1
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Omar R, Tavolacci SC, Liou L, Villavisanis DF, Broza YY, Haick H. Real-time prognostic biomarkers for predicting in-hospital mortality and cardiac complications in COVID-19 patients. PLOS Glob Public Health 2024; 4:e0002836. [PMID: 38446834 PMCID: PMC10917247 DOI: 10.1371/journal.pgph.0002836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/07/2024] [Indexed: 03/08/2024]
Abstract
Hospitalized patients with Coronavirus disease 2019 (COVID-19) are highly susceptible to in-hospital mortality and cardiac complications such as atrial arrhythmias (AA). However, the utilization of biomarkers such as potassium, B-type natriuretic peptide, albumin, and others for diagnosis or the prediction of in-hospital mortality and cardiac complications has not been well established. The study aims to investigate whether biomarkers can be utilized to predict mortality and cardiac complications among hospitalized COVID-19 patients. Data were collected from 6,927 hospitalized COVID-19 patients from March 1, 2020, to March 31, 2021 at one quaternary (Henry Ford Health) and five community hospital registries (Trinity Health Systems). A multivariable logistic regression prediction model was derived using a random sample of 70% for derivation and 30% for validation. Serum values, demographic variables, and comorbidities were used as input predictors. The primary outcome was in-hospital mortality, and the secondary outcome was onset of AA. The associations between predictor variables and outcomes are presented as odds ratio (OR) with 95% confidence intervals (CIs). Discrimination was assessed using area under ROC curve (AUC). Calibration was assessed using Brier score. The model predicted in-hospital mortality with an AUC of 90% [95% CI: 88%, 92%]. In addition, potassium showed promise as an independent prognostic biomarker that predicted both in-hospital mortality, with an AUC of 71.51% [95% Cl: 69.51%, 73.50%], and AA with AUC of 63.6% [95% Cl: 58.86%, 68.34%]. Within the test cohort, an increase of 1 mEq/L potassium was associated with an in-hospital mortality risk of 1.40 [95% CI: 1.14, 1.73] and a risk of new onset of AA of 1.55 [95% CI: 1.25, 1.93]. This cross-sectional study suggests that biomarkers can be used as prognostic variables for in-hospital mortality and onset of AA among hospitalized COVID-19 patients.
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Affiliation(s)
- Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Sooyun Caroline Tavolacci
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Lathan Liou
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Dillan F. Villavisanis
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Yoav Y. Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, Israel
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2
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Omar R, Saliba W, Khatib M, Zheng Y, Pieters C, Oved H, Silberman E, Zohar O, Hu Z, Kloper V, Broza YY, Dvir T, Grinberg Dana A, Wang Y, Haick H. Biodegradable, Biocompatible, and Implantable Multifunctional Sensing Platform for Cardiac Monitoring. ACS Sens 2024; 9:126-138. [PMID: 38170944 PMCID: PMC10825867 DOI: 10.1021/acssensors.3c01755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/17/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
Cardiac monitoring after heart surgeries is crucial for health maintenance and detecting postoperative complications early. However, current methods like rigid implants have limitations, as they require performing second complex surgeries for removal, increasing infection and inflammation risks, thus prompting research for improved sensing monitoring technologies. Herein, we introduce a nanosensor platform that is biodegradable, biocompatible, and integrated with multifunctions, suitable for use as implants for cardiac monitoring. The device has two electrochemical biosensors for sensing lactic acid and pH as well as a pressure sensor and a chemiresistor array for detecting volatile organic compounds. Its biocompatibility with myocytes has been tested in vitro, and its biodegradability and sensing function have been proven with ex vivo experiments using a three-dimensional (3D)-printed heart model and 3D-printed cardiac tissue patches. Moreover, an artificial intelligence-based predictive model was designed to fuse sensor data for more precise health assessment, making it a suitable candidate for clinical use. This sensing platform promises impactful applications in the realm of cardiac patient care, laying the foundation for advanced life-saving developments.
