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Li H, Chan L, Chan P, Wen C. An interpretable knee replacement risk assessment system for osteoarthritis patients. Osteoarthr Cartil Open 2024; 6:100440. [PMID: 38385105 PMCID: PMC10878788 DOI: 10.1016/j.ocarto.2024.100440] [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: 11/14/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024] Open
Abstract
Objective Knee osteoarthritis (OA) is a complex disease with heterogeneous representations. Although it is modifiable to prevention and early treatment, there still lacks a reliable and accurate prognostic tool. Hence, we aim to develop a quantitative and self-administrable knee replacement (KR) risk stratification system for knee osteoarthritis (KOA) patients with clinical features. Method A total of 14 baseline features were extracted from 9592 cases in the Osteoarthritis Initiative (OAI) cohort. A survival model was constructed using the Random Survival Forests algorithm. The prediction performance was evaluated with the concordance index (C-index) and average receiver operating characteristic curve (AUC). A three-class KR risk stratification system was built to differentiate three distinct KR-free survival groups. Thereafter, Shapley Additive Explanations (SHAP) was introduced for model explanation. Results KR incidence was accurately predicted by the model with a C-index of 0.770 (±0.0215) and an average AUC of 0.807 (±0.0181) with 14 clinical features. Three distinct survival groups were observed from the ten-point KR risk stratification system with a four-year KR rate of 0.79%, 5.78%, and 16.2% from the low, medium, and high-risk groups respectively. KR is mainly caused by pain medication use, age, surgery history, diabetes, and a high body mass index, as revealed by SHAP. Conclusion A self-administrable and interpretable KR survival model was developed, underscoring a KR risk scoring system to stratify KOA patients. It will encourage regular self-assessments within the community and facilitate personalised healthcare for both primary and secondary prevention of KOA.
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Affiliation(s)
- H.H.T. Li
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
- Department of Prosthetics and Orthotics, Tuen Mun Hospital, Hong Kong
| | - L.C. Chan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
| | - P.K. Chan
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong
| | - C. Wen
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong
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Burotto M, Zvirbule Z, Mochalova A, Runglodvatana Y, Herraez-Baranda L, Liu SN, Chan P, Shearer-Kang E, Liu X, Tosti N, Zanghi JA, Leutgeb B, Felip E. Corrigendum to 'IMscin001 Part 2: a randomised phase III, open-label, multicentre study examining the pharmacokinetics, efficacy, immunogenicity, and safety of atezolizumab subcutaneous versus intravenous administration in previously treated locally advanced or metastatic non-small-cell lung cancer and pharmacokinetics comparison with other approved indications': [Annals of Oncology 34 (2023) p693-702]. Ann Oncol 2024; 35:482. [PMID: 38195363 DOI: 10.1016/j.annonc.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Affiliation(s)
- M Burotto
- Centro de Investigación, Clínica Bradford Hill, Santiago, Chile.
| | - Z Zvirbule
- Latvian Oncology Center, Riga Eastern Clinical University Hospital, Riga, Latvia
| | - A Mochalova
- Department of Antitumor Drug Therapy, MEDSI Clinical Hospital, Moscow, Russia
| | - Y Runglodvatana
- Faculty of Medicine, Vajira Hospital, Bangkok Metropolitan University, Bangkok, Thailand
| | - L Herraez-Baranda
- Product Development Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - S N Liu
- Clinical Pharmacology, Genentech, Inc., South San Francisco, USA
| | - P Chan
- Clinical Pharmacology, Genentech, Inc., South San Francisco, USA
| | - E Shearer-Kang
- Product Safety Development, Genentech, Inc., South San Francisco, CA, USA
| | - X Liu
- Data and Statistical Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - N Tosti
- Product Development Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - J A Zanghi
- BioAnalytical Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - B Leutgeb
- Product Development Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - E Felip
- Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Clinical Research Department, Vall d'Hebron Institute of Oncology, Barcelona, Spain
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Burotto M, Zvirbule Z, Mochalova A, Runglodvatana Y, Herraez-Baranda L, Liu SN, Chan P, Shearer-Kang E, Liu X, Tosti N, Zanghi JA, Leutgeb B, Felip E. IMscin001 Part 2: a randomised phase III, open-label, multicentre study examining the pharmacokinetics, efficacy, immunogenicity, and safety of atezolizumab subcutaneous versus intravenous administration in previously treated locally advanced or metastatic non-small-cell lung cancer and pharmacokinetics comparison with other approved indications. Ann Oncol 2023; 34:693-702. [PMID: 37268157 DOI: 10.1016/j.annonc.2023.05.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/19/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Atezolizumab intravenous (IV) is approved for the treatment of various solid tumours. To improve treatment convenience and health care efficiencies, a coformulation of atezolizumab and recombinant human hyaluronidase PH20 was developed for subcutaneous (SC) use. Part 2 of IMscin001 (NCT03735121) was a randomised phase III, open-label, multicentre, noninferiority study comparing the drug exposure of atezolizumab SC with atezolizumab IV. PATIENTS AND METHODS Eligible patients with locally advanced/metastatic non-small-cell lung cancer were randomised 2 : 1 to receive atezolizumab SC (1875 mg; n = 247) or IV (1200 mg; n = 124) every 3 weeks. The co-primary endpoints were cycle 1 observed trough serum concentration (Ctrough) and model-predicted area under the curve from days 0 to 21 (AUC0-21 d). The secondary endpoints were steady-state exposure, efficacy, safety, and immunogenicity. Exposure following atezolizumab SC was then compared with historical atezolizumab IV values across approved indications. RESULTS The study met both of its co-primary endpoints: cycle 1 observed Ctrough {SC: 89 μg/ml [coefficient of variation (CV): 43%] versus IV: 85 μg/ml (CV: 33%); geometric mean ratio (GMR), 1.05 [90% confidence interval (CI) 0.88-1.24]} and model-predicted AUC0-21 d [SC: 2907 μg d/ml (CV: 32%) versus IV: 3328 μg d/ml (CV: 20%); GMR, 0.87 (90% CI 0.83-0.92)]. Progression-free survival [hazard ratio 1.08 (95% CI 0.82-1.41)], objective response rate (SC: 12% versus IV: 10%), and incidence of anti-atezolizumab antibodies (SC: 19.5% versus IV: 13.9%) were similar between arms. No new safety concerns were identified. Ctrough and AUC0-21 d for atezolizumab SC were consistent with the other approved atezolizumab IV indications. CONCLUSIONS Compared with IV, atezolizumab SC demonstrated noninferior drug exposure at cycle 1. Efficacy, safety, and immunogenicity were similar between arms and consistent with the known profile for atezolizumab IV. Similar drug exposure and clinical outcomes following SC and IV administration support the use of atezolizumab SC as an alternative to atezolizumab IV.
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Affiliation(s)
- M Burotto
- Centro de Investigación, Clínica Bradford Hill, Santiago, Chile.
