman who showed signs of reduced tissue perfusion and the early stage of skin necrosis following injection of hyaluronic acid fillers in the chin. This complication was successfully treated by ultrasound-guided injection of hyaluronidase, resulting in a full recovery without residual symptoms. To minimize the risk of serious complications treatment with hyaluronic acid fillers should be carried out by an experienced practitioner.
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Hammad Uddin MK, Khan Sadiq MS, Ahmed A, Khan M, Maniar T, Mateen SM, Saba B, Kashif SM, Usman S, Najeeb S, Khurshid Z, Zafar MS. Applications of Metformin in Dentistry-A review. J Taibah Univ Med Sci 2023; 18:1299-1310. [PMID: 37275952 PMCID: PMC10239065 DOI: 10.1016/j.jtumed.2023.03.014] [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: 11/12/2022] [Revised: 03/10/2023] [Accepted: 03/30/2023] [Indexed: 06/07/2023] Open
Abstract
Metformin is a versatile drug with numerous medical uses. It is known primarily as an anti-hyperglycemic drug that has become the main oral blood-glucose-lowering medication for managing type 2 diabetes mellitus globally. Its use has been reported in a variety of oral conditions and dentistry in general. Recent clinical trials have indicated the effectiveness of adjunct topical application of metformin in improving the periodontal parameters of patients with diabetes and periodontitis. Additionally, studies have suggested that metformin stimulates odontogenic differentiation and mineral synthesis of stem cells in the tooth pulp. Metformin also stimulates osteoblast proliferation, decreases osteoclast activity and exerts regenerative effects on periodontal bone, thus making it a viable candidate for periodontal regeneration. Metformin monotherapy significantly enhances osseointegration of endosseous implants and has been reported to have anti-cancer effects on oral squamous cell carcinoma by impeding tumor progression. Animal studies have indicated that metformin improves orthodontic tooth movement and resists orthodontic appliance corrosion. This narrative review aims to provide a current summary of research highlighting the prospective uses of metformin in dentistry.
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Affiliation(s)
- Muhammad Khawaja Hammad Uddin
- Department of Science of Dental Materials, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Sindh, Pakistan
- School of Dental Care Professionals (SDCP), Dow University of Health Sciences Karachi, Sindh, Pakistan
| | - Muhammad Shahrukh Khan Sadiq
- Department of Oral Pathology, Bahria University Dental College, Bahria University Health Sciences Campus (Karachi) Karachi, Sindh, Pakistan
| | - Ashfaq Ahmed
- Department of Science of Dental Materials, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Sindh, Pakistan
- Department of Oral Pathology, Bahria University Dental College, Bahria University Health Sciences Campus (Karachi) Karachi, Sindh, Pakistan
| | - Mariam Khan
- Department of Science of Dental Materials, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Sindh, Pakistan
- Department of Oral Pathology, Bahria University Dental College, Bahria University Health Sciences Campus (Karachi) Karachi, Sindh, Pakistan
| | - Tooba Maniar
- Department of Science of Dental Materials, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Sindh, Pakistan
- Department of Oral Pathology, Bahria University Dental College, Bahria University Health Sciences Campus (Karachi) Karachi, Sindh, Pakistan
| | - Syeda Mamoona Mateen
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Sindh, Pakistan
| | - Bilquees Saba
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Sindh, Pakistan
- Department of Medicine, Ziauddin Medical College, Ziauddin University, Karachi, Sindh, Pakistan
| | - Syed Muhammad Kashif
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Sindh, Pakistan
- Department of General Medicine, Civil Hospital, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Shumaila Usman
- Dr Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Sindh, Pakistan
- Department of Molecular Medicine, Ziauddin Medical College, Ziauddin University, Karachi, Sindh, Pakistan
| | - Shariq Najeeb
- Evidentia Dental Outcomes Research, Calgary, Alberta, Canada
- Schulich Dentistry, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C, Canada
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, King Faisal University, Hofuf, Al-Ahsa, Saudi Arabia
- Center of Excellence for Regenerative Dentistry, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina Al Munawara, 41311, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
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Khan M, Khan I, Tauseef I, Haleem KS, Shah TA, Naz S, Nazir N, Aziz T, Thamer HA. Cloning and periplasmic soluble expression of hepatitis B surface antigen gene in Escherichia coli. Eur Rev Med Pharmacol Sci 2023; 27:11734-11745. [PMID: 38164836 DOI: 10.26355/eurrev_202312_34770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The objective of this study was to clone and express the hepatitis B surface antigen gene (HBsAg) in Escherichia coli (E. coli), thereby aiming to develop potential local therapeutics for combating Hepatitis B virus (HBV) infection in the Pakistani community by producing HBsAg in E. coli. MATERIALS AND METHODS Blood serum samples were collected from hepatitis B-infected patients, and their genomic DNA was extracted. Real-time and nested polymerase chain reaction (PCR) was performed to amplify the HBsAg gene. The gene of interest was cloned into the pET20b expression vector and transformed into E. coli BL21 (DE3) using Isopropyl β-D-1-thiogalactopyranoside (IPTG) induction. The gene's precise size was confirmed with gene-specific external and internal primers (681 bp and 400 bp, respectively). RESULTS The HBsAg gene was successfully sequenced and submitted to GenBank, exhibiting 98% homology with targeted HBV sequences worldwide. The expression of HBsAg protein was confirmed through silver staining, Coomassie staining, western blot, and dot blot analysis. CONCLUSIONS The expressed protein clones are now available for further development as a local recombinant DNA vaccine to prevent hepatitis B viral infection in the local community.
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Affiliation(s)
- M Khan
- Department of Microbiology, Hazara University, Garden Campus, Mansehra, Pakistan.
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11
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La Charite J, Khan M, Dudovitz R, Nuckols T, Sastry N, Huang C, Lei Y, Schickedanz A. Specific domains of positive childhood experiences (PCEs) associated with improved adult health: A nationally representative study. SSM Popul Health 2023; 24:101558. [PMID: 38034480 PMCID: PMC10685007 DOI: 10.1016/j.ssmph.2023.101558] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Background Positive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure. Methods We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures. Results The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure. Conclusion Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.
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Affiliation(s)
- Jaime La Charite
- Department of General Internal Medicine, University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, 90024, USA
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mariam Khan
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
- Fielding School of Public Health at University of California, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA
| | - Rebecca Dudovitz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
| | - Teryl Nuckols
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, California, 8700 Beverly Blvd Ste 113 Los Angeles, California, 90048, USA
| | - Narayan Sastry
- Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
| | - Cher Huang
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Yvonne Lei
- David Geffen School of Medicine at University of California, 10833 Le Conte Ave., Los Angeles, CA, 90095, USA
| | - Adam Schickedanz
- Department of Pediatrics, University of California, Los Angeles, California, 10833 LeConte Ave., 12-358 CHS, Los Angeles, California, 90095, USA
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12
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Brand Kanters ART, Steenen SA, Gilden J, Khan M. [Treatment with botulinum toxin of masseter hypertrophy, myalgia of the tendons and attrition induced by bruxism]. Ned Tijdschr Tandheelkd 2023; 130:525-529. [PMID: 38051087 DOI: 10.5177/ntvt.2023.12.23058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Bruxism is a disabling condition in which unconscious contractions of the masticulatory muscles lead to teeth grinding and jaw clenching. Symptoms include toothache, temporomandibular dysfunction, headache and attrition. Treatment options range from conservative approaches to invasive interventions. Education, stress reduction, avoidance of stimulants, and relaxation techniques can help in mild cases. Wearing an occlusal splint can reduce attrition. Botulinum neurotoxin type A (BoNT-A) injections are a treatment option temporarily causing partial paralysis of the masticulatory muscles. BoNT-A is a treatment for reducing symptoms and improving the quality of life of patients with bruxism that has been proven safe and effective. The effects usually last several months. To achieve the best results and minimize side effects, BoNT-A injections should be applied by an experienced practitioner.
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Cristoforetti G, Baffigi F, Batani D, Dudzak R, Fedosejevs R, Filippov ED, Gajdos P, Juha L, Khan M, Koester P, Krus M, Mancelli D, Martynenko AS, Nicolai P, Pikuz SA, Renner O, Tentori A, Volpe L, Woolsey N, Zeraouli G, Gizzi LA. Investigation on the origin of hot electrons in laser plasma interaction at shock ignition intensities. Sci Rep 2023; 13:20681. [PMID: 38001120 PMCID: PMC10673912 DOI: 10.1038/s41598-023-46189-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Shock Ignition is a two-step scheme to reach Inertial Confinement Fusion, where the precompressed fuel capsule is ignited by a strong shock driven by a laser pulse at an intensity in the order of [Formula: see text] W/cm[Formula: see text]. In this report we describe the results of an experiment carried out at PALS laser facility designed to investigate the origin of hot electrons in laser-plasma interaction at intensities and plasma temperatures expected for Shock Ignition. A detailed time- and spectrally-resolved characterization of Stimulated Raman Scattering and Two Plasmon Decay instabilities, as well as of the generated hot electrons, suggest that Stimulated Raman Scattering is the dominant source of hot electrons via the damping of daughter plasma waves. The temperature dependence of laser plasma instabilities was also investigated, enabled by the use of different ablator materials, suggesting that Two Plasmon Decay is damped at earlier times for higher plasma temperatures, accompanied by an earlier ignition of SRS. The identification of the predominant hot electron source and the effect of plasma temperature on laser plasma interaction, here investigated, are extremely useful for developing the mitigation strategies for reducing the impact of hot electrons on the fuel ignition.