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Affiliation(s)
- Rawan Omar
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Walaa Saliba
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Muhammad Khatib
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Youbin Zheng
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Calvin Pieters
- Department
of Chemical Engineering, Technion-Israel
Institute of Technology, Haifa 320003, Israel
| | - Hadas Oved
- Shmunis
School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Eric Silberman
- Shmunis
School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Orr Zohar
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Zhipeng Hu
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Viki Kloper
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Yoav Y. Broza
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Tal Dvir
- Shmunis
School of Biomedicine and Cancer Research, Faculty of Life Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
- Department
Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel
- The
Chaoul Center for Nanoscale Systems, Tel
Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv 6997801, Israel
- Sagol Center
for Regenerative Biotechnology, Tel Aviv
University, Tel Aviv 6997801, Israel
| | - Alon Grinberg Dana
- Department
of Chemical Engineering, Technion-Israel
Institute of Technology, Haifa 320003, Israel
| | - Yan Wang
- Department
of Chemical Engineering, Guangdong Technion-Israel
Institute of Technology (GTIIT), Shantou 515063, Guangdong, China
| | - Hossam Haick
- Department
of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
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3
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Omar R, Yuan M, Wang J, Sublaban M, Saliba W, Zheng Y, Haick H. Self-powered freestanding multifunctional microneedle-based extended gate device for personalized health monitoring. Sens Actuators B Chem 2024; 398:134788. [PMID: 38164440 PMCID: PMC10652171 DOI: 10.1016/j.snb.2023.134788] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 01/03/2024]
Abstract
Online monitoring of prognostic biomarkers is critically important when diagnosing disorders and assessing individuals' health, especially for chronic and infectious diseases. Despite this, current diagnosis techniques are time-consuming, labor-intensive, and performed offline. In this context, developing wearable devices for continuous measurements of multiple biomarkers from body fluids has considerable advantages including availability, rapidity, convenience, and minimal invasiveness over the conventional painful and time-consuming tools. However, there is still a significant challenge in powering these devices over an extended period, especially for applications that require continuous and long-term health monitoring. Herein, a new freestanding, wearable, multifunctional microneedle-based extended gate field effect transistor biosensor is fabricated for online detection of multiple biomarkers from the interstitial fluid including sodium, calcium, potassium, and pH along with excellent electrical response, reversibility, and precision. In addition, a hybrid powering system of triboelectric nanogenerator and solar cell was developed for creating a freestanding, closed-loop platform for continuous charging of the device's battery and integrated with an Internet of Things technology to broadcast the measurements online, suggesting a stand-alone, stable multifunctional tool which paves the way for advanced practical personalized health monitoring and diagnosis.
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Affiliation(s)
- Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, PR China
| | - Jing Wang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
| | - Majd Sublaban
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
| | - Walaa Saliba
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3GJ,United Kingdom
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion - Israel Institute of Technology, Haifa 320003, Israel
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Omar R, Zheng Y, Haick H. Protocol to fabricate wearable stretchable microneedle-based sensors. STAR Protoc 2023; 4:102751. [PMID: 37999973 PMCID: PMC10709397 DOI: 10.1016/j.xpro.2023.102751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Creating highly stretchable and robust electrodes while retaining conductivity and stability is challenging. Furthermore, combining these elastic parts with rigid ones brings its own problems due to the discrepancy in firmness between the flexible patches and rigid constructions. Here, we present a protocol to create a stable, conductive, and flexible microneedle sensor patch. We describe steps for using polystyrene-block-polyisoprene-block-polystyrene with silver nanowires, besides fabricating rigid microneedles and combining them together using a thickness-gradient strategy. For complete details on the use and execution of this protocol, please refer to Zheng et al. (2022).1.
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Affiliation(s)
- Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel; Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool L69 3GJ, UK.
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel.