| | - Z Zvirbule
- Latvian Oncology Center, Riga Eastern Clinical University Hospital, Riga, Latvia
| | - A Mochalova
- Department of Antitumor Drug Therapy, MEDSI Clinical Hospital, Moscow, Russia
| | - Y Runglodvatana
- Faculty of Medicine, Vajira Hospital, Bangkok Metropolitan University, Bangkok, Thailand
| | - L Herraez-Baranda
- Product Development Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - S N Liu
- Clinical Pharmacology, Genentech, Inc., South San Francisco, USA
| | - P Chan
- Clinical Pharmacology, Genentech, Inc., South San Francisco, USA
| | - E Shearer-Kang
- Product Safety Development, Genentech, Inc., South San Francisco, CA, USA
| | - X Liu
- Data and Statistical Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - N Tosti
- Product Development Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - J A Zanghi
- BioAnalytical Sciences, Genentech, Inc., South San Francisco, CA, USA
| | - B Leutgeb
- Product Development Oncology, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - E Felip
- Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Clinical Research Department, Vall d'Hebron Institute of Oncology, Barcelona, Spain
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Wang Z, Lau JTF, Lam PPK, Chan P, Fong F, Mo PKH. Promotion of human papillomavirus vaccination among Chinese men who have sex with men: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 3:9-15. [PMID: 37357584] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Affiliation(s)
- Z Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J T F Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P P K Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F Fong
- Neo-Health, Hong Kong SAR, China
| | - P K H Mo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kannan P, Cheing G, Fung B, Leung WC, Tang G, Chung R, Chan P. A new biofeedback device to improve adherence to pelvic floor muscle training in women with urinary incontinence: a randomised controlled pilot trial (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 6:23-24. [PMID: 36535794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- P Kannan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
| | - G Cheing
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
| | - B Fung
- Physiotherapy Department, Kwong Wah Hospital
| | - W C Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital
| | - G Tang
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital
| | - R Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
| | - P Chan
- The University of Hong Kong
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Burotto M, Zvirbule Z, Mochalova A, Runglodvatana Y, Herraez Baranda L, Liu S, Chan P, Shearer-Kang E, Shivhare M, Tosti N, Zanghi J, Leutgeb B, Felip E. 61MO IMscin001 (part 2: randomized phase III): Pharmacokinetics (PK), efficacy and safety of atezolizumab (atezo) subcutaneous (SC) vs intravenous (IV) in previously treated locally advanced or metastatic non-small cell lung cancer (NSCLC). Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Geynisman D, Chan P, Robert N, Chen L, Del Tejo V, Rosenblatt L, Huo S, Doshi G. 1465P Real-world (RW) outcomes in metastatic renal cell carcinoma (mRCC) patients treated with first-line (1L) nivolumab plus ipilimumab (NIVO+IPI) in the United States. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1568] [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: 11/01/2022] Open
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8
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Ubels S, Verstegen M, Klarenbeek B, Bouwense S, van Berge Henegouwen M, Daams F, van Det MJ, Griffiths EA, Haveman JW, Heisterkamp J, Koshy R, Nieuwenhuijzen G, Polat F, Siersema PD, Singh P, Wijnhoven B, Hannink G, van Workum F, Rosman C, Matthée E, Slootmans CAM, Ultee G, Schouten J, Gisbertz SS, Eshuis WJ, Kalff MC, Feenstra ML, van der Peet DL, Stam WT, van Etten B, Poelmann F, Vuurberg N, van den Berg JW, Martijnse IS, Matthijsen RM, Luyer M, Curvers W, Nieuwenhuijzen T, Taselaar AE, Kouwenhoven EA, Lubbers M, Sosef M, Lecot F, Geraedts TCM, van Esser S, Dekker JWT, van den Wildenberg F, Kelder W, Lubbers M, Baas PC, de Haas JWA, Hartgrink HH, Bahadoer RR, van Sandick JW, Hartemink KJ, Veenhof X, Stockmann H, Gorgec B, Weeder P, Wiezer MJ, Genders CMS, Belt E, Blomberg B, van Duijvendijk P, Claassen L, Reetz D, Steenvoorde P, Mastboom W, Klein Ganseij HJ, van Dalsen AD, Joldersma A, Zwakman M, Groenendijk RPR, Montazeri M, Mercer S, Knight B, van Boxel G, McGregor RJ, Skipworth RJE, Frattini C, Bradley A, Nilsson M, Hayami M, Huang B, Bundred J, Evans R, Grimminger PP, van der Sluis PC, Eren U, Saunders J, Theophilidou E, Khanzada Z, Elliott JA, Ponten J, King S, Reynolds JV, Sgromo B, Akbari K, Shalaby S, Gutschow CA, Schmidt H, Vetter D, Moorthy K, Ibrahim MAH, Christodoulidis G, Räsänen JV, Kauppi J, Söderström H, Manatakis DK, Korkolis DP, Balalis D, Rompu A, Alkhaffaf B, Alasmar M, Arebi M, Piessen G, Nuytens F, Degisors S, Ahmed A, Boddy A, Gandhi S, Fashina O, Van Daele E, Pattyn P, Robb WB, Arumugasamy M, Al Azzawi M, Whooley J, Colak E, Aybar E, Sari AC, Uyanik MS, Ciftci AB, Sayyed R, Ayub B, Murtaza G, Saeed A, Ramesh P, Charalabopoulos A, Liakakos T, Schizas D, Baili E, Kapelouzou A, Valmasoni M, Pierobon ES, Capovilla G, Merigliano S, Silviu C, Rodica B, Florin A, Cristian Gelu R, Petre H, Guevara Castro R, Salcedo AF, Negoi I, Negoita VM, Ciubotaru C, Stoica B, Hostiuc S, Colucci N, Mönig SP, Wassmer CH, Meyer J, Takeda FR, Aissar Sallum RA, Ribeiro U, Cecconello I, Toledo E, Trugeda MS, Fernández MJ, Gil C, Castanedo S, Isik A, Kurnaz E, Videira JF, Peyroteo M, Canotilho R, Weindelmayer J, Giacopuzzi S, De Pasqual CA, Bruna M, Mingol F, Vaque J, Pérez C, Phillips AW, Chmelo J, Brown J, Han LE, Gossage JA, Davies AR, Baker CR, Kelly M, Saad M, Bernardi D, Bonavina L, Asti E, Riva C, Scaramuzzo R, Elhadi M, Abdelkarem Ahmed H, Elhadi A, Elnagar FA, Msherghi AAA, Wills V, Campbell C, Perez Cerdeira M, Whiting S, Merrett N, Das A, Apostolou C, Lorenzo A, Sousa F, Adelino Barbosa J, Devezas V, Barbosa E, Fernandes C, Smith G, Li EY, Bhimani N, Chan P, Kotecha K, Hii MW, Ward SM, Johnson M, Read M, Chong L, Hollands MJ, Allaway M, Richardson A, Johnston E, Chen AZL, Kanhere H, Prasad S, McQuillan P, Surman T, Trochsler MI, Schofield WA, Ahmed SK, Reid JL, Harris MC, Gananadha S, Farrant J, Rodrigues N, Fergusson J, Hindmarsh A, Afzal Z, Safranek P, Sujendran V, Rooney S, Loureiro C, Leturio Fernández S, Díez del Val I, Jaunoo S, Kennedy L, Hussain A, Theodorou D, Triantafyllou T, Theodoropoulos C, Palyvou T, Elhadi M, Abdullah Ben Taher F, Ekheel M, Msherghi AAA. Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score. Br J Surg 2022. [DOI: https://doi.org/10.1093/bjs/znac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Background
Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.
Methods
This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.
Results
Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.
Conclusion
The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.
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Affiliation(s)
- Sander Ubels
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Moniek Verstegen
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Bastiaan Klarenbeek
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
| | - Stefan Bouwense
- Department of Surgery, Maastricht University Medical Centre+ , Maastricht , the Netherlands
| | - Mark van Berge Henegouwen
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Freek Daams
- Department of Surgery, Amsterdam UMC, Cancer Centre Amsterdam, University of Amsterdam , Amsterdam , the Netherlands
| | - Marc J van Det
- Department of Surgery, ZGT hospital group , Almelo , the Netherlands
| | - Ewen A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham , Birmingham , UK
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham , Birmingham , UK
| | - Jan W Haveman
- Department of Surgery, University Medical Centre Groningen, University of Groningen , Groningen , the Netherlands
| | - Joos Heisterkamp
- Department of Surgery, Elisabeth-TweeSteden Hospital , Tilburg , the Netherlands
| | - Renol Koshy
- Department of Surgery, Newcastle upon Tyne Hospital NHS Trust , Newcastle upon Tyne , UK
- Department of Surgery, University Hospitals of Coventry and Warwickshire NHS Trust , Coventry , UK
| | | | - Fatih Polat
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Pritam Singh
- Department of Surgery, Nottingham University Hospitals NHS Trust , Nottingham , UK
- Department of Surgery, Regional Oesophago-Gastric Unit, Royal Surrey County Hospital , Guildford , UK
| | - Bas Wijnhoven
- Department of Surgery, Erasmus University Medical Centre , Rotterdam , the Netherlands
| | - Gerjon Hannink
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Frans van Workum
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
- Department of Surgery, Canisius-Wilhelmina Hospital , Nijmegen , the Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre , Nijmegen , the Netherlands
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Grigioni S, Achamrah N, Chan P, Guérin C, Bôle-Feysot C, Delay J, Colange G, Bubenheim M, Jésus P, Tavolacci M, Déchelotte P, Coëffier M. Intestinal permeability and appetite regulating peptides-reactive immunoglobulins in severely malnourished women with anorexia nervosa. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kaderbhai F, Kalu E, Chan P. P–383 Cytogenetic analysis of products of conception from miscarriages following natural conception and IVF pregnancy: a comparative study. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Do cytogenetic results from products of conception from miscarriages differ from patients conceiving by natural conception versus IVF? Summary answer: Cytogenetic results were similar, with no statistical difference from miscarriages following natural conception and assisted conception.