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Affiliation(s)
| | - F Baffigi
- Istituto Nazionale di Ottica, CNR, Pisa, Italy
| | - D Batani
- Université de Bordeaux, CNRS, CEA, CELIA, 33405, Talence, France
| | - R Dudzak
- Institute of Plasma Physics of the CAS, Prague, Czech Republic
- Institute of Physics of the CAS, Prague, Czech Republic
| | | | | | - P Gajdos
- Institute of Plasma Physics of the CAS, Prague, Czech Republic
| | - L Juha
- Institute of Physics of the CAS, Prague, Czech Republic
| | - M Khan
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, UK
| | - P Koester
- Istituto Nazionale di Ottica, CNR, Pisa, Italy
| | - M Krus
- Institute of Plasma Physics of the CAS, Prague, Czech Republic
| | - D Mancelli
- Institute of Plasma Physics and Lasers, Hellenic Mediterranean University Research Centre, Rethymnon, Greece
- Department of Electronic Engineering, Hellenic Mediterranean University, Chania, Greece
| | - A S Martynenko
- JIHT RAS, Moscow, 125412, Russia
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Ph Nicolai
- Université de Bordeaux, CNRS, CEA, CELIA, 33405, Talence, France
| | - S A Pikuz
- JIHT RAS, Moscow, 125412, Russia
- NRNU MEPhI, Moscow, 115409, Russia
| | - O Renner
- Institute of Plasma Physics of the CAS, Prague, Czech Republic
- Institute of Physics of the CAS, Prague, Czech Republic
- The Extreme Light Infrastructure ERIC, Dolni Brezany, Czech Republic
| | - A Tentori
- Université de Bordeaux, CNRS, CEA, CELIA, 33405, Talence, France
| | - L Volpe
- Centro de Laseres Pulsados (CLPU), 37185, Villamayor, Salamanca, Spain
- ETSI Aeronáutica y del Espacio, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - N Woolsey
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, UK
| | - G Zeraouli
- Centro de Laseres Pulsados (CLPU), 37185, Villamayor, Salamanca, Spain
| | - L A Gizzi
- Istituto Nazionale di Ottica, CNR, Pisa, Italy
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14
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Al-Ghouti MA, Ashfaq MY, Khan M, Al Disi Z, Da'na DA, Shoshaa R. State-of-the-art adsorption and adsorptive filtration based technologies for the removal of trace elements: A critical review. Sci Total Environ 2023; 895:164854. [PMID: 37353014 DOI: 10.1016/j.scitotenv.2023.164854] [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] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/23/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
Water and wastewater are contaminated with various types of trace elements that are released from industrial activities. Their presence, at concentrations above the permissible limit, will cause severe negative impacts on human health and the environment. Due to their cost-effectiveness, simple design, high efficiency, and selectivity, adsorption, and adsorptive filtration are techniques that have received lots of attention as compared to other water treatment techniques. Adsorption isotherms and kinetic studies help to understand the mechanisms of adsorption and adsorption rates, which can be used to develop and optimize different adsorbents. This state-of-the-art review provides and combines the advancements in different conventional and advanced adsorbents, biosorbents, and adsorptive membranes for the removal of trace elements from water streams. Herein, this review discusses the sources of different trace elements and their impact on human health. The review also covers the adsorption technique with a focus on various advanced adsorbents, their adsorption capacities, and adsorption isotherm modeling in detail. In addition, biosorption is critically discussed together with its mechanisms and biosorption isotherms. In the end, the application of various advanced adsorptive membranes is discussed and their comparison with adsorbents and biosorbents is systematically presented.
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Affiliation(s)
- Mohammad A Al-Ghouti
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Mohammad Y Ashfaq
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mariam Khan
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Zulfa Al Disi
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Dana A Da'na
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Rouzan Shoshaa
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
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15
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D'Anna G, Shah L, Kranz PG, Hirsch JA, Khan M, Johnson M, Feydy A, Nathan J, Manfre L, Nguyen DT, Sze G, Goethem JV, Vanhoenacker FM. Results of an International Survey on Spinal Imaging by the ASNR/ASSR/ESNR/ESSR "Nomenclature 3.0" Working Group. Semin Musculoskelet Radiol 2023; 27:561-565. [PMID: 37816364 DOI: 10.1055/s-0043-1768247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Our goal was to determine if "Nomenclature 2.0," the classification of lumbar disk pathology consensus, should be updated. We conducted a social media and e-mail-based survey on preferences regarding the use of classification on magnetic resonance spine reporting. Members of the European Society of Neuroradiology, European Society of Musculoskeletal Radiology, American Society of Neuroradiology, and American Society of Spine Radiology received a 15-question online survey between February and March 2022. A total of 600 responses were received from 63 countries. The largest number of responses came from Italy and the United States. We found that 71.28% of respondents used Nomenclature 2.0, Classification of Lumbar Disk Pathology. But classification on stenosis is used less often: 53.94% and 60% of respondents do not use any classification of spinal canal stenosis and foraminal stenosis, respectively. When queried about which part of Nomenclature needs improving, most respondents asked for a Structured Reporting Template (SRT), even though 58.85% of respondents do not currently use any template and 54% routinely use a clinical information questionnaire. These results highlight the importance of an updated Nomenclature 3.0 version that integrates the classifications of lumbar disk disease and spinal canal and foraminal stenosis. Further attention should also be directed toward developing a robust endorsed SRT.
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Affiliation(s)
- Gennaro D'Anna
- Neuroimaging Unit, ASST Ovest Milanese, Legnano, Milan, Italy
| | - Lubdha Shah
- Department of Radiology, University of Utah, Salt Lake City, Utah
| | - Peter G Kranz
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Joshua A Hirsch
- Department of Neurointerventional Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - M Khan
- Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Michele Johnson
- Departments of Radiology and Biomedical Imaging and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | | | - J Nathan
- Department of Neuroradiology, Emory School of Medicine, Atlanta, Georgia
| | - L Manfre
- Minimal Invasive Spine Department of Neurosurgery, Istituto Oncologico del Mediterraneo IOM, Viagrande, Italy
| | - Dan T Nguyen
- Neuroradiology and Pain Solutions of Oklahoma, Oklahoma City, Oklahoma
| | - Gordan Sze
- Department of Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Johan Van Goethem
- Department of Radiology, University Hospital Antwerp, Antwerp, Belgium
- Department of Medical and Molecular Imaging, General Hospital VITAZ, Sint-Niklaas, Belgium
| | - Filip M Vanhoenacker
- Department of Radiology General Hospital Sint-Maarten Mechelen, Antwerp University Hospital, Edegem, Belgium
- Antwerp/Ghent University Faculty of Medicine and Health Sciences, Faculty of Medicine KU Leuven, Leuven, Belgium
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16
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Cappelli L, Poiset SJ, Khan M, Kayne A, Nelson NG, Gardner C, Uppendahl A, Zhan T, Wang ZX, Judy K, Andrews DW, Alnahhas I, Shi W. Institutional Validation Study Inferring 2% MGMT Methylation Positive Impact on Survival in Newly Diagnosed Glioblastoma (GBM) Patients. Int J Radiat Oncol Biol Phys 2023; 117:e92-e93. [PMID: 37786215 DOI: 10.1016/j.ijrobp.2023.06.852] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) O6-methylguanine DNA methyltransferase (MGMT) MATERIALS/METHODS: is a well-established prognostic factor in patients with newly diagnosed glioblastoma (GBM). However, there is no consensus on a standardized method of threshold for MGMT testing. Previous studies have reported levels of as little as 1-3% to confer better prognosis. This study reports a single institutional experience of determining methylation status via methylation-sensitive high-resolution melting (MS-HRM). Previous literature suggests 10% cutoff for MGMT methylation using MS-HRM. We hereby report clinical outcomes using a lower threshold of 2%. MATERIALS/METHODS GBM patients treated at our institution retrospectively reviewed between the years 2013 and 2022 were included in the study. Patients who received hypofractionated radiation (<60 Gy) were excluded. All patients had MS-HRM test for MGMT methylation status. A real-time PCR assay was used to amplify a 62 base-pair region of MGMT for both methylated and unmethylated alleles. PCR products underwent HRM analysis and the fraction of methylated DNA was determined by comparison with a standard curve. Clinical data were collected retrospectively. Kaplan-Meier and log-rank tests were performed to compare survival. RESULTS A total of 181 patients with newly diagnosed GBM were initially included in this study. 42 patients treated with hypofractionated radiation were excluded. All patients received concurrent and maintenance temozolomide. Median age was 61.5 years. A total of 84 patients had MGMT methylation levels <2%, and 55 patients had MGMT methylation level ≥ 2% with a median methylation level of 28.5% (Range 0.8%-100%). Patients with MGMT methylation level ≥ 2% had an improved median overall survival (25.1 vs 16.0 months; p = 0.006) and improved median progression free survival (11.3 vs 7.9 months; p = 0.017). In a multivariable mode that included age, use of tumor-treating fields, KPS, sex, and BMI, only age, KPS, and MGMT remained significant. CONCLUSION Our institutional review confirmed low level of MGMT hypermethylation (≥ 2%) predicts improved outcome in patients with newly diagnosed GBM. Further investigation on optimal cut off level for MGMT methylation is still warranted.