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5
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Light A, Kanthabalan A, Pavlou M, Omar R, Adeleke S, Giganti F, Brew-Graves C, Emara A, Haroon A, Latifoltojar A, Sidhu H, Freeman A, Orczyk C, Nikapota A, Dudderidge T, Hindley R, Payne H, Mitra A, Bomanji J, Winkler M, Horan G, Punwani S, Ahmed H, Shah T. Tumor characteristics of multiparametric MRI-detected and -undetected lesions in patients with suspected radiorecurrent prostate cancer: An analysis from the FOcal RECurrent Assessment and Salvage Treatment (FORECAST) trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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6
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Maity A, Milyutin Y, Maidantchik VD, Pollak YH, Broza Y, Omar R, Zheng Y, Saliba W, Huynh T, Haick H. Ultra-Fast Portable and Wearable Sensing Design for Continuous and Wide-Spectrum Molecular Analysis and Diagnostics. Adv Sci (Weinh) 2022; 9:e2203693. [PMID: 36266981 PMCID: PMC9731699 DOI: 10.1002/advs.202203693] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/13/2022] [Indexed: 06/16/2023]
Abstract
The design and characterization of spatiotemporal nano-/micro-structural arrangement that enable real-time and wide-spectrum molecular analysis is reported and demonestrated in new horizons of biomedical applications, such as wearable-spectrometry, ultra-fast and onsite biopsy-decision-making for intraoperative surgical oncology, chiral-drug identification, etc. The spatiotemporal sesning arrangement is achieved by scalable, binder-free, functionalized hybrid spin-sensitive (<↑| or <↓|) graphene-ink printed sensing layers on free-standing films made of porous, fibrous, and naturally helical cellulose networks in hierarchically stacked geometrical configuration (HSGC). The HSGC operates according to a time-space-resolved architecture that modulate the mass-transfer rate for separation, eluation and detection of each individual compound within a mixture of the like, hereby providing a mass spectrogram. The HSGC could be used for a wide range of applictions, including fast and real-time spectrogram generator of volatile organic compounds during liquid-biopsy, without the need of any immunochemistry-staining and complex power-hungry cryogenic machines; and wearable spectrometry that provide spectral signature of molecular profiles emiited from skin in the course of various dietry conditions.
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Affiliation(s)
- Arnab Maity
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Yana Milyutin
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Vivian Darsa Maidantchik
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Yael Hershkovitz Pollak
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Yoav Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Walaa Saliba
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
| | - Tan‐Phat Huynh
- Laboratory of Molecular Science and EngineeringFaculty of Science and EngineeringAbo Akademi UniversityHenrikinkatu 2TurkuFI‐20500Finland
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology InstituteTechnion – Israel Institute of TechnologyHaifa3200003Israel
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7
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Omar R, Sarkar P, Mamun A, Mitchell D, Kommu S. A simple stitch to aid dorsal vein complex ligation with subsequent completion of robot assisted radical prostatectomy at sustained low-pressure pneumoperitoneum. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02155-3] [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: 11/05/2022] Open
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8
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Zakeri R, Carnemolla A, Marvasti P, Mok J, Jassil F, Chaiyasoot K, Lichfield J, Alves M, Mansoor R, Omar R, Batterham R. O106 Maximising the benefits of bariatric surgery through targeting ghrelin: a randomised, double-blind, placebo-controlled crossover study in people with suboptimal weight loss after bariatric surgery. Br J Surg 2022. [DOI: 10.1093/bjs/znac242.106] [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: 11/06/2022]
Abstract
Abstract
Introduction
One in 5 people have a suboptimal weight-loss (WL) response to bariatric surgery. The causes are unclear, but patients report resumed hunger and increased food intake, eating behaviours driven by the orexigenic hormone, ghrelin. This proof-of-concept study aimed to evaluate the impact of reducing circulating acyl-ghrelin, the biologically active isoform, on appetite and energy intake in people with suboptimal WL and aberrant ghrelin profile after bariatric surgery.
Methods
Thirty-five patients with <20%WL from 12 months after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) and aberrant circulating ghrelin profile underwent 10 days of treatment with a novel, highly-selective ghrelin o-acyltransferase inhibitor, GLWL-01, and placebo. The primary endpoint was within-person change in ad libitum energy intake during a test meal on day 10. Secondary endpoints assessed subjective appetite, food cravings, macronutrient intake, gut hormones, cardiometabolic profile and body composition. Ethical approval was obtained.