What is known already
Cytogenetic sampling of products of conception (POC) following recurrent miscarriages (RM) are recommended to rule out parental chromosomal rearrangements. The RCOG recommends cytogenetic testing in cases of recurrent miscarriages (3 consecutive miscarriages). However some units routinely request cytogenetic analysis following a single miscarriage following an IVF pregnancy. There is no evidence to support the routine sampling of POCs following assisted conception. Study design, size, duration: Retrospective cohort study of 117 cytogenetic samples, followed up by the outcome of parental karyotyping if applicable. Patients were categorised based on mode of conception into natural conception (NC) with recurrent miscarriages (≥3) or one miscarriage following IVF. Data collected between 2018–2020. Primary Outcome measure: Presence and type of cytogenetic abnormality; individual parental targeted G-band karyotyping result. Participants/materials, setting, methods: A total of 117 cytogenetic results were reviewed, of which 35 were unsuitable for analysis due to contamination (Total n = 79: NC = 60, IVF = 19). Main results and the role of chance: Cytogenetic analysis showed abnormal results in 59% of miscarriages following natural conception and 53% of miscarriages from IVF pregnancy (p = 0.46).
Abnormal cytogenetic results were mainly sporadic. Trisomy 16 was the commonest abnormality in both groups. Others included Trisomy 15, 22, 21, 8, 13, 5, 9, 10, 14, 18, single X (Turner’s), all occurring in the same frequency in both groups. As expected 35 out of 45 abnormal cytogenetic results occurred with a maternal age greater than 35 years.
One couple from the NC group were referred to a geneticist for a Trisomy 9 imbalance. All other parental karyotyping results were normal.
Limitations, reasons for caution
This study contains a small sample size, and would benefit from further data collection to account for a percentage of samples being inadequate for analysis. Wider implications of the findings: Cytogenetic results were similar from miscarriages following natural conception and assisted conception. IVF does not increase the risk of miscarriage from abnormal embryonic karyotype. Routine cytogenetic testing following one miscarriage in patients undergoing IVF is not cost effective.
Trial registration number
Not applicable
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Affiliation(s)
- F Kaderbhai
- Kingston Hospital NHS Foundation Trust, Obstetrics & Gynaecology Department, Surrey, United Kingdom
| | - E Kalu
- Kingston Hospital NHS Foundation Trust, Obstetrics & Gynaecology Department, Surrey, United Kingdom
| | - P Chan
- Kingston Hospital NHS Foundation Trust, Obstetrics & Gynaecology Department, Surrey, United Kingdom
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Bultelle F, Boutet I, Devin S, Caza F, St-Pierre Y, Péden R, Brousseau P, Chan P, Vaudry D, Le Foll F, Fournier M, Auffret M, Rocher B. Molecular response of a sub-antarctic population of the blue mussel (Mytilus edulis platensis) to a moderate thermal stress. Mar Environ Res 2021; 169:105393. [PMID: 34217095 DOI: 10.1016/j.marenvres.2021.105393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
The Kerguelen Islands (49°26'S, 69°50'E) represent a unique environment due to their geographical isolation, which protects them from anthropogenic pollution. The ability of the endemic mussel, part of the Mytilus complex, to cope with moderate heat stress was explored using omic tools. Transcripts involved in six major metabolic functions were selected and the qRT-PCR data indicated mainly changes in aerobic and anaerobic energy metabolism and stress response. Proteomic comparisons revealed a typical stress response pattern with cytoskeleton modifications and elements suggesting increased energy metabolism. Results also suggest conservation of protein homeostasis by the long-lasting presence of HSP while a general decrease in transcription is observed. The overall findings are consistent with an adaptive response to moderate stresses in mussels in good physiological condition, i.e. living in a low-impact site, and with the literature concerning this model species. Therefore, local blue mussels could be advantageously integrated into biomonitoring strategies, especially in the context of Global Change.
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Affiliation(s)
- F Bultelle
- UMR-I 02 INERIS-URCA-ULH SEBIO / Environmental Stresses and Biomonitoring of Aquatic Ecosystems, FR CNRS 3730 Scale, Université Le Havre Normandie, F-76063, Le Havre Cedex, France.
| | - I Boutet
- Station Biologique de Roscoff CNRS, Laboratory Adaptation & Diversity in Marine Environment (UMR7144 CNRS-SU), Sorbonne Université, Roscoff, France.
| | - S Devin
- UMR 7360 LIEC, Université Metz-Lorraine, France.
| | - F Caza
- INRS-Institut Armand-Frappier, 531 Boul. des Prairies, Laval, Québec, H7V 1B7, Canada.
| | - Y St-Pierre
- INRS-Institut Armand-Frappier, 531 Boul. des Prairies, Laval, Québec, H7V 1B7, Canada.
| | - R Péden
- UMR-I 02 INERIS-URCA-ULH SEBIO / Environmental Stresses and Biomonitoring of Aquatic Ecosystems, FR CNRS 3730 Scale, Université Le Havre Normandie, F-76063, Le Havre Cedex, France; UMR-I 02 INERIS-URCA-ULH SEBIO / Environmental Stresses and Biomonitoring of Aquatic Ecosystems, Université de REIMS Champagne-Ardenne, Campus Moulin de la Housse, 51687, Reims, France.
| | - P Brousseau
- Institut des Sciences de la mer, Le Parc de la rivière Mitis, Sainte-Flavie, Québec, G0J 2L0, Canada.
| | - P Chan
- Normandie Univ, UNIROUEN, Plateforme PISSARO, IRIB, 76821, Mont-Saint-Aignan, France.
| | - D Vaudry
- Normandie Univ, UNIROUEN, Plateforme PISSARO, IRIB, 76821, Mont-Saint-Aignan, France; Normandie Univ, UNIROUEN, INSERM U1239 DC2N, 76821, Mont-Saint-Aignan, France.
| | - F Le Foll
- UMR-I 02 INERIS-URCA-ULH SEBIO / Environmental Stresses and Biomonitoring of Aquatic Ecosystems, FR CNRS 3730 Scale, Université Le Havre Normandie, F-76063, Le Havre Cedex, France.
| | - M Fournier
- Institut des Sciences de la mer, Le Parc de la rivière Mitis, Sainte-Flavie, Québec, G0J 2L0, Canada.
| | - M Auffret
- UMR CNRS 6539-LEMAR/ Laboratoire des Sciences de l'Environnement Marin, Technopôle Brest-Iroise, 29280, Plouzané, France.
| | - B Rocher
- UMR-I 02 INERIS-URCA-ULH SEBIO / Environmental Stresses and Biomonitoring of Aquatic Ecosystems, FR CNRS 3730 Scale, Université Le Havre Normandie, F-76063, Le Havre Cedex, France.
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Nicholas PRM, Carter R, Chan P, Jamal B. A Systematic Review Of Primary Ankle Arthrodesis In The Treatment Of Pilon Fractures. Foot (Edinb) 2021; 47:101780. [PMID: 33962114 DOI: 10.1016/j.foot.2021.101780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/05/2021] [Accepted: 01/10/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pilon fractures are severe, intra-articular and comminuted fractures to the distal tibia. They are uncommon injuries and are often associated with fibular fractures. The optimal management of these fractures is widely debated. Open reduction and internal fixation (ORIF) and external fixation have been used to treat these fractures. Ankle arthrodesis is often used in the latter stages of management for end-stage ankle arthritis. The aim of this systematic review was to identify the outcomes associated with using primary ankle arthrodesis in pilon fractures. METHODS Ovid Medline and PubMed were searched from the inception of their databases until October 2018. Eligible literature for use in our review included patient cohorts that had been operated in the form of primary ankle arthrodesis. All relevant data was included that met the inclusion criteria. The demographic of the patients with pilon fractures and this operative management were identified. The outcomes of interest were fusion rate, infection rate, length of follow-up and patient reported outcomes. 8 papers were deemed eligible for review. RESULTS Of the 8 papers that were eligible, 6 were retrospective studies, 1 was a case report and 1 was an abstract. There were a total of 109 patients included. Fusion rate was 100% in 5 of the studies. 6 of the 7 studies that reported on infection rate had no post-operative infections. Outcome assessment scores were used in 5 of the studies. The SF-36 score, the FOAS and the AOFAS were used. CONCLUSIONS This review shows that primary ankle arthrodesis yields reasonable results in the management of pilon fractures. However, the quantity and quality of current literature is not sufficient and further studies with larger cohorts and longer follow-up times are warranted.