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Affiliation(s)
- L Cappelli
- Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - S J Poiset
- Department of Radiation Oncology, Sidney Kimmel Cancer Center of Thomas Jefferson University, Philadelphia, PA
| | - M Khan
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - A Kayne
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - N G Nelson
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, PA, Philadelphia, PA
| | - C Gardner
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - A Uppendahl
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - T Zhan
- Dept of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Z X Wang
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA
| | - K Judy
- Dept of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA
| | - D W Andrews
- Department of Neurosurgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
| | - I Alnahhas
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA
| | - W Shi
- Department of Radiation Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
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Cappelli L, Uppendahl A, Gardner C, Dejarlais A, Reddy A, Khan M, Kayne A, Poiset SJ, Zhan T, Judy K, Andrews DW, Simone NL, Alnahhas I, Shi W. Body Mass Index (BMI) at Time of Diagnosis as a Prognostic Indicator in Patients with Newly Diagnosed Glioblastoma (GBM). Int J Radiat Oncol Biol Phys 2023; 117:e93. [PMID: 37786217 DOI: 10.1016/j.ijrobp.2023.06.853] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Glioblastoma (GBM) is the most common primary brain cancer in adults with very poor prognosis. Metabolic drivers of tumorigenesis are highly relevant within the central nervous system, where glucose is the sole source of energy. The impact of obesity on survival outcomes in patients with GBM has not been well reported and some initial results are inconsistent. This study investigates the factor of body mass index (BMI) in patients diagnosed with GBM. This study evaluated the prognostic association of BMI with survival outcomes in patients with newly diagnosed GBM. MATERIALS/METHODS Patientswith newly diagnosed GBM at our institution from 2015-2022 were included in this study. All patients were >18 years of age and received 60 Gy of radiation therapy with concurrent and adjuvant temozolomide following maximal safe resection. Through retrospective chart review, patient BMI at the time of diagnosis and overall survival (OS) were recorded. Analysis was done between patient groups of underweight/normal weight (BMI <25) and overweight/obese (BMI ≥ 25.00). The subgroup of overweight patients was also divided into subgroups of overweight (BMI 25.00-29.99) and obese (BMI≥30.00). A difference in clinical outcomes of overall survival was evaluated between the groups using Gehan-Breslow-Wilcoxon and log-rank tests. RESULTS Atotal of 393 patients met inclusion criteria. Median age 57.3 years, range 18.8-92.7. 185 female and 208 were male. 120 patients had a BMI <25 and 273 had a BMI ≥ 25.00. Median survival in patients with BMI <25 was 24.90 months and in patients with BMI ≥ 25.00, 18.20 months (p = 0.0001; HR 0.6552, 95% CI 0.5299-0.8101). We further divided patients with BMI ≥ 25.00 to 25-29.99 (n = 152) and BMI≥30.00 (n = 121). Both groups' OS were significantly worse than patients with BMI < 25 (p = 0.006). There was no difference in survival outcomes between patients with a BMI 25.00-29.99 and BMI≥30.00, with median OS 19.0 months and 18.1 months, respectively. CONCLUSION Patient baseline BMI <25 appears to be a prognostic indicator and correlates to improves overall survival for patients with newly diagnosed GBM. This study adds to the existing literature supporting overweight/obesity is associated with worse survival for GBM patients. Additional studies are warranted for further analysis of BMI and survival outcomes in GBM patients across patient demographics.
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Affiliation(s)
- L Cappelli
- Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - A Uppendahl
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - C Gardner
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - A Dejarlais
- Drexel College of Medicine, Philadelphia, PA
| | - A Reddy
- The College of New Jersey, Ewing, NJ
| | - M Khan
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - A Kayne
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, PA
| | - S J Poiset
- Department of Radiation Oncology, Sidney Kimmel Cancer Center of Thomas Jefferson University, Philadelphia, PA
| | - T Zhan
- Dept of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - K Judy
- Dept of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA
| | - D W Andrews
- Department of Neurosurgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
| | - N L Simone
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - I Alnahhas
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA
| | - W Shi
- Department of Radiation Oncology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA
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Nojszewska N, Idilli O, Sarkar D, Ahouiyek Z, Arroyo-Berdugo Y, Sandoval C, Amin-Anjum MS, Bowers S, Greaves D, Saeed L, Khan M, Salti S, Al-Shami S, Topoglu H, Punzalan JK, Farias JG, Calle Y. Bone marrow mesenchymal/fibroblastic stromal cells induce a distinctive EMT-like phenotype in AML cells. Eur J Cell Biol 2023; 102:151334. [PMID: 37354622 DOI: 10.1016/j.ejcb.2023.151334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023] Open
Abstract
The development of epithelial-to-mesenchymal transition (EMT) like features is emerging as a critical factor involved in the pathogenesis of acute myeloid leukaemia (AML). However, the extracellular signals and the signalling pathways in AML that may regulate EMT remain largely unstudied. We found that the bone marrow (BM) mesenchymal/fibroblastic cell line HS5 induces an EMT-like migratory phenotype in AML cells. AML cells underwent a strong increase of vimentin (VIM) levels that was not mirrored to the same extent by changes of expression of the other EMT core proteins SNAI1 and SNAI2. We validated these particular pattern of co-expression of core-EMT markers in AML cells by performing an in silico analysis using datasets of human tumours. Our data showed that in AML the expression levels of VIM does not completely correlate with the co-expression of core EMT markers observed in epithelial tumours. We also found that vs epithelial tumours, AML cells display a distinct patterns of co-expression of VIM and the actin binding and adhesion regulatory proteins that regulate F-actin dynamics and integrin-mediated adhesions involved in the invasive migration in cells undergoing EMT. We conclude that the BM stroma induces an EMT related pattern of migration in AML cells in a process involving a distinctive regulation of EMT markers and of regulators of cell adhesion and actin dynamics that should be further investigated. Understanding the tumour specific signalling pathways associated with the EMT process may contribute to the development of new tailored therapies for AML as well as in different types of cancers.
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Affiliation(s)
- N Nojszewska
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - O Idilli
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - D Sarkar
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - Z Ahouiyek
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - Y Arroyo-Berdugo
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - C Sandoval
- Department of Chemical Engineering, Universidad de La Frontera, Temuco, Chile
| | - M S Amin-Anjum
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - S Bowers
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - D Greaves
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - L Saeed
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - M Khan
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - S Salti
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - S Al-Shami
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - H Topoglu
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - J K Punzalan
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK
| | - J G Farias
- Department of Chemical Engineering, Universidad de La Frontera, Temuco, Chile
| | - Y Calle
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK.
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Arran C, Bradford P, Dearling A, Hicks GS, Al-Atabi S, Antonelli L, Ettlinger OC, Khan M, Read MP, Glize K, Notley M, Walsh CA, Kingham RJ, Najmudin Z, Ridgers CP, Woolsey NC. Measurement of Magnetic Cavitation Driven by Heat Flow in a Plasma. Phys Rev Lett 2023; 131:015101. [PMID: 37478421 DOI: 10.1103/physrevlett.131.015101] [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] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 03/22/2023] [Accepted: 05/17/2023] [Indexed: 07/23/2023]
Abstract
We describe the direct measurement of the expulsion of a magnetic field from a plasma driven by heat flow. Using a laser to heat a column of gas within an applied magnetic field, we isolate Nernst advection and show how it changes the field over a nanosecond timescale. Reconstruction of the magnetic field map from proton radiographs demonstrates that the field is advected by heat flow in advance of the plasma expansion with a velocity v_{N}=(6±2)×10^{5} m/s. Kinetic and extended magnetohydrodynamic simulations agree well in this regime due to the buildup of a magnetic transport barrier.
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Affiliation(s)
- C Arran
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
| | - P Bradford
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
| | - A Dearling
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
| | - G S Hicks
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, United Kingdom
| | - S Al-Atabi
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, United Kingdom
| | - L Antonelli
- First Light Fusion Ltd., Unit 9/10 Oxford Industrial Park, Mead Road, Yarnton, Kidlington OX5 1QU, United Kingdom
| | - O C Ettlinger
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, United Kingdom
| | - M Khan
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
| | - M P Read
- First Light Fusion Ltd., Unit 9/10 Oxford Industrial Park, Mead Road, Yarnton, Kidlington OX5 1QU, United Kingdom
| | - K Glize
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 OQX, United Kingdom
| | - M Notley
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot OX11 OQX, United Kingdom
| | - C A Walsh
- Lawrence Livermore National Laboratory, 7000 East Avenue, Livermore, California 94550-9234, USA
| | - R J Kingham
- Blackett Laboratory, Imperial College London, London SW7 2BZ, United Kingdom
| | - Z Najmudin
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, London SW7 2BZ, United Kingdom
| | - C P Ridgers
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
| | - N C Woolsey
- York Plasma Institute, University of York, York YO10 5DD, United Kingdom
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Shields AD, Knutzen D, Khan M, Sobh O, Jacobs K. Prenatal diagnosis of familial porencephaly associated with fetal stroke. Ultrasound Obstet Gynecol 2023; 62:153-154. [PMID: 36722041 DOI: 10.1002/uog.26168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/01/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Affiliation(s)
- A D Shields
- Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT, USA
| | - D Knutzen
- Department of Obstetrics and Gynecology, Baylor College of Medicine, San Antonio, TX, USA
| | - M Khan
- Department of Neurology, St Louis University School of Medicine, St Louis, MO, USA
| | - O Sobh
- Department of Obstetrics and Gynecology, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, USA
| | - K Jacobs
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Minneapolis, MN, USA
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21
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Khan M, Al-Ghouti MA, Khraisheh M, Shomar B, Hijji Y, Tong Y, Mansour S, Nasser MS. Synthesis of nanostructured novel ion-imprinted polymer for selective removal of Cu 2+ and Sr 2+ ions from reverse osmosis concentrated brine. Environ Res 2023; 231:116024. [PMID: 37121345 DOI: 10.1016/j.envres.2023.116024] [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] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 04/15/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
This study aims to prepare an ion-imprinted polymer (IIP) using copper sulfate as a template and potassium persulfate as an initiator to selectively adsorb copper ions (Cu2+) from aqueous solutions and in an attempt to also test its applicability for removing strontium ions (Sr2+). The prepared polymer was denoted by IIP-Cu. Various physical and chemical characterizations were performed for the prepared IIP-Cu. The scanning electron microscopy and transmission electron microscopy analyses confirmed the cavities formed after the removal of the template. It also indicated that the IIP-Cu had a rough and porous topology. The X-ray photoelectron spectroscopy confirmed the successful removal of the Cu template from IIP-Cu. The Brunauer-Emmet-Teller revealed that the surface area of IIP-Cu is as high as 152.3 m2/g while the pore radius is 8.51 nm. The effect of pH indicated that the maximum adsorption of Cu2+ was achieved at pH 8 with 98.7%. Isotherm studies revealed that the adsorption of Cu2+ was best explained using Langmuir models with a maximum adsorption capacity of 159 mg/g. The effect of temperature revealed that an increase in temperature had an adverse impact on Cu2+ removal from the aqueous solution, which was further confirmed by thermodynamic studies. The negative value of standard enthalpy change (-4.641 kJ/mol) revealed that the adsorption of Cu2+ onto IIP-Cu was exothermic. While the continuous increase in Gibbs free energy from -6776 kJ/mol to -8385 kJ/mol with the increase in temperature indicated that the adsorption process was spontaneous and feasible. Lastly, the positive value of the standard entropy change (0.023 J/mol.K) suggested that the Cu2+ adsorption onto IIP-Cu had a good affinity at the solid-liquid surface. The efficiency of the prepared IIP-Cu was also tested by studying the adsorption capacity using Sr2+ and real brine water. The results revealed that IIP-Cu was able to remove 63.57% of Sr2+ at pH 8. While the adsorption studies revealed that the experiment was best described using the Langmuir model with a maximum adsorption capacity of 76.92 mg/g. Additionally, IIP-Cu was applied in a real brine sample, which consisted of various metal ions. The highest percentage of Cu2+ removal was 90.6% and the lowest was 65.63% in 1:4 and 1:1 brine ratios, respectively. However, this study indicates the successful application of IIP-Cu in a real sample when it comes to the effective and efficient removal of Cu2+ in a solution consisting of various competing ions.