Results
Thirty-one participants (26 RYGB, 9 SG) completed both cycles. GLWL-01 produced a 58.9±27.2% decrease in fasting plasma acyl-ghrelin and 29.3±27.1% increase in desacyl-ghrelin after 10 days. Marked reduction in subjective hunger, food cravings and hedonic influence on appetite was observed with GLWL-01, however objective appetite measures – ad libitum and free-living energy intake – did not change. Circulating levels of cardiovascular risk-conferring lipoproteins significantly improved and no adverse impact on glycaemic control was observed.
Conclusion
Pharmacological modulation of the ghrelin system may be used as part of a personalised therapeutic approach to optimise clinical outcomes in patients with suboptimal WL after bariatric surgery.
Take-home message
This first-in-human mechanistic study shows that pharmacological modulation of the ghrelin system is a promising therapeutic strategy for maximising weight loss response to bariatric surgery.
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Affiliation(s)
- R Zakeri
- Centre for Obesity Research, University College London
- Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Foundation Trust
- National Institute of Health Research UCLH Biomedical Research Centre
| | - A Carnemolla
- Centre for Obesity Research, University College London
| | - P Marvasti
- Centre for Obesity Research, University College London
| | - J Mok
- Centre for Obesity Research, University College London
- Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Foundation Trust
| | - F Jassil
- Centre for Obesity Research, University College London
- Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Foundation Trust
| | - K Chaiyasoot
- Centre for Obesity Research, University College London
- Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Foundation Trust
| | - J Lichfield
- Centre for Obesity Research, University College London
| | - M Alves
- Unit for Multidisciplinary Research in Biomedicine, University of Porto
| | - R Mansoor
- Department of Statistical Science, University College London
| | - R Omar
- Department of Statistical Science, University College London
| | - R Batterham
- Centre for Obesity Research, University College London
- Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Foundation Trust
- National Institute of Health Research UCLH Biomedical Research Centre
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9
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Zheng Y, Omar R, Zhang R, Tang N, Khatib M, Xu Q, Milyutin Y, Saliba W, Broza YY, Wu W, Yuan M, Haick H. A Wearable Microneedle-Based Extended Gate Transistor for Real-Time Detection of Sodium in Interstitial Fluids. Adv Mater 2022; 34:e2108607. [PMID: 34918409 DOI: 10.1002/adma.202108607] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Sodium is a prominent prognostic biomarker for assessing health status, such as dysnatremia. As of now, detection and monitoring of sodium levels in the human body is carried out by means of laborious and bulky laboratory equipmentand/or by offline analysis of various body fluids. Herein, an innovative stretchable, skin-conformal and fast-response microneedle extended-gate FET biosensor is reported for real-time detection of sodium in interstitial fluids for minimally invasive health monitoring along with high sensitivity, low limit of detection, excellent biocompatibility, and on-body mechanical stability. The integration of the reported device with a wireless-data transmitter and the Internet-of-Things cloud for real-time monitoring and long-term analysis is reported and discussed. This platform would eventually help bringing unlimited possibilities for effecient medical care and accurate clinical decision-making.