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Affiliation(s)
- P R M Nicholas
- Department of Surgery, University Hospital Ayr, Ayr, United Kingdom.
| | - R Carter
- Division of foot, ankle and limb reconstruction surgery, Department of Trauma and Orthopaedics, The Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - P Chan
- Division of foot, ankle and limb reconstruction surgery, Department of Trauma and Orthopaedics, The Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - B Jamal
- Division of foot, ankle and limb reconstruction surgery, Department of Trauma and Orthopaedics, The Queen Elizabeth University Hospital, Glasgow, United Kingdom
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13
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Dickie G, Chan P, Cheuk R, Grogan M, Tripcony, L. PO-0174 Cervix cancer treated with PDR brachytherapy boost. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Grigioni S, Achamrah N, Chan P, Guérin C, Bôle-feysot C, Delay J, Colange G, Bubenheim M, Tavolacci MP, Déchelotte P, Coëffier M. Le rapport lactulose/mannitol, marqueur de perméabilité intestinale, est augmenté au cours de l’anorexie mentale sans modification des autoanticorps dirigés contre les peptides de la prise alimentaire. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Chan P, Colby DJ, Kroon E, Sacdalan C, Pinyakorn S, Paul R, Robb M, Valcour V, Ananworanich J, Marra C, Spudich S. Clinical and laboratory impact of concomitant syphilis infection during acute HIV. HIV Med 2021; 22:502-511. [PMID: 33728759 DOI: 10.1111/hiv.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Cognitive impairment has been reported in people living with HIV-1 (PLWH) with prior syphilis, while PLWH who present with incident syphilis have reduced blood CD4 T-lymphocyte and elevated HIV-1 RNA levels. However, the clinical, virological and neurocognitive effects of syphilis during acute HIV-1 (AHI) remain unknown. METHODS Pre-antiretroviral therapy laboratory outcomes and neurocognitive performance in a four-test battery in the SEARCH10/RV254 AHI cohort were compared according to syphilis status, determined by serum Treponema pallidum haemagglutination (TPHA), Venereal Disease Research Laboratory (VDRL) and syphilis treatment history. Impaired cognitive performance was defined as having z-scores ≤ -1 in at least two tests or ≤ -2 in at least one test. RESULTS Out of 595 AHI participants (97% male, median age of 26 years and estimated duration of HIV-1 infection of 19 days), 119 (20%) had history of syphilis (TPHA-positive), of whom 51 (9%) had untreated syphilis (TPHA-positive/VDRL-positive/without prior treatment). Compared with those without syphilis (TPHA-negative), individuals with untreated syphilis had higher CD8 T-lymphocyte levels but not higher plasma HIV-1 RNA or lower CD4 T-lymphocyte levels. Taking into account estimated duration of HIV-1 infection (P < 0.001), and later Fiebig stages (III-V) (P < 0.001), those with untreated syphilis had higher CD8 T-lymphocyte levels (P = 0.049). Individuals with any syphilis (TPHA-positive), but not untreated syphilis, had higher odds of impaired cognitive performance than those without (P = 0.002). CONCLUSIONS During AHI, individuals with any history of syphilis (TPHA-positive) had poorer cognitive performance than those without syphilis. However, syphilis was not associated with worsened HIV disease measures as described in chronic infection.
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Affiliation(s)
- P Chan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - D J Colby
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - E Kroon
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - C Sacdalan
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - S Pinyakorn
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - R Paul
- Missouri Institute of Mental Health, University of Missouri-St Louis, St Louis, MO, USA
| | - M Robb
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - V Valcour
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - J Ananworanich
- SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.,Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - C Marra
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - S Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
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16
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Chan L, Li H, Chan P, Wen C. A machine learning-based approach to decipher multi-etiology of knee osteoarthritis onset and deterioration. Osteoarthritis and Cartilage Open 2021; 3:100135. [DOI: 10.1016/j.ocarto.2020.100135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/27/2020] [Accepted: 12/31/2020] [Indexed: 12/25/2022] Open
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17
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Chhetri JK, Ma L, Zheng Z, Liu FY, Zhao J, Gu ZQ, Chan P. Apolipoprotein E Polymorphism and Frailty: Apolipoprotein ε4 Allele Is Associated with Fatigue but Not Frailty Syndrome in a Community-Dwelling Older Population Cohort. J Nutr Health Aging 2021; 25:410-415. [PMID: 33786555 DOI: 10.1007/s12603-020-1522-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Frailty is known to be influenced by genetics, however, little evidence on the association of Apolipoprotein E (ApoE) genotype and frailty exists which we aim to investigate. DESIGN This study is a cross-sectional analysis from a prospective longitudinal study cohort. SETTING AND PARTICIPANTS Community-dwelling individuals aged 55 years and older from Beijing region in China. MEASUREMENTS A total of 3,569 older adults with a mean age of 75.06(±6.79) years were included. We investigated the association between ApoE polymorphism and frailty syndrome using the frailty index (FI) and frailty phenotype (including association with individual components of the frailty phenotype). Logistic regressions were performed to investigate the relation between ApoE variants and frailty. RESULTS There was no significant association between ApoE variants and frailty as assessed by the FI. In the age and sex-adjusted model, compared to the ApoE e3/e3 carriers ApoE e4 carriers had almost 1.5 times higher odds of being frail as assessed by the frailty phenotype. However, the significance was lost on the model with adjustment for cognitive impairment. Compared to the ApoE e3/e3 carriers ApoE e4 carriers had almost two times higher odds of fatigue. ApoE e4 heterozygotes had higher odds of fatigue compared to ApoE e4 non-carriers. No significant association was found between ApoE variants and other components of frailty phenotype. CONCLUSIONS Our findings do not support an association between ApoE genotype and frailty irrespective of the frailty assessment tools. Fatigue in older adults is the only component of frailty phenotype influenced by ApoE genotype.
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Affiliation(s)
- J K Chhetri
- Piu Chan, MD, PhD, Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China, E-mail: , Tel: +86-10-83198677
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Chhetri JK, Xue QL, Ma L, Chan P, Varadhan R. Intrinsic Capacity as a Determinant of Physical Resilience in Older Adults. J Nutr Health Aging 2021; 25:1006-1011. [PMID: 34545921 PMCID: PMC8035602 DOI: 10.1007/s12603-021-1629-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/28/2020] [Indexed: 12/02/2022]
Abstract
The traditional disease-oriented model of healthcare is inadequate to address the needs of the older population. Greater attention should be given to strategies that promote healthy aging. Recently proposed constructs of intrinsic capacity (IC) and physical resilience (PR) hold great potential to reshape geriatric medicine and aging research. These constructs accentuate the positive health attributes of older people in contrast to the popular frailty construct that is centered on functional deficits. IC was introduced by the World Health Organization (WHO) as a composite of all the physical and mental capacities. WHO has emphasized enhancement of IC throughout the life course so as to maintain functional ability in old age. PR, recently highlighted by the National Institute on Aging, is the ability to successfully cope with stressors. High levels of resilience can result in desirable clinical and functional outcomes after stressors. Therefore, it is important to understand the underlying physiology of PR and the risk factors contributing to diminished PR. The main goal of this article is to explore the potential relationship between IC and PR. Based on a classical theory of aging, we postulate that IC is a determinant of PR and is also a high-level integrative measure of physiologic reserve which is the fundamental factor underlying one's ability to withstand stressors. A major implication of our postulates is that even though IC is only one of the many determinants of PR, it could serve as an important intervenable target for enhancing resilience in older adults.
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Affiliation(s)
- Jagadish K. Chhetri
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, No. 45 Changchun Street, Xicheng District, Beijing, 100053 China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
- Department of Medicine, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Q.-L. Xue
- Department of Medicine, Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD USA
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, USA
| | - L. Ma
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, No. 45 Changchun Street, Xicheng District, Beijing, 100053 China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - P. Chan
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, No. 45 Changchun Street, Xicheng District, Beijing, 100053 China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Ravi Varadhan
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, USA
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, 550 N. Broadway, Suite 1103-A, Baltimore, MD 21205 USA
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Abstract
Although geriatric research in general has increased in recent years, there is no effective treatment for frailty. Among older adults, those with frailty have an increased risk of falls, disability, and death. The population of older adults has increased rapidly in China, and resulting in an increased demand for medical care services for older adults, including those with frailty. However, much of the research on frailty has been conducted in Europe and the United States, and European and American standards for frailty are not always applicable to Chinese individuals. Clinicians and researchers in China have shown increasing interest in frailty in recent years. Here, we reviewed the current state of frailty research in China.