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Affiliation(s)
- Mariam Khan
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, P.O. Box: 2713, Qatar
| | - Mohammad A Al-Ghouti
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, P.O. Box: 2713, Qatar.
| | - Majeda Khraisheh
- Department of Chemical Engineering, College of Engineering, Qatar University, Doha, P.O. Box: 2713, Qatar
| | - Basem Shomar
- Environmental Science Center, Qatar University, Doha, P.O. Box: 2713, Qatar
| | - Yousef Hijji
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, P.O. Box: 2713, Qatar
| | - Yongfeng Tong
- Core Labs, Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University (HBKU) 34110 Qatar Foundation, Doha, Qatar
| | - Said Mansour
- Core Labs, Qatar Environment and Energy Research Institute (QEERI), Hamad Bin Khalifa University (HBKU) 34110 Qatar Foundation, Doha, Qatar
| | - Mustafa Saleh Nasser
- Gas Processing Center, College of Engineering, Qatar University, Doha, P.O. Box 2713, Qatar
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22
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Mainardi G, Hatami S, Wagner M, Khan M, Wang X, Pidborochynski T, Nagendran J, Conway J, Freed D. Subnormothermic Machine Perfusion of Neonatal and Small Pediatric Sized Hearts. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.879] [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: 04/05/2023] Open
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23
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Hatami S, Wagner M, Mainardi G, Khan M, Himmat S, Nagendran J, Freed D. Superior Cardiac Protection in Combined Ex-Situ Perfusion of Heart and Liver: Lessons Learned. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.206] [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: 04/05/2023] Open
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Gilani S, Batra M, Tandon M, Khan M, Jegannathen A, Gahir D, Karanam S, Sivaramalingam M. P093 Impact of breast size on partial breast radiotherapy planning and short term outcome: a single institution experience at University Hospital of North Midlands (UHNM) UK. Breast 2023. [DOI: 10.1016/s0960-9776(23)00210-2] [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: 03/17/2023] Open
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Affiliation(s)
- Mariam Khan
- General Surgery Residency, Corewell Health-West, Grand Rapids, Michigan
| | - James Ogilvie
- Colon and Rectal Surgery, Corewell Health West, Grand Rapids, Michigan
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Li AZ, Khan M, Nguyen NT, Breitman L, Luca J, Van Doren E, Gia Kieu Ngan N, Thị Hoàng Yến N, Dang K, Tan Tai T, Taylor RH. Huế dental students' use and perception of an online dental learning platform: A pilot study. J Dent Educ 2023; 87:401-407. [PMID: 36377379 DOI: 10.1002/jdd.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/16/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE/OBJECTIVES Online educational materials are growing in use, and dental students worldwide can benefit from higher quality and more accessible online supplemental resources. This study was created to evaluate the learning resources non-English speaking dental students desire and to pilot My Dental Key (MDK), an English, evidence-based, online dental educational platform. METHODS Third to sixth year dental students at the Huế University of Medicine and Pharmacy were asked to pilot MDK over a 5-week period and were invited to answer three surveys throughout the study. A preliminary survey was given to gauge the participants' (n = 209) preferences regarding the use of English-based dental educational resources. Participants (n = 58) completed a presurvey prior to accessing MDK. After the 5-week period, participants (n = 38) were given a postsurvey to evaluate the platform's effectiveness as a supplemental educational resource. RESULTS Overall, we found that: (1) students desire credible online supplemental resources in addition to current resources provided by their school, (2) the multimodal content that MDK provides is a strength that bridges language barriers (3) participants perceived that the content on MDK would help them in class and when treating patients. CONCLUSIONS Improving the quality of online supplemental dental resources will have the capability to progress the current educational landscape, and further resources should be created to best serve the global dental community.
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Affiliation(s)
- Alice Z Li
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Mariam Khan
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Nicholas T Nguyen
- School of Dentistry in Baltimore, University of Maryland, College Park, Maryland, USA
| | - Leela Breitman
- UNC Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Jennifer Luca
- The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Emily Van Doren
- Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Nguyen Gia Kieu Ngan
- Faculty of Odonto-Stomatology, Huế University of Medicine and Pharmacy, Huế, Vietnam
| | | | - Khoa Dang
- Huế University of Medicine and Pharmacy, Huế, Vietnam
| | - Tran Tan Tai
- Faculty of Odonto-Stomatology, Huế University of Medicine and Pharmacy, Huế, Vietnam
| | - Russell H Taylor
- Faculty at Harvard School of Dental Medicine, Brookline, Massachusetts, USA
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27
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Khan M, Kelley J, Wright GP. Starting a minimally invasive inguinal lymphadenectomy program: Initial learning experience and outcomes. Surgery 2023; 173:633-639. [PMID: 36379745 DOI: 10.1016/j.surg.2022.07.052] [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] [Received: 05/03/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is promising data on minimally invasive inguinal lymphadenectomy indicating decreased wound complications compared with the standard open approach. We examined our institutional experience with starting a minimally invasive inguinal lymphadenectomy program. METHODS This is a retrospective case series of consecutive patients undergoing videoscopic minimally invasive inguinal lymphadenectomy from August 2017 to March 2022 by a single surgeon. Patients meeting criteria for inguinal lymphadenectomy were considered for minimally invasive inguinal lymphadenectomy unless there was skin involvement by tumor or bulky disease. Data collected included patient characteristics, primary cancer, surgery, and postoperative complications. RESULTS There were 26 patients included. The mean age was 60.6 ± 16.2 years. Most patients were female (n = 17, 65.4%), and the primary diagnosis was melanoma (n = 21, 19.2%). In 6 cases (23.1%), minimally invasive inguinal lymphadenectomy was combined with deep pelvic node dissection, but most patients did not have a concurrent procedure (n = 15, 57.7%). The median operative time was 119.0 minutes (range, 89.0-160.0), or 130.5 minutes (range, 89.0-345.0) when including concurrent procedures. The mean number of nodes retrieved was 9.8 ± 3.7, with a positive node identified in 19 patients (73.1%) during minimally invasive inguinal lymphadenectomy. There were 12 (46.2%) patients experiencing at least one postoperative complication within 30 days of surgery, the most common being infection (n = 4, 15.4%). One patient required reoperation for infected hematoma washout. Postoperative intervention for seroma was undertaken in 3 patients (11.5%). CONCLUSION Minimally invasive inguinal lymphadenectomy is a safe approach to inguinal lymph node dissection, in terms of node retrieval and postoperative complications, and can feasibly be adopted into practice with minimal learning curve.
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Affiliation(s)
- Mariam Khan
- Spectrum Health General Surgery Residency, Grand Rapids, MI.
| | - Jesse Kelley
- Spectrum Health Surgical Oncology, Grand Rapids, MI
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Liévano-Karim L, Thaxton T, Bobbitt C, Yee N, Khan M, Franke T. A Balancing Act: How Professionals in the Foster Care System Balance the Harm of Intimate Partner Violence as Compared to the Harm of Child Removal. Int J Child Maltreat 2023:1-24. [PMID: 36785696 PMCID: PMC9909141 DOI: 10.1007/s42448-023-00153-0] [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] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
The striking prevalence of child exposure to intimate partner violence (IPV) and its associated adverse health outcomes necessitates a robust response from professionals who must grapple with the ethical dilemma of how to serve and support children in these circumstances. In 2020, 42 participants from four different professional backgrounds (attorneys, nonprofit leadership, licensed therapists, and social workers) were interviewed or participated in a focus group discussion. All groups acknowledged the shortfalls of current intervention practices, which often result in child removal. Group 1, which included social workers that work for children's legal services, minor's counsel, and Los Angeles Department of Child and Family Services social workers, were more conflicted in their recommendations for change. Some Group 1 participants recommended more training, while others thought more training would make little difference and recommended more substantial changes to prevent child removal when possible. Group 2, which included parents' counsel, and Group 3, which included social workers, attorneys, and nonprofit leadership at IPV nonprofits, were more closely aligned in their recommendations, primarily focusing on systemic changes to the child welfare system. Participants whose employment required them to advocate for parents tend to view child removal from a non-offending parent as harmful for both the child and IPV survivor. These findings illuminate how the perspectives of these diverse participants are influenced by their professional and personal experiences.