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Affiliation(s)
- Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Rongjun Zhang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, P. R. China
- Institute of Molecular Medicine (IMM), Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200240, P. R. China
| | - Ning Tang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Muhammad Khatib
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Qi Xu
- Institute of Nanoscience and Nanotechnology, School of Materials and Energy, Lanzhou University, Lanzhou, 730000, P. R. China
| | - Yana Milyutin
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Walaa Saliba
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Yoav Y Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710126, P. R. China
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, P. R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an, 710126, P. R. China
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10
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Tang N, Zhang R, Zheng Y, Wang J, Khatib M, Jiang X, Zhou C, Omar R, Saliba W, Wu W, Yuan M, Cui D, Haick H. Highly Efficient Self-Healing Multifunctional Dressing with Antibacterial Activity for Sutureless Wound Closure and Infected Wound Monitoring. Adv Mater 2022; 34:e2106842. [PMID: 34741350 DOI: 10.1002/adma.202106842] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [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: 08/30/2021] [Revised: 10/10/2021] [Indexed: 05/17/2023]
Abstract
Wound healing represents a major clinical and public healthcare problem that is frequently challenged by infection risks, detrimental consequences on the surrounding tissues, and difficulties to monitor the healing process. Here we report on a novel self-healing, antibacterial, and multifunctional wound dressing for sutureless wound closure and real-time monitoring of the healing parameters. The self-healing elastomer contains cetyltrimethylammonium bromide (CTAB) and has high mechanical toughness (35 MJ m-3 ), biocompatibility, and outstanding antibacterial activity (bactericidal rate is ≈90% in 12 h), enabling the wound dressing to effectively inhibit bacterial growth and accelerate infected wound healing. In vivo tests based on full-thickness skin incision model shows that the multifunctional wound dressing can help in contracting wound edges and facilitate wound closure and healing, as could be evidenced by notably dense and well-organized collagen deposition. The test provides an evidence that the integrated sensor array within the multifunctional wound dressing can monitor temperature, pH, and glucose level of the wound area in real-time, providing reliable and timely information of the condition of the wound. Ultimately, the reported multifunctional dressing would be of high value in managing the burden associated with wound healing via personalised monitoring and treatment approaches, digital and other people-centred solutions for health care.
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Affiliation(s)
- Ning Tang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, P. R. China
| | - Rongjun Zhang
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Jing Wang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Muhammad Khatib
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Xue Jiang
- School of Advanced Materials and Nanotechnology, Xidian University, Xi'an, 710126, P. R. China
| | - Cheng Zhou
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, P. R. China
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Walaa Saliba
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Xidian University, Xi'an, 710126, P. R. China
| | - Miaomiao Yuan
- The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Daxiang Cui
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, P. R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa, 3200003, Israel
- School of Advanced Materials and Nanotechnology, Xidian University, Xi'an, 710126, P. R. China
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11
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Abstract
The sustainable operation of wearable sensors plays an important role in continuous and longtime health monitoring. Conventional batteries, which are bulky and rigid, do not satisfy these requirements and, rather, cause additional economic burdens and environmental problems by regular replacement of power sources. This article provides a review on an alternative solution in the form of self-powered devices that can harvest energy from the surrounding environment to support the operation of the wearable sensor. The Review starts with an introduction of the self-powered triboelectric nanosensors (TENSs) and its two independent modules: the energy harvester and the sensing module. The Review continues with the TENS-related bioinspired designs for wearable applications, while providing a bird's-eye view of their characteristics and applications. The ongoing challenges and prospects for providing personal healthcare with self-powered TENS are presented and discussed.
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Affiliation(s)
- Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Zhipeng Hu
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Tuan Duong
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Jing Wang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, Haifa 3200003, Israel.,School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi'an 710126, P. R. China
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Zheng Y, Tang N, Omar R, Hu Z, Duong T, Wang J, Wu W, Haick H. Smart Materials Enabled with Artificial Intelligence for Healthcare Wearables. Adv Funct Materials 2021; 31. [DOI: 10.1002/adfm.202105482] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Indexed: 08/30/2023]
Abstract
AbstractContemporary medicine suffers from many shortcomings in terms of successful disease diagnosis and treatment, both of which rely on detection capacity and timing. The lack of effective, reliable, and affordable detection and real‐time monitoring limits the affordability of timely diagnosis and treatment. A new frontier that overcomes these challenges relies on smart health monitoring systems that combine wearable sensors and an analytical modulus. This review presents the latest advances in smart materials for the development of multifunctional wearable sensors while providing a bird's eye‐view of their characteristics, functions, and applications. The review also presents the state‐of‐the‐art on wearables fitted with artificial intelligence (AI) and support systems for clinical decision in early detection and accurate diagnosis of disorders. The ongoing challenges and future prospects for providing personal healthcare with AI‐assisted support systems relating to clinical decisions are presented and discussed.