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Affiliation(s)
- L Ma
- Dr. Lina Ma, Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China, E-mail:
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Gupta S, Chan P, Lachiewicz M, Shockley M. Transcervical Tissue Extraction at the Time of Laparoscopic Myomectomy. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Girotra S, Nallamothu B, Tang Y, Chan P. Association of acute resuscitation and post-resuscitation survival with overall risk-standardized survival to discharge for in-hospital cardiac arrest. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0754] [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: 11/14/2022] Open
Abstract
Abstract
Background
Although survival for in-hospital cardiac arrest (IHCA) varies markedly across sites, it remains unknown whether high survival at top-performing hospitals is due to high rates of acute resuscitation survival (i.e., achievement of return of spontaneous circulation [ROSC]), post-resuscitation survival (i.e., survival to discharge among patients who achieved ROSC), or both.
Methods
Using 2015–2018 Get With The Guidelines (GWTG)-Resuscitation data, we identified 290 hospitals (86,426 patients) with IHCA. For each hospital, we calculated overall risk-standardized survival (RSSR) to discharge for IHCA using a previously validated hierarchical regression model and categorized hospitals into quartiles based on that metric. Risk-adjusted rates of acute resuscitation survival (defined as return of spontaneous circulation for >20 minutes [ROSC]) and post-resuscitation survival (defined as the proportion of patients achieving ROSC who survived to hospital discharge) were also computed for each hospital. We examined the correlation between a hospital's overall RSSR with its risk-adjusted rate of acute resuscitation and post-resuscitation survival.
Results
Among study hospitals, the median RSSR was 25.1% (inter-quartile range [IQR]: 21.9%–27.7%). The median risk-adjusted rate of acute resuscitation survival was 72.4% (IQR: 67.9%–76.9%) and post-resuscitation survival was 34.0% (IQR: 31.5%–37.7%). Hospital rates of RSSR were less strongly correlated with risk-adjusted rates of acute resuscitation survival (rho=0.50, P<0.001) than post-resuscitation survival (rho=0.90, P<0.001). Compared with hospitals in the lowest quartile of RSSR, hospitals in the highest quartile had substantially higher rates of acute resuscitation survival (Q4: 75.4% vs. Q1: 66.8%; P<0.001) and post-resuscitation survival (Q4: 40.3% vs. Q1: 28.7%; P<0.001). Notably, there was no correlation between hospital risk-adjusted rates of acute resuscitation survival and post-resuscitation survival (rho=0.09, P=0.11).
Conclusion
Hospital that excel in overall IHCA survival in general excel in either acute resuscitation or post-resuscitation care. As most hospital-based quality improvement initiatives largely focus on acute resuscitation survival, our findings suggest that efforts to strengthen post-resuscitation care may offer additional opportunities to improve IHCA survival.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): NHLBI
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Affiliation(s)
- S Girotra
- University of Iowa, Iowa, United States of America
| | - B Nallamothu
- University of Michigan, Ann Arbor, United States of America
| | - Y Tang
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - P Chan
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
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Cheng A, Yip E, Tsang J, Chan P, Choi A, Yiu B, Kam J, Young G, So K, Zuo Z, Cheung Y, Zhou K, Lam T. PCN10 ORAL H2RA for Taxane Hypersensitivity Prevention: A Pharmacokinetic-Guided Decision. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chhetri JK, Chan P, Vellas B, Touchon J, Gauthier S. Report from the First Clinical Trials on Alzheimer's Disease (CTAD) Asia-China 2018 : Bringing together Global Leaders. J Prev Alzheimers Dis 2020; 6:144-147. [PMID: 30756122 DOI: 10.14283/jpad.2019.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Population of older adults in Asia, and particularly in China is increasing rapidly. Older population are at increased risk of Alzheimer's disease (AD) and other dementias. Soon, the Chinese population with AD will represent almost half of the world's AD population. There is a desperate need of disease modifying therapies to delay or slow the progression of AD, to tackle this emerging healthcare emergency. In this context, the first CTAD Asia-China conference was held in China to bring together Western and Asian leaders in AD. This meeting focused largely on how to develop successful trials in China, utilizing past experiences from the West.
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Affiliation(s)
- J K Chhetri
- J.K Chhetri, Department of Neurobiology, Geriatrics and Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China,
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Noventa A, Herpe G, Vesselle G, Guibal A, Velasco S, Chan P, Ingrand P, Boucebci S, Tasu JP. Erratum to “Chart for renal tumor microwave ablation from human study” [Diagn. Interv. Imaging 99 (2018) 609–14]. Diagn Interv Imaging 2020; 101:327. [DOI: 10.1016/j.diii.2019.12.010] [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: 10/24/2022]
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McCullen M, Grosskopf C, Jafary S, Chan P, Chen V. P270 Using a rabbit model to observe corticospinal contributions of noninvasive electrical stimulation. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.380] [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: 10/24/2022]
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Sun H, Sun F, Zhang XQ, Fang XH, Chan P. The Prevalence and Clinical Characteristics of Essential Tremor in Elderly Chineses: A Population-Based Study. J Nutr Health Aging 2020; 24:1061-1065. [PMID: 33244561 DOI: 10.1007/s12603-020-1472-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the prevalence and the clinical feature of essential tremor (ET) in a community cohort in Beijing. METHODS Using a door-to-door, two-phase approach, we investigated 2,835 residents aged ≥55 years old from rural, urban, and mountain areas. RESULTS The prevalence rate of ET was 4.29%, 2.85%, and 2.29% in rural, urban, and mountain areas, respectively. The overall age- and sex-adjusted prevalence was 3.29%. Among those aged ≥75 years, the prevalence rate in the urban area was higher than those in the rural and mountain areas. The prevalence rate increased with age, and the prevalence was higher among men (6.0%) than among women (3.6%). There was a correlation of ET prevalence with age, sex, and habitation area, but not with alcohol, tea drinking, and occupation. Women (25%) with ET were more likely to have head tremor than men (16.9%). CONCLUSIONS The ET prevalence in the elderly of Beijing was 3.29% which is higher in the urban area and in men.
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Affiliation(s)
- H Sun
- Piu Chan, MD PhD, Department of Neurology, Neurobiology and Geriatrics, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Beijing, 100053, China, Tel: +86-10-83198677, Fax: +86-10-83161294,
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Chhetri JK, Chan P, Arai H, Chul Park S, Sriyani Gunaratne P, Setiati S, Assantachai P. Prevention of COVID-19 in Older Adults: A Brief Guidance from the International Association for Gerontology and Geriatrics (IAGG) Asia/Oceania region. J Nutr Health Aging 2020; 24:471-472. [PMID: 32346683 PMCID: PMC7156899 DOI: 10.1007/s12603-020-1359-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/28/2022]
Affiliation(s)
- J K Chhetri
- Dr. Jagadish K Chhetri M.D, Xuanwu Hospital of Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China, E-mail:, Tel: +86-10-83198677
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Abstract
OBJECTIVES Multimorbidity is common in older hospitalized adults. To date, however, few studies have addressed multimorbidity in the older population of Chinese inpatients. We aimed to investigate the multimorbidity rate and associated risk factors in older adult inpatients in China. DESIGN, SETTING, PARTICIPANTS This study was conducted in the medical wards of a tertiary-care hospital from. The patients were recruited aged between 60 to 101 (74.14±8.46) years. MEASUREMENTS Data were obtained from the China Comprehensive Geriatric Assessment Study, conducted in 2011-2012 in China. A total of 4,633 inpatients older than 60 years was recruited from 12 hospitals in 7 cities throughout China. The prevalence of comorbidity, distribution of common chronic diseases, and the associated risk factors were studied. RESULTS A total of 4,348 people aged 60 to 101 (74.14±8.46) years completed questionnaires. The average frequency of multimorbidity was 69.3% (95% CI, 67.9% to 70.6%). The prevalence of multimorbidity increased with age and was higher in men (71.6%; 95% CI, 69.9% to 73.3%) than in women (65.3%, 95% CI 63.0% to 67.6%), and higher in the northern region (71.7%, 95% CI 69.9% to 73.5%) than in the southern region (66.0%; 95% CI, 63.8% to 68.1%). The most frequent chronic diseases were hypertension, coronary heart disease, diabetes, cataract, and stroke. Area (OR=0.556; 95% CI, 0.465 to 0.666), region (OR=0.834; 95% CI, 0.723 to 0.962), body mass index (BMI) (OR=1.124; 95% CI, 1.017 to 1.242), and impairment of activities of daily living (OR=0.911; 95% CI, 0.855 to 0.970) were independent factors associated with multimorbidity. CONCLUSIONS Multimorbidity is common in older Chinese inpatients with a national prevalence of 69.3% that increases in line with age. Age, region, area, BMI, and daily activities were independent factors significantly associated with multimorbidity in older inpatients. Clinicians should therefore focus more attention on multimorbidity.