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Affiliation(s)
| | - Taylor Thaxton
- School of Public Health, UC Berkeley, Berkeley, CA USA
- Charles R Drew/David Geffen School of Medicine, UCLA, Los Angeles, CA USA
| | | | - Nicole Yee
- UCLA Pritzker Center for Strengthening Children and Families, UCLA, Los Angeles, CA USA
| | - Mariam Khan
- Fielding School of Public Health, UCLA, Los Angeles, CA USA
- David Geffen School of Medicine, UCLA, Los Angeles, CA USA
| | - Todd Franke
- Luskin School of Public Affairs, UCLA, Los Angeles, CA USA
- UCLA Pritzker Center for Strengthening Children and Families, UCLA, Los Angeles, CA USA
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29
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Khan M, Backer G, Alvarado A, Wang S, Devireddy D, Parker J, Assifi MM, Chung M, Wright GP, Chandana SR. Does distance traveled impact management and outcomes in patients with pancreatic adenocarcinoma who are candidates for curative resection? J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.668] [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: 01/25/2023] Open
Abstract
668 Background: We investigated the impact of distance traveled to a tertiary care center for treatment in the management and outcomes of patients with pancreatic adenocarcinoma (PDAC). Methods: Patients treated for operable PDAC at a single institution from 2010-2019 were retrospectively reviewed. Data was collected on demographics, tumor characteristics, social determinants of health, diagnostic/staging work-up, surgical details, and outcomes. Patients were divided into three groups based on distance from our institution: Group A, <10 miles, Group B, >11-50 miles, or Group C, > 50 miles. The primary outcome was two-year survival. Results: There were 314 patients included. The mean age was 67.6+10.5 years. Patients farther from the hospital were less likely to undergo CT with contrast (Group B 97.1% versus Group C 89.0%, p = 0.02) and more likely to get MRCP (Group A 17.0% versus Group C 36.3%, p = 0.01) for staging. Distance was also associated with increased time to first encounter with medical or surgical oncology (Group A 6 days versus Group C 9 days, p = 0.02) and treatment initiation (Group A 22 days versus Group C 28 days, p < 0.001). There were no differences in postoperative complications, length of stay, discharge disposition, or follow-up. Two-year survival was better in Group A than Group B (54.1% versus 35.5%, p = 0.04). There was no difference in five-year survival. In the multivariable model for two-year survival, no patient or tumor characteristics were significant. Conclusions: In this PDAC population, patients living farther from a tertiary cancer center had worse two-year postoperative survival. Prospective studies in this area are needed.
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Mrklas KJ, Boyd JM, Shergill S, Merali S, Khan M, Nowell L, Goertzen A, Pfadenhauer LM, Paul K, Sibley KM, Swain L, Vis-Dunbar M, Hill MD, Raffin-Bouchal S, Tonelli M, Graham ID. Tools for assessing health research partnership outcomes and impacts: a systematic review. Health Res Policy Syst 2023; 21:3. [PMID: 36604697 PMCID: PMC9817421 DOI: 10.1186/s12961-022-00937-9] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts. METHODS We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist. RESULTS From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist. CONCLUSION This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.
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Affiliation(s)
- K. J. Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Strategic Clinical Networks™, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB Canada
| | - J. M. Boyd
- Knowledge Translation Program, St Michael’s Hospital, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON Canada
| | - S. Shergill
- Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - S. Merali
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - M. Khan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
| | - L. Nowell
- Faculty of Nursing, University of Calgary, Calgary, AB Canada
| | - A. Goertzen
- Faculty of Science, University of Alberta, Edmonton, AB Canada
| | - L. M. Pfadenhauer
- Institute for Medical Information Processing, Biometry, and Epidemiology–IBE, Ludwig-Maximilian Universität Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - K. Paul
- University of Calgary Summer Studentships Program, Calgary, AB Canada
| | - K. M. Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB Canada
| | - L. Swain
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - M. Vis-Dunbar
- University of British Columbia - Okanagan, Kelowna, BC Canada
| | - M. D. Hill
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
- Departments of Clinical Neurosciences, Medicine and Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | | | - M. Tonelli
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
- Office of the Vice-President (Research), University of Calgary, Calgary, AB Canada
| | - I. D. Graham
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON Canada
- School of Epidemiology and Public Health & School of Nursing, University of Ottawa, Ottawa, ON Canada
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Pandev R, Khan M, Ratheesh V. Riedel's Thyroiditis: Pitfalls in Diagnosis and Subsequent Complications. Case Rep Endocrinol 2023; 2023:9989953. [PMID: 37096012 PMCID: PMC10122592 DOI: 10.1155/2023/9989953] [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] [Received: 12/10/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 04/26/2023] Open
Abstract
Riedel's thyroiditis is a rare disease of chronic inflammation with fibrotic infiltration of the thyroid gland and its surrounding vital structures. Due to its low incidence, there are often delays in diagnosis as it is commonly mistaken for other thyroid diseases. We report the case of a 34-year-old female patient who presented with a firm, enlarged mass in the neck, compression symptoms, and hypothyroidism. Lab tests showed elevated A-TG (thyroglobulin antibodies) and A-TPO (thyroid peroxidase antibodies) levels. Based on the disease presentation and supporting lab findings, the patient was misdiagnosed with Hashimoto's thyroiditis and treated accordingly. Yet the patient's symptoms grew progressively worse. She was discovered to have severe tracheal compression and bilateral RLN (recurrent laryngeal nerve) palsy. Tracheotomy became a necessary surgical intervention after the development of respiratory failure, but this procedure was complicated by the development of an intraoperative pneumothorax. After an open biopsy, histology revealed Riedel's thyroiditis. A new treatment was introduced, with which the patient's condition improved. However, she continued to suffer from the open tracheocutaneous fistula left by the tracheostomy, which adversely affected her everyday life. A follow-up operation was performed to close the fistula. In this case report, we discuss the consequences of misdiagnosing the patient and delaying the appropriate treatment for her disease.
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Affiliation(s)
- R. Pandev
- Medical University of Pleven, Pleven, Bulgaria
- University Hospital Saint Marina, Pleven, Bulgaria
| | - M. Khan
- Medical University of Pleven, Pleven, Bulgaria
| | - V. Ratheesh
- Medical University of Pleven, Pleven, Bulgaria
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32
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Khan M, Thompson J, Kiiskila L, Oboh O, Truong T, Prentice A, Assifi MM, Chung M, Wright GP. Timing and necessity of staging imaging in clinical stage II cutaneous melanoma: Cost-effectiveness and clinical decision analysis. Am J Surg 2023; 225:93-98. [PMID: 36400601 DOI: 10.1016/j.amjsurg.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/02/2022] [Accepted: 10/12/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Preoperative imaging in clinical stage II melanoma is not indicated per National Comprehensive Cancer Network (NCCN) guidelines but remains common in clinical practice. METHODS Patients presenting with cutaneous clinical stage II melanoma from 2007 to 2019 were retrospectively reviewed. A clinical decision analysis with cost data was designed to understand ideal practice patterns in managing stage II melanoma, with pre-versus selective post-operative imaging as the initial decision node. RESULTS There were 277 subjects included, and 143 underwent preoperative imaging (49.5%). This changed management (i.e. no surgery) in one patient (0.4%). Overall, 16 patients had additional findings on imaging (5.8%). Upfront surgery with selective postoperative imaging was a more cost-effective strategy than routine performance of preoperative imaging, with savings of $1677 per patient. CONCLUSION Preoperative imaging is a low yield, costly approach for patients with clinical stage II melanoma with minimal impact on the decision to proceed with surgical management.
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Affiliation(s)
- Mariam Khan
- Spectrum Health General Surgery Residency Program, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Jessica Thompson
- Spectrum Health General Surgery Residency Program, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Lindsey Kiiskila
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Oselenonome Oboh
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Thao Truong
- Department of Surgery, Michigan State University College of Human Medicine, 15 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - Anthony Prentice
- Spectrum Health Department of Nursing, Surgical Services, 100 Michigan St. NE, Grand Rapids, MI, USA, 49503.
| | - M Mura Assifi
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
| | - Mathew Chung
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
| | - G Paul Wright
- Division of Surgical Oncology, Spectrum Health Medical Group, 145 Michigan St. NE Suite 5500, Grand Rapids, MI, USA, 49503.
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Al-Absi RS, Khan M, Abu-Dieyeh MH, Ben-Hamadou R, Nasser MS, Al-Ghouti MA. The recovery of strontium ions from seawater reverse osmosis brine using novel composite materials of ferrocyanides modified roasted date pits. Chemosphere 2023; 311:137043. [PMID: 36336019 DOI: 10.1016/j.chemosphere.2022.137043] [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: 04/23/2022] [Revised: 09/10/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
In this study, three types of adsorbents were used to remove and recover strontium ions (Sr2+) from aqueous and brine solution of seawater reverse osmosis (SWRO), namely roasted date pits (RDP) and RDP modified using copper and nickel salts of potassium hexacyanoferrates to obtain RDP-FC-Cu, and RDP-FC-Ni, respectively. Additionally, the influence of various parameters, including pH, temperature, initial concentration, and co-existing ions was also evaluated. The results revealed that pH 10 was the optimum pH in which the maximum Sr2+ ions were adsorbed. Additionally, all adsorbents had a high adsorption capacity (99.9 mg/g) for removing Sr2+ ions at the highest concentration (100 mg/L) and a temperature of 45 °C was found to be the optimum temperature. A scanning electron microscopy for the adsorbents before and after the adsorption of strontium showed the remarkable pore filling onto the active sites of all adsorbents. The thermodynamics parameter demonstrated that the adsorption occurred in an endothermic environment, and that, the reaction was spontaneous, and favorable at all the temperatures investigated. According to isotherm studies, the Langmuir model was the best-fit isotherm model; indicating that strontium adsorption involved the formation of monolayers and multilayers at higher temperatures (45 °C). Furthermore, high desorption percentages (above 90%) were achieved for all the adsorbents when an HCl concentration of 0.5 M was used. This showed the high reusability of the adsorbents. Lastly, the adsorption of strontium from the SWRO brine containing a number of metal ions was extremely sufficient as all the adsorbents were efficient to adsorb a high amount of Sr2+ despite the presence of other competing ions.
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Affiliation(s)
- Rana S Al-Absi
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Mariam Khan
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Mohammed H Abu-Dieyeh
- Biological Sciences Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Radhouane Ben-Hamadou
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar
| | - Mustafa S Nasser
- Gas Processing Center, College of Engineering, Qatar University, Doha, Qatar
| | - Mohammad A Al-Ghouti
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, 2713, Doha, Qatar.
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Bagri NK, Khan M, Pandey RM, Lodha R, Kabra SK, Angurana SK, Awasthi S, Bamnawat H, Bhat JI, Bhutia TD, Charoo BA, Choudhary A, Choudhary B, Das RR, Dwibedi B, Ghosh S, Girish M, Gulla KM, Goyal JP, Gupta P, I S, Jindal A, John J, Joshi P, Kaur R, Khera D, Kumar A, Kumar P, Kumar P, Lalitha AV, Maheshwari M, Malik S, Mondal R, Muralidharan J, Pawar G, Prasad A, Rao SK, Ratageri VH, Sarkar M, Satpathy AK, Sankar J, Sharma S, Singh A, Singh K, Singhal T, Sood M, Sudeepthi SV, Tiwari L, Verma N, Yonzon R. Initial Immunomodulation and Outcome of Children with Multisystem Inflammatory Syndrome Related to COVID-19: A Multisite Study from India. Indian J Pediatr 2022; 89:1236-1242. [PMID: 35699843 PMCID: PMC9192925 DOI: 10.1007/s12098-022-04254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment. METHODS In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition for MIS-C, were collected. The primary composite outcome was the requirement of vasoactive/inotropic support on day 2 or beyond or need of mechanical ventilation on day 2 or beyond after initiation of immunomodulatory treatment or death during hospitalization in the treatment groups. Logistic regression and propensity score matching analyses were used to compare the outcomes in different treatment arms based on the initial immunomodulation, i.e., IVIG alone, IVIG plus steroids, and steroids alone. RESULTS The data of 368 children (diagnosed between April 2020 and June 2021) meeting the WHO case definition for MIS-C, were analyzed. Of the 368 subjects, 28 received IVIG alone, 82 received steroids alone, 237 received IVIG and steroids, and 21 did not receive any immunomodulation. One hundred fifty-six (42.39%) children had the primary outcome. On logistic regression analysis, the treatment group was not associated with the primary outcome; only the children with shock at diagnosis had higher odds for the occurrence of the outcome [OR (95% CI): 11.4 (5.19-25.0), p < 0.001]. On propensity score matching analysis, the primary outcome was comparable in steroid (n = 45), and IVIG plus steroid (n = 84) groups (p = 0.515). CONCLUSION While no significant difference was observed in the frequency of occurrence of the primary outcome in different treatment groups, data from adequately powered RCTs are required for definitive recommendations.
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Affiliation(s)
- Narendra Kumar Bagri
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - S K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Suresh Kumar Angurana
- Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shally Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Harshita Bamnawat
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Javeed Iqbal Bhat
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Tsultem D Bhutia
- Department of Pediatrics, New STNMMS Hospital, Gangtok, Sikkim, India
| | - Bashir Ahmad Charoo
- Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Abhijit Choudhary
- Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Bharat Choudhary
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bhagirathi Dwibedi
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanajit Ghosh
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Meenakshi Girish
- Department of Pediatrics, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Krishna Mohan Gulla
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jagdish Prasad Goyal
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Prakriti Gupta
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shivanand I
- Department of Pediatrics, KIMS, Hubbali, Karnataka, India
| | - Atul Jindal
- Department of Pediatrics, All India Institute of Medical Sciences, Raipur, India
| | - Joseph John
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Preetha Joshi
- Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Ravleen Kaur
- Department of Pediatrics, Dr Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh, India
| | - Daisy Khera
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Amit Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Pradeep Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prawin Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - A V Lalitha
- Department of Pediatric Intensive Care, St. John's Medical College and Hospital, Bangalore, Karanataka, India
| | - Mahesh Maheshwari
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
| | - Shikha Malik
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
| | - Rakesh Mondal
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Jayashree Muralidharan
- Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gayatri Pawar
- Department of Pediatrics, KIMS, Hubbali, Karnataka, India
| | - Arun Prasad
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sunil Kumar Rao
- Department of Pediatrics, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | | | - Mihir Sarkar
- Department of Pediatrics, Medical College Kolkata, Kolkata, West Bengal, India
| | - Amit Kumar Satpathy
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jhuma Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Seema Sharma
- Department of Pediatrics, Dr Rajendra Prasad Government Medical College Kangra at Tanda, Himachal Pradesh, India
| | - Ankur Singh
- Department of Pediatrics, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Tanu Singhal
- Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Mangla Sood
- Department of Pediatrics, IGMC, Shimla, Himachal Pradesh, India
| | | | - Lokesh Tiwari
- Department of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Nishant Verma
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ruth Yonzon
- Department of Pediatrics, New STNMMS Hospital, Gangtok, Sikkim, India
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Khan RU, Khan M, Sohail A, Ullah R, Iqbal A, Ahmad B, Khan IU, Tariq A, Ahmad M, Said A, Ullah S, Ali A, Rahman MU, Zaman A, Bilal H. Efficacy of pentamidine-loaded chitosan nanoparticles as a novel drug delivery system for Leishmania tropica. Trop Biomed 2022; 39:511-517. [PMID: 36602209 DOI: 10.47665/tb.39.4.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study compares the in vitro effects of nanoparticles loaded pentamidine drug and conventional pentamidine on Leishmania tropica. Herein, pentamidine-loaded chitosan nanoparticles (PTN-CNPs) have been synthesized through an ionic gelation method with sodium tripolyphosphate (TPP). Next, the physical characteristics of PTN-CNPs were determined through the surface texture, zeta potential, in vitro drug release, drug loading content (DLC), and encapsulation efficacy (EE) and compared its efficacy with free pentamidine (PTN) drug against promastigotes and axenic amastigotes forms of L. tropica in vitro. The PTN-CNPs displayed a spherical shape having a size of 88 nm, an almost negative surface charge (-3.09 mV), EE for PTN entrapment of 86%, and in vitro drug release of 92% after 36 h. In vitro antileishmanial activity of PTN-CNPs and free PTN was performed against Leishmania tropica KWH23 promastigote and axenic amastigote using 3-(4, 5- dimethylthiazol-2-yl)-2, 5-diphenyletetrazolium bromide (MTT) assay. It was observed that the effect of PTN-CNPs and free PTN on both forms of the parasite was dose and time dependent. Free PTN presented low efficacy even at higher dose (40 µg/ml) with 25.6 ± 1.3 and 26.5 ±1.4 mean viability rate of the promastigotes and axenic amastigotes, respectively after 72 hrs incubation. While PTN-CNPs showed strong antileishmanial effects on both forms of parasite with 16 ± 0.4 and 19 ± 0.7 mean viability rate at the same higher concentration (40 µg/ml) after 72 hrs incubation. Half maximal inhibitory concentration (IC50) values of PTN-CNPs toward promastigotes and amastigotes were obtained as 0.1375 µg/ml and 0.1910 µg/ml, respectively. In conclusion, PTN-CNPs effectively inhibited both forms of the L. tropica; however, its effect was more salient on promastigotes. This data indicates that the PTN-CNPs act as a target drug delivery system. However, further research is needed to support its efficacy in animal and human CL.
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Affiliation(s)
- R U Khan
- Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan
| | - M Khan
- Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan
| | - A Sohail
- Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan
| | - R Ullah
- Department of Dairy Technology, Faculty of Veterinary and Animal Sciences, University of Agriculture Dera Ismail Khan, Pakistan
| | - A Iqbal
- Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - B Ahmad
- Department of Animal Sciences, Faculty of Veterinary and Animal Sciences, MNS University of Agriculture Multan, Punjab, 25000, Pakistan
| | - I U Khan
- Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - A Tariq
- Directorate of Livestock and Dairy Development Department, Khyber Pakhtunkhwa, Pakistan
| | - M Ahmad
- Department of Animal Sciences, Quaid-E Azam University Islamabad, Pakistan
| | - A Said
- Department of Parasitology, University of Agriculture Faisalabad, Pakistan
| | - S Ullah
- Department of Biochemistry, Hazara University Mansehra, Pakistan
| | - A Ali
- Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan
| | - M U Rahman
- Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan
| | - A Zaman
- Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - H Bilal
- Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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Scott RHH, Barlow D, Trickey W, Ruocco A, Glize K, Antonelli L, Khan M, Woolsey NC. Shock-Augmented Ignition Approach to Laser Inertial Fusion. Phys Rev Lett 2022; 129:195001. [PMID: 36399760 DOI: 10.1103/physrevlett.129.195001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/24/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Shock ignition enables high gain at low implosion velocity, reducing ablative Rayleigh-Taylor instability growth, which can degrade conventional direct drive. With this method, driving a strong shock requires high laser power and intensity, resulting in inefficiencies in the drive and the generation of hot electrons that can preheat the fuel. A new "shock-augmented ignition" pulse shape is described that, by preconditioning the ablation plasma before launching a strong shock, enables the shock ignition of thermonuclear fuel, but importantly, with substantially reduced laser power and intensity requirements. The reduced intensity requirement with respect to shock ignition limits laser-plasma instabilities, such as stimulated Raman and Brillouin scatter, reducing the risk of hot-electron preheat and restoring the laser coupling advantages of conventional direct drive. Simulations indicate that, due to the reduced power requirements, high gain (∼100) ignition of large-scale direct drive implosions (outer radius ∼1750 μm, deuterium-tritium ice thickness ∼165 μm) may be possible within the power and energy limits of existing facilities such as the National Ignition Facility. Moreover, this concept extends to indirect drive implosions, which exhibit substantial yield increases at reduced implosion velocity. Shock-augmented ignition expands the viable design space of laser inertial fusion.