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Affiliation(s)
- L Zhang
- Piu Chan, MD, Department of Neurobiology, Xuanwu Hospital of Capital MedicalUniversity, Beijing 100053, China. . Zhe Tang, MD, Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Han C, Lu Y, Cheng H, Wang C, Chan P. The impact of long-term exposure to ambient air pollution and second-hand smoke on the onset of Parkinson disease: a review and meta-analysis. Public Health 2019; 179:100-110. [PMID: 31770719 DOI: 10.1016/j.puhe.2019.09.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 04/06/2019] [Revised: 09/04/2019] [Accepted: 09/30/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Long-term exposure to particulate and gaseous air pollution (AP) may trigger the development of Parkinson disease (PD), but this association remains controversial. The relationship between second-hand smoke (SS) and PD risk is also inconclusive. We aimed to systematically review epidemiological studies investigating the association between these AP exposures and PD risk. STUDY DESIGN This was a systematic review and meta-analysis of studies investigating the relationship of ambient AP and SS with PD risk. METHODS PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases were searched. We used a random-effects model to derive pooled estimates of relative risk (RR) and corresponding 95% confidence intervals (CIs) per increment in pollutant concentration. The studied AP included particulate matter with aerodynamic diameter <2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxides (NO2, NOx), ozone (O3), and carbon monoxide (CO). RESULTS In total, 21 studies with 222,051 patients with PD were eligible for inclusion. We found marginally significant increased risk of PD with per 10-μg/m3 increase in concentration of PM2.5 (RR = 1.08, 95% CI = 0.98-1.19), NO2 (RR = 1.03, 95% CI = 0.99-1.07), and O3 (RR = 1.01, 95% CI = 1.00-1.02). A positive but non-significant association was also detected for CO (RR = 1.32, 95% CI = 0.82-2.11). Furthermore, an inverse PD-SS relationship was noted irrespective of exposure occasions and timing (at home: RR = 0.73, 95% CI = 0.56-0.95; at work: RR = 0.82, 95% CI = 0.57-1.17; in children: RR = 0.91, 95% CI = 0.76-1.08). Both sensitivity and subgroup analyses generated results comparable with those of the overall analyses. CONCLUSIONS Our study suggested that exposure to PM2.5, NO2, and O3 might contribute to higher risk of PD, whereas SS conferring reduced PD risk. Public and environmental health strategies that aim at reducing outdoor AP levels might reduce the burden of PD. More prospective cohort studies with personal exposure measurements are warranted in the future.
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Affiliation(s)
- C Han
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Xicheng District, Beijing, China
| | - Y Lu
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, NHC Key Laboratory of Human Disease Comparative Medicine, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences and Comparative Medical Center, Peking Union Medical College, 5 Pan Jia Yuan Nan Li, Chaoyang District, Beijing, China
| | - H Cheng
- Obstetrics and Gynecology Department, Huangpi District Hospital of Traditional Chinese Medicine, 48 Banqiao Road, Huangpi District, Wuhan, Hubei, China
| | - C Wang
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Xicheng District, Beijing, China; Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Clinical Center for Parkinson's Disease, Capital Medical University, Beijing, China; Key Laboratories for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, 45 Changchun Road, Xicheng District, Beijing, China
| | - P Chan
- National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital of Capital Medical University, 45 Changchun Road, Xicheng District, Beijing, China; Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Clinical Center for Parkinson's Disease, Capital Medical University, Beijing, China; Key Laboratories for Neurodegenerative Diseases of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, 45 Changchun Road, Xicheng District, Beijing, China.
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Pekker I, Lim L, Simon J, Gormley M, Li Z, Pollak J, Potts K, Watford S, Posey J, Chan P, Urtishak K, Garg K, Hosseini A, Li M. Analytical performance of the resolution-HRD plasma assay used to identify mCRPC patients with biallelic disruption of DNA repair genes for treatment with niraparib. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miller J, Bruen C, Wilburn J, Mackey C, Prekker M, Chan P, Peacock W, Stauderman K, Dunn M, Hebbar S. 353 An Open-Label, Dose-Response Study of CM4620-Injectable Emulsion in Emergency Department Patients With Acute Pancreatitis. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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Abstract
As aging is becoming a global phenomenon, the burden of population aging is increasing rapidly, and is soon expected to be the highest in low-and middle-income countries. China represents the world's largest population, and will face the largest number of older individuals, while the economy still remains developing. There is an urgent need to address the negative consequences of aging such as disability, that creates a myriad of challenges, including financial burden to the economy. In order to achieve successful aging-i.e., aging without being frail or disabled, the traditional healthcare model based on a disease-centered approach is not enough, but require a more holistic course. Here, we briefly outline the current scenario of aging and disability in the Chinese older population, its impact and challenges. We strongly believe that public health initiatives centered on frailty, a clinically distinguishable state of extreme vulnerability in older adults, could be the most relevant approach to meet the current needs of the aging population. Such initiatives are immediately needed to reshape the existing model of geriatric healthcare, to promote healthy aging and to reduce the burden of disability in the Chinese population.
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Affiliation(s)
- J K Chhetri
- Jagadish K Chhetri M.D, Department of Neurobiology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
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Abstract
BACKGROUND Although frailty status greatly impacts health care in countries with rapidly aging populations, little is known about the frailty status in Chinese older adults. OBJECTIVES Given the increased health care needs associated with frailty, we sought to develop an easily applied self-report screening tool based on four of the syndromic frailty components and sought to validate it in a population of older adults in China. DESIGN Prospective epidemiological cohort study. SETTING Community-dwelling residents living in Beijing, China. PARTICIPANTS 1724 community-dwelling adults aged ≥60 years in 2004 with an 8-year follow up. MEASUREMENTS We developed a simple self-report frailty screening tool-the Frailty Screening Questionnaire (FSQ)-based on the modified Fried frailty components. The predictive ability for outcome was assessed by age and sex adjusted Cox proportional hazards model. RESULTS According to FSQ criteria, 7.1% of the participants were frail. Frailty was associated with poor physical function, fractures, falls, and mortality. Both frailty and pre-frailty were associated with a higher mortality rate: frailty-hazards ratio (HR), 3.94, 95% confidence interval (CI), 3.16-4.92, P<0.001; pre-frailty-HR, 1.89; 95% CI, 1.57-2.27, P <0.001; adjusted models for this variable did not affect the estimates of the association. Among the four frailty components, slowness was the strongest predictor of mortality. The combination of the four components provided the best risk prediction. CONCLUSIONS FSQ is a self-report frailty measurement tool that can be rapidly performed to identify older adults with higher risk of adverse health outcomes.
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Affiliation(s)
- L Ma
- Dr. Jeremy D. Walston, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. E-mail: ; Dr. Zhe Tang, Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Xicheng District, Beijing 100053, China. Tel: 86-010-63162077. E-mail:
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Herrero MB, Lusignan MF, Son WY, Sabbah M, Buckett W, Chan P. ICSI outcomes using testicular spermatozoa in non-azoospermic couples with recurrent ICSI failure and no previous live births. Andrology 2019; 7:281-287. [PMID: 30734539 DOI: 10.1111/andr.12591] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 12/21/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The use of testicular over ejaculated spermatozoa for ICSI has been presented as an alternative to overcome infertility in men with poor semen parameters or high levels of sperm DNA fragmentation. OBJECTIVE To evaluate the efficacy of testicular ICSI outcomes in couples with no previous live birth and recurrent ICSI failure using ejaculated spermatozoa by comparison to the outcomes of couples with similar history of recurrent ICSI using ejaculated spermatozoa only. MATERIALS AND METHODS A total of 145 couples undergoing ejaculated or testicular ICSI cycles with no previous live births and with at least two previous failed ICSI cycles with ejaculated spermatozoa were evaluated retrospectively. ICSI was performed either with ejaculated (E-ICSI) or with testicular (T-ICSI) spermatozoa. Semen parameters and sperm DNA quality were assessed prior to the oocyte collection day. Primary outcomes included cumulative live birth and pregnancy rates. Secondary analysis included percentage of DNA fragmentation in ejaculated spermatozoa (SCSA® and TUNEL). RESULTS Patients undergoing T-ICSI (n = 77) had a significantly higher clinical pregnancy rate/fresh embryo transfer (ET) (27.9%; 17/61) and cumulative live birth rate (23.4%; 15/64) compared to patients using E-ICSI (n = 68) (clinical pregnancy rate/fresh ET: 10%; 6/60 and cumulative live birth rate: 11.4%; 7/61). Further, T-ICSI yield significantly better cumulative live birth rates than E-ICSI for men with high TUNEL (≥36%) (T-ICSI: 20%; 3/15 vs. E-ICSI: 0%; 0/7, p < 0.025), high SCSA® (≥25%) scores (T-ICSI: 21.7%; 5/23 vs. E-ICSI: 9.1%; 1/11, p < 0.01), or abnormal semen parameters (T-ICSI: 28%; 7/25 vs. E-ICSI: 6.7%; 1/15, p < 0.01). CONCLUSIONS The use of testicular spermatozoa for ICSI in non-azoospermic couples with no previous live births, recurrent ICSI failure, and high sperm DNA fragmentation yields significantly better live birth outcomes than a separate cohort of couples with similar history of ICSI failure entering a new ICSI cycle with ejaculated spermatozoa.