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Affiliation(s)
- R H H Scott
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, OX11 0QX, United Kingdom
| | - D Barlow
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, OX11 0QX, United Kingdom
| | - W Trickey
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, YO10 5DD, United Kingdom
| | - A Ruocco
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, OX11 0QX, United Kingdom
| | - K Glize
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Harwell Oxford, OX11 0QX, United Kingdom
| | - L Antonelli
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, YO10 5DD, United Kingdom
| | - M Khan
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, YO10 5DD, United Kingdom
| | - N C Woolsey
- York Plasma Institute, School of Physics, Engineering and Technology, University of York, York, YO10 5DD, United Kingdom
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Khan M, Ricks A, Yao L. ELEVATED HISTAMINE LEVELS WITH NORMAL TRYPTASE IN ANAPHYLAXIS. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.810] [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: 11/11/2022]
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38
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Esposito E, Chen X, Khan M, Kleinberg L, Theodore N, Lubelski D, Lo S, Lee SH, Bydon A, Redmond K. Use of Anti-Resorptive Medications prior to Stereotactic Body Radiotherapy for Spinal Metastasis Reduced the Incidence of Vertebral Body Compression Fracture. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.865] [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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39
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Manzar G, Wu S, Khan M, Corrigan K, Yoder A, Gunther J, Thomas S, Manasanch E, Lee H, Lim T, Amini B, Lin P, Orlowski R, Patel K, Becnel M, Kaufman G, Weber D, Dabaja B, Pinnix C, Fang P. Outcome of Patients with Central Nervous System Multiple Myeloma (CNS-MM) Treated with CNS-Directed Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1473] [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: 10/31/2022]
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Ma S, Yu H, Yu B, Gill J, Khan M, Chatterjee U, Iovoli A, Farrugia M, Singh A. Optimal Threshold of Smoking in Pack-Years and its Association with Survival Outcomes Among Patients Treated with Chemoradiation for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1386] [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: 10/31/2022]
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Patel P, Cao Y, Chen X, Kleinberg L, Khan M, Lee SH, Lo S, Redmond K. Stereotactic Body Radiation Therapy for High-Grade Malignant Epidural Spinal Cord Compression from Solid Tumor Metastases. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.347] [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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Ricks A, Khan M, Yao L. CHRONIC SPONTANEOUS URTICARIA, LOW HISTAMINE DIET AS A TREATMENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.946] [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: 11/11/2022]
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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [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] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abhilash Jain
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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Kambalapalli S, Baral N, Seri A, Khan M, Moza A, Kunadi A. Incidence and periprocedural outcomes of heparin-induced thrombocytopenia in on-pump vs off-pump coronary artery bypass grafting patients – analysis from 2016–2019 national inpatient sample. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heparin administered after Coronary Artery Bypass Grafting (CABG) can cause Heparin induced thrombocytopenia (HIT) leading to bleeding or thromboembolic complications. Despite its low incidence, HIT can lead to increased morbidity and in-hospital mortality.
Purpose
To study the incidence and periprocedural outcomes of HIT in On-pump vs Off-pump CABG patients.
Methods
This is a retrospective observational study involving index hospitalizations for CABG between January 1 2016–December 31 2019 from the National Inpatient Sample, the largest all-payer public database of hospital care data in the United States. Our study population included discharged adult patients (≥18 years) hospitalised for CABG using ICD-10 codes (validated in previous studies). Confounders were adjusted using Multivariable Regression Analysis.
Results
During 2016–2019, there were 100,715 principal hospitalizations for On-pump and 25,956 for Off-pump CABG. Mean age was 74.6±13.2 years. The incidence of HIT in the On-pump cohort was 0.33% (n=333) and 0.33% (n=85) in the Off-pump cohort. The On-pump cohort had 76% (n=76,543) males, 24% (n=24172) females (p<0.0001) and the Off-pump cohort had 74.5% (n=19337) males, 24.5% (n=6359) females (p<0.001). The On-pump cohort had 78.2% Whites, 7.1% Blacks, 7.7% Hispanics, and 7% other races, while the Off-pump cohort had 76.9% Whites, 7.8% blacks, 8.9% Hispanics and 6.4% other races. A total of 42.9% hospitalizations in the On-pump cohort had a Charlson Comorbidity Index (CCI) of three or higher and it was 43.5% hospitalizations in the Off-pump cohort. In-hospital mortality in the On-pump cohort was 1.6% and 2% in the Off-pump cohort.
Compared to the non-HIT cohort, On-pump HIT cohort had more females (31.2% vs 24%, p=0.02), were older (mean age: 67.2 years vs 65.7 years; p=0.006), had higher CCI of three or higher (65.8% vs 42.8%, p<0.001), longer LOS (22.2 days vs 9.2 days, p<0.001) with higher in-hospital mortality (13.5% vs 1.5%, p<0.001). Multivariate regression analysis showed HIT cohort had higher odds of in-hospital mortality than non-HIT cohort (aOR: 8; 95% CI: 5.7, 11.2; p<0.001) after controlling for age, sex, race, hospital region and status, income, insurance status and CCI.
The Off-pump HIT cohort had similar incidence of females (26% vs 27%, p=0.710), were older (mean age: 68 years vs 65.8 years; p=0.045), had higher CCI of three or higher (65.9% vs 43.5%, p<0.001), had longer LOS (22.9 days vs 9.4 days, p<0.001) with higher in-hospital mortality (10.6% vs 2%, p<0.001) compared to the non-HIT cohort. Multivariate regression analysis showed HIT cohort had higher odds of in-hospital mortality than non-HIT cohort (aOR: 4.7; 95% CI: 2.3, 9.5; p<0.001) after controlling for age, sex, race, hospital region and status, income, insurance status and CCI.
Conclusion
Our study observed that in-hospital mortality in patients with HIT was significantly high compared to patients without HIT after undergoing On-pump or Off-pump CABG.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Kambalapalli
- McLaren Flint Michigan State University , Flint , United States of America
| | - N Baral
- McLaren Flint Michigan State University , Flint , United States of America
| | - A Seri
- McLaren Flint Michigan State University , Flint , United States of America
| | - M Khan
- McLaren Flint Michigan State University , Flint , United States of America
| | - A Moza
- McLaren Flint Michigan State University , Flint , United States of America
| | - A Kunadi
- McLaren Flint Michigan State University , Flint , United States of America
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Seri A, Baral N, Kambalapalli S, Khan M, Paul T. Association and outcomes of vf according to involved coronary artery in STEMI – a nationwide analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ventricular fibrillation (VF) is common in acute ST segment elevation myocardial infarction (STEMI) and is associated with increased in-hospital mortality rate.
Purpose
We sought to investigate the association between VF and artery involved in STEMI
Methods
This is a retrospective observational study of hospitalizations between January 1, 2016 and December 31, 2019, using the National Inpatient Sample (NIS), the largest all-payer public database of hospital care in the United States.
Results
A total of 138,201 patients were primarily hospitalized for STEMI from 2016 to 2019. Among them 12,318 had right coronary artery (RCA) lesions, 427 had left main (LM) lesions, 2381 had left circumflex (LCx) lesions and 12,765 had left anterior descending (LAD) lesions. Mean age of patients with VF and STEMI was 62 years and that with RCA (63 years), LM (65 years), LCx (62 years), LAD (60 years), p<0.001. Females were 30.5% (n=42,231) among all STEMI group and 29.8% (n=3672) RCA, 29% (n=124) LM, 27.4%(n=653) LCx and 28.6%(n=3645) LAD, p<0.001. In-hospital mortality for all patients with STEMI was 7.9%. The in-hospital mortality associated with STEMI there was 5%, 23.4%, 6.6%, 7.1%, (p<0.001) for RCA, LM, LCx and LAD respectively. The incidence of VF among all patients with STEMI was 8.3% (n=11425) and for LM, LAD, LCX, and RCA was 12.9%, 10.7%, 9.2% and 7.9% (p<0.001). Mean hospital length of stay for VF with RCA (6.2 days), LM (5.5 days), LCx (6.9 days) and LAD (7.4 days). After adjusting for age, gender, race, income, comorbidities, hospital teaching status, region and year, patients with STEMI who had VF had higher odds of mortality (aOR 6.4, 95% CI, 6.1 to 6.8; P<0.001). The highest likelihood of mortality observed in patients with VF who had and LCx STEMI (aOR 7.9, CI 95%, 5 to 12.4; p<0.001) followed by RCA STEMI (aOR 7.4, 95% CI 6 to 9.1; p<0.001), and LM STEMI (aOR 6.1, 95% 3.1 to 12; p<0.001).