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Affiliation(s)
- M B Herrero
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - M F Lusignan
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - W-Y Son
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - M Sabbah
- The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - W Buckett
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada
| | - P Chan
- MUHC Reproductive Centre, McGill University Health Centre, Montreal, QC, Canada.,The Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Surgery, McGill University, Montreal, QC, Canada
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Chan P. PO179 Novel Cardiac Protective Agent, AFC1, Attenuated Ischemic Reperfusion Induced Ventricular Remodeling via Inhibiting PDGFR and JAK/STAT Pathways. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.157] [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: 11/24/2022] Open
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Nobis S, Morin A, Achamrah N, Belmonte L, Legrand R, Chan P, Do Rego J, Vaudry D, Dechelotte P, Goichon A, Coeffier M. Ralentissement de la vidange gastrique dans le modèle animal d’anorexie « activity-based anorexia » : rôle du métabolisme protéique ? NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Novanta A, Herpe G, Vesselle G, Guibal A, Velasco S, Chan P, Ingrand P, Boucebi S, Tasu JP. Chart for renal tumor microwave ablation from human study. Diagn Interv Imaging 2018; 99:609-614. [DOI: 10.1016/j.diii.2018.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/28/2018] [Accepted: 05/15/2018] [Indexed: 10/28/2022]
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Villamor GA, Andras LM, Chan P, Jalloh H, Sanders AE, Yang J, Choi PD, Tolo VT, Skaggs DL. Stomaching the pain of spinal fusion: gastrointestinal discomfort is as severe as back pain in 50% of adolescent idiopathic scoliosis patients following posterior spinal fusion. J Child Orthop 2018; 12:539-543. [PMID: 30294380 PMCID: PMC6169568 DOI: 10.1302/1863-2548.12.180037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE There have been no prospective studies investigating gastrointestinal (GI) symptoms of patients with adolescent idiopathic scoliosis (AIS) following posterior spinal fusion (PSF). The purpose of this study was to evaluate the incidence and severity of self-reported GI symptoms following PSF. METHODS In all, 40 AIS patients undergoing PSF were prospectively enrolled between March 2015 and October 2016. Patients completed a survey on each postoperative, inpatient day regarding nausea, emesis, constipation, abdominal pain and back pain, rating their pain on a scale of 1 to 10. RESULTS Abdominal pain (50%), emesis (63%), nausea (65%) and constipation (68%) were experienced by the majority of patients. Of those reporting back pain, the mean pain level during the postoperative period was 5.1 (0.2 to 9.6). Of those reporting abdominal pain, the mean pain level during the postoperative period was 5.5 (1.4 to 8.6), which was not different than the severity of their back-pain levels (mean = 6.0, p = 0.31). CONCLUSIONS Gastrointestinal issues in AIS patients following PSF are common. Abdominal pain was as severe as the back pain for half of the patients. LEVEL OF EVIDENCE II.
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Affiliation(s)
- G. A. Villamor
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - L. M. Andras
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - P. Chan
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - H. Jalloh
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - A. E. Sanders
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - J. Yang
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - P. D. Choi
- Shriners for Children Medical Center, Pasadena, California, USA
| | - V. T. Tolo
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - D. L. Skaggs
- Children’s Orthopaedic Center, Children’s Hospital Los Angeles, Los Angeles, California, USA, Correspondence should be sent to D. L. Skaggs, Children’s Orthopaedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS#69, Los Angeles, California 90027, USA. E-mail:
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Kirzner N, Etherington G, Ton L, Chan P, Paul E, Liew S, Humadi A. Relationship between facet joint distraction during anterior cervical discectomy and fusion for trauma and functional outcome. Bone Joint J 2018; 100-B:1201-1207. [DOI: 10.1302/0301-620x.100b9.bjj-2018-0199.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The purpose of this retrospective study was to investigate the clinical relevance of increased facet joint distraction as a result of anterior cervical decompression and fusion (ACDF) for trauma. Patients and Methods A total of 155 patients (130 men, 25 women. Mean age 42.7 years; 16 to 87) who had undergone ACDF between 1 January 2001 and 1 January 2016 were included in the study. Outcome measures included the Neck Disability Index (NDI) and visual analogue scale (VAS) for pain. Lateral cervical spine radiographs taken in the immediate postoperative period were reviewed to compare the interfacet distance of the operated segment with those of the facet joints above and below. Results There was a statistically significant relationship between greater facet distraction and increased NDI and VAS pain scores. This was further confirmed by Spearman correlation, which showed evidence of a moderate correlation between both NDI score and facet joint distraction (Spearman correlation coefficient 0.34; p < 0.001) and VAS score and facet distraction (Spearman correlation coefficient 0.52; p < 0.001). Furthermore, there was a discernible transition point between outcome scores. Significantly worse outcomes, in terms of both NDI scores (17.8 vs 8.2; p < 0.001) and VAS scores (4.5 vs 1.3; p < 0.001), were seen with facet distraction of 3 mm or more. Patients who went on to have a posterior fusion also had increased NDI and VAS scores, independent of facet distraction. Conclusion After undergoing ACDF for the treatment of cervical spine injury, patients with facet joint distraction of 3 mm or more have worse NDI and VAS pain scores. Cite this article: Bone Joint J 2018;100-B:1201–7.
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Affiliation(s)
| | | | - L. Ton
- Alfred Hospital, Prahran, Australia
| | - P. Chan
- Alfred Hospital, Prahran, Australia
| | - E. Paul
- Alfred Hospital, Prahran, Australia
| | - S. Liew
- Alfred Hospital, Prahran, Australia
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40
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Hoffman I, Lewis B, Chan P. Circulation of cosmogenic 22Na using the global monitoring network of the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO). J Environ Radioact 2018; 187:8-15. [PMID: 29459255 DOI: 10.1016/j.jenvrad.2018.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/23/2018] [Accepted: 01/23/2018] [Indexed: 06/08/2023]
Abstract
Using a recently published global data set of 22Na and 7Be from the global monitoring network of the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), atmospheric circulation and stratosphere-troposphere interactions are examined. Cosmogenic 22Na has a half-life well-suited to environmental processes with durations from several months to a decade. Combined with corresponding 7Be observations, these two cosmogenic isotopes form a useful environmental tracer and new radiochronometer to study physical interactions of air masses in the stratosphere and troposphere.
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Affiliation(s)
- I Hoffman
- Radiation Protection Bureau, Health Canada, 775 Brookfield Rd., Ottawa, Ontario, Canada.
| | - B Lewis
- Department of Chemistry and Chemical Engineering, Royal Military College of Canada, PO Box 17000, Kingston, Ontario, Canada
| | - P Chan
- Department of Chemistry and Chemical Engineering, Royal Military College of Canada, PO Box 17000, Kingston, Ontario, Canada
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Nobis S, Morin A, Achamrah N, Belmonte L, Legrand R, Chan P, do Rego JL, Vaudry D, Gourcerol G, Déchelotte P, Goichon A, Coëffier M. Delayed gastric emptying and altered antrum protein metabolism during activity-based anorexia. Neurogastroenterol Motil 2018; 30:e13305. [PMID: 29411462 DOI: 10.1111/nmo.13305] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/05/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Anorexia nervosa, a restrictive eating disorder, is often associated with gastrointestinal disorders, particularly a delayed gastric emptying. However, the mechanisms remained poorly documented. Thus, we aimed to evaluate gastric emptying and antrum protein metabolism in the Activity-Based Anorexia model (ABA). METHODS Females C57Bl/6 mice were randomized into 3 groups: Control, ABA, and Limited Food Access (LFA). Food access has been progressively limited from 6 h/day at day 6 to 3 h/day at day 9 and until day 17. ABA mice had free access to an activity wheel. Gastric emptying was assessed. On gastric extracts, a proteomic analysis was performed, as well as an evaluation of protein synthesis and protein oxidation. KEY RESULTS Both LFA and ABA mice exhibited a delayed gastric emptying compared with Controls (P < .05). Proteomic approach revealed 15 proteins that were differentially expressed. Among these proteins, we identified 2 clusters of interest contributing to (i) the organization of muscle fiber with ACTA2, VCL, KRT19, KRT8, and DES proteins and (ii) "heat shock proteins" with STIP1, HSPD1, and HSPA8 proteins. ABA mice specifically exhibited an increased rate of gastric oxidized proteins. CONCLUSIONS AND INFERENCES Delayed gastric emptying observed in anorectic conditions appears to be secondary to malnutrition. However, an oxidative stress is specifically present in the stomach of ABA mice. Its role remains to be further studied.