Conclusion
Highest in-hospital mortality was observed in patients with STEMI who had VF in LCx, followed by RCA and LM. There was higher occurrence of VF in STEMI involving LM.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Seri
- McLaren Regional Medical Center , Flint , United States of America
| | - N Baral
- McLaren Regional Medical Center , Flint , United States of America
| | - S Kambalapalli
- McLaren Regional Medical Center , Flint , United States of America
| | - M Khan
- McLaren Regional Medical Center , Flint , United States of America
| | - T Paul
- East Tennessee State University , Nashville , United States of America
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Lee G, Durante A, Vellone E, Dellafiore F, Cagginelli G, Khan M, Baker EE, Khatib R. Patients and healthcare professionals views on injectables for cardiovascular disease. Eur Heart J 2022. [PMCID: PMC9619637 DOI: 10.1093/eurheartj/ehac544.2757] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Injectable medicines are increasingly used to manage risk factors for cardiovascular (CV) events, such as PCSK-9 inhibitors in dyslipidaemia and GLP-1 agonists in diabetes. However, there is a paucity of data around the administrative and clinical practicalities when using these injectables, and limited information on patient and healthcare professionals' perceptions. Purpose To identify the facilitators and barriers on the use of injectable therapies with CV benefits by undertaking interviews with patients, caregivers and healthcare professionals (HCPs). Methods Interviews were conducted via telephone and using MS Teams due to Covid-19 restrictions in the United Kingdom (London and Leeds) and Italy (Rome and Milan) in 2021. Coding was undertaken using NVivo and thematic analysis performed. Results A total of 56 patients were interviewed: 30 in the U.K. (mean age 66 yrs, 60% male) and 26 patients in Italy (mean age 63 yrs, 80% male) and 11 caregivers (mean age 59 yrs, 73% female). A total of 38 HCPs were interviewed, 19 in each country and composed of physicians (n=18), pharmacists (n=10), nurses (n=9) and pharmacy technician (n=1). Three distinct themes were identified: (i) Organisational and governance issues - relating to prescribing restrictions and availability of the drugs locally (PCSK9i are initiated and supplied from hospitals) and lack of communication between hospital and primary care setting; (ii) Clinical issues around HCPs' skills and experience - including: lack of experience with these injectables, lack of time to provide education to patients and caregivers, therapeutic inertia (HCPs not adopting a change in practice despite the evidence or due to bureaucratic restrictions) as well as lack of knowledge on long-term effects, and finally (iii) Patient-related issues - relating to behaviours and beliefs such as reluctance about using injectable therapies, and lack of education about these injectables in terms of indications/clinical benefits for use. Despite some differences in the prescribing of these injectables in the two countries, the analysis captured similar facilitators and barriers. Facilitators included prior use of injectables (e.g. insulin), and the ability to reach a clinical target of lower cholesterol by having just a “one shot”. HCPs stated that access to rapid pathology tests would aid uptake of injectables with CV benefit as well as having educational tools on these injectables in practice. Conclusion This qualitative study identified barriers to initiation, continuation, and adherence with injectable therapies with CV benefits but also highlighted areas where changes can be made especially around education and support for patients and HCPs. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): ACNAP education grant. Sponsored by Amgem and Novo Nordisk
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Affiliation(s)
- G Lee
- King's College London , London , United Kingdom
| | - A Durante
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | - E Vellone
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | | | - G Cagginelli
- University of Rome Tor Vergata, Nursing , Rome , Italy
| | - M Khan
- Leeds Teaching Hospitals NHS Trust, Pharmacy , Leeds , United Kingdom
| | - E E Baker
- King's College London , London , United Kingdom
| | - R Khatib
- Leeds Teaching Hospitals NHS Trust, Pharmacy , Leeds , United Kingdom
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Barrowcliff A, Khan M, Fox K, Khatib R. Management of statin intolerance in a pharmacy led cardiology innovative medicines optimisation lipid clinic. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Statins are cornerstone in the management of atherosclerotic cardiovascular disease. If a patient has experienced clinically significant adverse drug reactions (ADRs), representing an unacceptable risk or may result in adherence issues, we would consider them intolerant. The prevalence is lower in randomised trials than cohort observational studies, 5% vs. 17%.
Purpose
To assess how many people we reviewed in clinic were able to be re-challenged and successfully continued on a statin, free from side effects.
Methods
Over 6 months we reviewed all patients referred to our innovative clinic for lipid optimisation labelled as “statin intolerant”. Initially, as per our protocol, we adopted a person-centred approach and explored this label (actual vs. potential concerns, any previous issues, symptoms experienced and timings, statins tried (if any), and patient's feelings on re-challenge). A statin re-challenge was offered if not contraindicated. If agreed, based on shared-decision making, we offered patients a once weekly statin (usually rosuvastatin 5mg) with a clear self-management plan to up/down-titrate frequency and dose, until they identify a tolerated regimen. We measured LDL-C at baseline and every 3 months thereafter until satisfactory.
Results
Of 207 patients referred 152 (73%) were labelled as “statin intolerant”. Average age was 62 (±11), 51% females. 78% for secondary prevention and 37% had familial hypercholesterolaemia. The average baseline LDL-C was 4.4mmol/L. 108 (71%) qualified for PCSK9 inhibitors therapy (PCSK9i) as per UK NICE guidance.
The top 3 reported ADRs were musculoskeletal side effects (48%), GI upsets (13%) and deranged LFTs (7%).
25 (58%) of those “intolerant” who did not qualify for PCSK9i attempted a re-challenge with statins vs. 44 (41%) among those who qualified.
Of the 69 patients, who accepted a re-challenge, 43 (62%) were successfully restarted on a statin. At an average of 14 months post re-challenge, LDL-C (available for >80% of the sample) was reduced by an average of 31% in those not on PCSK9i, compared to a 62% reduction (sustained over an average of 40 months) in those on combination therapy with PCSK9i.
The top 3 rosuvastatin regimens established were 5mg OD (29%), 5mg weekly (24%) and 10mg OD (15%). Approximately 80% of patients were on rosuvastatin, and the rest accepted atorvastatin, pravastatin or simvastatin.
There was no attempt to re-challenge in 77 (51%) patients, mostly due to choice (45%) or statins re-challenged prior to referral (44%). We stopped statins in 6 cases due to intolerable ADRs.
Conclusion(s)
By using a person-centred approach, and a variety of strategies to tackle “statin intolerance” we have successfully re-established over 60% of patients with very high CVD risk on statins. While patients who qualified for PCSK9i therapy were less likely to consider re-challenge with statins (41% v 58%), combination lipid-lowering therapies produced better reduction in LDL-C.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Khan
- Leeds Teaching Hospitals , Leeds , United Kingdom
| | - K Fox
- Leeds Teaching Hospitals , Leeds , United Kingdom
| | - R Khatib
- Leeds Teaching Hospitals , Leeds , United Kingdom
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Bhagyaraj S, Al-Ghouti MA, Khan M, Kasak P, Krupa I. Modified os sepiae of Sepiella inermis as a low cost, sustainable, bio-based adsorbent for the effective remediation of boron from aqueous solution. Environ Sci Pollut Res Int 2022; 29:71014-71032. [PMID: 35589901 PMCID: PMC9515050 DOI: 10.1007/s11356-022-20578-3] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
The occurrence of boron in low concentration is essential; however, a higher concentration of boron source in water has a toxic effect on humans as well as have retard effect on agricultural plant growth. Thus, the affordable and facile method to remediate water from higher boron concentrations is highly demanded. This report explores the ability of naturally occurring sustainable bio-waste os sepiae (cuttlefish bone, CFB) as an effective adsorbent for the removal of boron from water. Chemical activation of the os sepiae powder was examined to improve the efficiency of boron adsorption. A batch adsorption study for boron considering various parameters such as chemical modification of os sepiae, pH, initial boron concentration, and the temperature was scrutinized. Untreated (CFB), alkali-treated (CFB-D) and acid-treated (CFB-A) os sepiae powders were investigated and the adsorption capacities reached up to 53.8 ± 0.04 mg/g, 66.4 ± 0.02 mg/g and 69.8 ± 0.02 mg/g, respectively, at optimal pH 8 and 25 °C. Boron adsorption by CFB, CFB-D, and CFB-A were well fitted with the linear Freundlich adsorption isotherm model with a correlation coefficient of 99.4%, 99.8%, and 99.7% respectively. Thermodynamic parameters indicated that the adsorption of boron by CFB is an exothermic process and more feasible at a lower temperature around 25 °C. Moreover, detailed morphological and chemical characterization of the influence of adsorbed boron on adsorbents was conducted and discussed. The Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) analysis spectra confirms the involvement of various functional groups including amino, carbonate (CO3)2-, and hydroxyl groups on the adsorbent in the adsorption mechanisms for boron removal. The results indicate that CFB can be an excellent example for the recycling and reuse of biowaste for water remediation.
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Affiliation(s)
- Sneha Bhagyaraj
- Center for Advanced Materials, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Mohammad A Al-Ghouti
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box: 2713, Doha, Qatar
| | - Mariam Khan
- Environmental Science Program, Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, P.O. Box: 2713, Doha, Qatar
| | - Peter Kasak
- Center for Advanced Materials, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Igor Krupa
- Center for Advanced Materials, Qatar University, P.O. Box 2713, Doha, Qatar.
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Go J, Tran J, Khan M, Al-Mohtaseb Z. Application of data mining algorithms to study data trends for corneal transplantation. J Fr Ophtalmol 2022; 45:700-709. [DOI: 10.1016/j.jfo.2022.01.023] [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] [Received: 08/02/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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