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Affiliation(s)
- S Nobis
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France
| | - A Morin
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France
| | - N Achamrah
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Nutrition Department, Rouen University Hospital, Rouen, France
| | - L Belmonte
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Nutrition Department, Rouen University Hospital, Rouen, France
| | - R Legrand
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France
| | - P Chan
- Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Platform in proteomics PISSARO, UNIROUEN, Normandie University, Rouen, France
| | - J-L do Rego
- Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Animal Behaviour Platform SCAC, UNIROUEN, Normandie University, Rouen, France
| | - D Vaudry
- Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Platform in proteomics PISSARO, UNIROUEN, Normandie University, Rouen, France.,INSERM Unit 1239, UNIROUEN, Normandie University, Rouen, France
| | - G Gourcerol
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Physiology Department, Rouen University Hospital, Rouen, France
| | - P Déchelotte
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Nutrition Department, Rouen University Hospital, Rouen, France
| | - A Goichon
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France
| | - M Coëffier
- INSERM Unit 1073, UNIROUEN, Normandie University, Rouen, France.,Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN, Normandie University, Rouen, France.,Nutrition Department, Rouen University Hospital, Rouen, France
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Leung FK, Lau TW, Yuen GW, Chan EM, Chan P, Lam RY. Effectiveness of a multidisciplinary approach to geriatric hip fractures in improving clinical outcomes and cost of care. Hong Kong Med J 2018; 24 Suppl 2:45-47. [PMID: 29938659] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- F Kl Leung
- Department of Orthopaedics and Traumatology, The University of Hong Kong
| | - T W Lau
- Department of Orthopaedics and Traumatology, Queen Mary Hospital
| | - G Wy Yuen
- School of Nursing, The University of Hong Kong
| | - E Mt Chan
- Department of Occupational Therapy, Queen Mary Hospital
| | - P Chan
- Central Nursing Department, Queen Mary Hospital
| | - R Yh Lam
- Physiotherapy Department, Queen Mary Hospital
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Abstract
OBJECTIVE Frailty, which involves low physical activity (PA), is as a well-established factor of increased risk of hospitalization, disability, and mortality. To date, there are no specific tools to assess PA among Chinese elderly. As part of the Beijing Longitudinal Study of Aging (BLSA), we aimed to develop the BLSA Leisure-Time Physical Activity Questionnaire (BLSA-PAQ) and assess its prediction of mortality. DESIGN Longitudinal study. SETTING Community. PARTICIPANTS 1810 Chinese older adults completed the BLSA-PAQ questionnaire. MEASUREMENTS BLSA-PAQ questionnaire containing four items: walking, outdoor chores, low-intensity exercise, and moderate-intensity exercise. Physical function was assessed through the balance test, chair-stand test, and the activities of daily living (ADL), and instrumental activities of daily living (IADL). Frailty was evaluated using a modified frailty phenotype and frailty index. RESULTS The following equation was obtained based on the 8-year mortality for the four BLSA-PAQ components: BLSA-PAQ index (BLSA-PAQ total score) = Walking score + Outdoor chores score + 2 × (low-intensity exercise score) + 3 × (moderate-intensity exercise score). The BLSA-PAQ index decreased with age, and was negatively related to modified frailty phenotype score and frailty index. Low PA and pre-low PA statuses were associated with poorer results in the balance and chair-stand tests, ADL dependency, IADL dependency, and frailty. After adjusting for age and gender, the 8-year mortality HRs were 1.453 (95% CI, 1.166-1.811) and 2.358 (95% CI, 1.856-2.995) for low PA and pre-low PA, respectively. Low PA defined by the BLSA-PAQ index was associated with frailty, disability, worse physical function, and higher mortality. CONCLUSION The BLSA-PAQ seems to be a reliable tool to measure PA in Chinese older adults. Further studies are needed to confirm these findings and validate the use of the BLSA-PAQ for frailty assessments of older adults.
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Affiliation(s)
- L Ma
- Dr. Zhe Tang, Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, #45 Changchun Street, Xicheng District, Beijing 100053, China. Tel: 86-010-63162077, Fax: 86-010-63162077. E-mail address:
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Gilman AR, Younes G, Tannus S, Son WY, Chan P, Buckett W. Does using testicular sperm retrieval rather than ejaculated spermatozoa improve reproductive outcomes in couples with previous ART failure and poor ovarian response? A case-controlled study. Andrology 2017; 6:142-145. [PMID: 29195015 DOI: 10.1111/andr.12447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/16/2017] [Accepted: 10/24/2017] [Indexed: 01/23/2023]
Abstract
The objective of this study was to assess whether testicular-retrieved spermatozoa improve reproductive outcomes compared to fresh ejaculate in women with poor ovarian response and a history of previous ART failure. The study was performed as a retrospective case-control study at a university-based reproductive center in Montreal, Quebec, Canada. Eighteen poor-responder patients were matched 3 : 1 with 54 controls. Poor responders were defined as those with ≤3 oocytes retrieved at oocyte pickup. Cases were identified as poor responders, and only those with previous IVF failure(s) as an indication for testicular-retrieved spermatozoa were included. Controls were age and cycle attempt number matched. All patients were included only once. From January 1, 2009 to December 31, 2015, all patients and controls underwent an IVF cycle using ICSI with either testicular spermatozoa or ejaculated spermatozoa, respectively. Outcomes included live birth rate, pregnancy rate, miscarriage rate, oocyte number, and embryo transfer (ET) day. The results showed live birth rates, pregnancy rates, and miscarriage rates were similar. There were fewer day 2 ETs (8.5% vs. 48.6%, p = 0.01) and more day 5 blastocyst transfers (25.0% vs. 5.4%, p = 0.05) in the testicular sperm retrieval group compared to controls and thus an overall suggestion of better embryo quality in the testicular sperm group. Overall, however, the use of testicular sperm retrieval appears to add little. Women with poor ovarian response typically have a poor prognosis with respect to live birth rates, and this is further supported in this study. The suggestion of better embryo quality in the testicular-retrieved sperm group would need to be further assessed in a larger multicentered study.
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Affiliation(s)
- A R Gilman
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - G Younes
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - S Tannus
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - W Y Son
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - P Chan
- MUHC Reproductive Centre, Montréal, QC, Canada
| | - W Buckett
- MUHC Reproductive Centre, Montréal, QC, Canada
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Goichon A, Ghouzali I, Bahlouli W, Chan P, Vaudry D, Déchelotte P, Ducrotté P, Coëffier M. SUN-P116: Immunoproteasome Subunit Beta2i Deficiency Modifies Colonic Proteome in Stressed Mice: Putative Role for Irritable Bowel Syndrome. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30511-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ng S, Chan P, Si Tou J, Tse M. THE TIMED UP AND GO TEST WITH ADDITIONAL MOTOR TASK FOR ASSESSING OLDER ADULTS WITH CHRONIC STROKE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Ng
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - P. Chan
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - J. Si Tou
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - M. Tse
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Affiliation(s)
- F. Liu
- Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, China,
| | - J. Qin
- Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, China,
| | - X. Liang
- Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, China,
| | - J. Wang
- Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, China,
| | - P. Chan
- Department of Geriatrics, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China,
- Department of Neurobiology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China,
- Department of Neurology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China
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Katigbak C, Zuo S, Chan P. CHINESE IMMIGRANTS’ VIEWS ON EXERCISE AND USING TECHNOLOGY TO ENHANCE PHYSICAL ACTIVITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C. Katigbak
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts,
| | - S. Zuo
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts,
| | - P. Chan
- Chinese Consolidated Benevolent Association of New England, Boston, Massachusetts
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Cotelle P, Chan P, Cotelle N, Bernier JL, Hénichart JP. Active site model peptides of glutathione peroxidase : a 77Se NMR study. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1992890191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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