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Affiliation(s)
- Youbin Zheng
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Ning Tang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Rawan Omar
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Zhipeng Hu
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
- School of Chemistry Xi'an Jiaotong University Xi'an 710126 P. R. China
| | - Tuan Duong
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Jing Wang
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology Interdisciplinary Research Center of Smart Sensors Xidian University Xi'an 710126 P. R. China
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute Technion‐Israel Institute of Technology Haifa 3200003 Israel
- School of Advanced Materials and Nanotechnology Interdisciplinary Research Center of Smart Sensors Xidian University Xi'an 710126 P. R. China
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Ali A, McKenzie E, Hassiotis A, Priebe S, Lloyd‐Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. A pilot randomised controlled trial of befriending by volunteers in people with intellectual disability and depressive symptoms. J Intellect Disabil Res 2021; 65:1010-1019. [PMID: 34570405 PMCID: PMC9291894 DOI: 10.1111/jir.12886] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to experience chronic depression compared with the general population, which may be compounded by loneliness and lower levels of social support. Befriending aims to provide social support and promote engagement in community activities. No randomised controlled trials have examined whether befriending improves symptoms of depression and social outcomes in people with ID. The aim of this pilot trial was to assess the feasibility and acceptability of a future larger trial of one-to-one befriending by volunteers in people with ID and depressive symptoms. METHODS Participants were adults with mild or moderate ID with a score of 5 or more on the Glasgow Depression Scale for People with Learning Disabilities (GDS-LD). They were randomised to the intervention arm (matched to a volunteer befriender for 6 months) or the control arm (usual care). Volunteers received training and supervision provided by two community befriending schemes. The main outcomes were feasibility of recruitment (minimum target n = 35), retention rate of participants, adherence (minimum 10 meetings), acceptability of the intervention, changes in depressive symptoms (assessed at baseline and 6 months) and feasibility of collecting data for a health economic analysis. RESULTS Recruitment was challenging, and only 16 participants with ID and 10 volunteers were recruited. Six participants were matched with a volunteer and no participants dropped out (except for two volunteers). Four participants completed 10 meetings (mean 11.8). Befriending was thought to be acceptable, but modifications were suggested. An exploratory analysis suggested that GDS-LD score was lower in the intervention group compared with the control group after adjusting for baseline scores, but not significant (adjusted mean difference: -4.0; 95% confidence interval: -11.2 to 3.2). CONCLUSIONS A large trial would not be feasible based on the recruitment strategies employed in this study. A further feasibility study addressing these challenges or the use of other study designs should be considered.
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Affiliation(s)
- A. Ali
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - E. McKenzie
- Research and Development OfficeGoodmayes Hospital, North East London NHS Foundation TrustLondonUK
| | - A. Hassiotis
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - S. Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services DevelopmentQueen Mary University of LondonLondonUK
| | - B. Lloyd‐Evans
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - R. Jones
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - M. Panca
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - R. Omar
- Department of Statistical ScienceUniversity College LondonLondonUK
| | - S. Finning
- Outward HousingOutward, Newlon HouseLondonUK
| | - S. Moore
- The Befriending SchemeSudburySuffolkUK
| | - C. Roe
- The Befriending SchemeSudburySuffolkUK
| | - M. King
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
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Omar R, Shaik M, Griggs C, Jensen JD, Boyd R, Oncel N, Webster DC, Du G. Star-shaped Poly(hydroxybutyrate)s from bio-based polyol cores via zinc catalyzed ring-opening polymerization of β-Butyrolactone. Eur Polym J 2021. [DOI: 10.1016/j.eurpolymj.2021.110756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Norrish G, Qu C, Field E, Cervi E, Elliott P, Ho C, Omar R, Kaski JP. External validation of the HCM Risk-Kids model for predicting sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sudden cardiac death (SCD) is the most common mode of death in childhood hypertrophic cardiomyopathy (HCM). The newly developed HCM Risk-Kids model provides clinicians with individualised estimates of risk. The aim of this study was to externally validate the model in a large independent, multi-centre patient cohort.
Methods
A retrospective, longitudinal cohort of patients diagnosed with HCM aged 1–16 years independent of the HCM-Risk-Kids development and internal validation cohort was studied. Data on HCM Risk-Kids predictor variables (unexplained syncope, non-sustained ventricular tachycardia, maximal left ventricular wall-thickness, left atrial diameter and left ventricular outflow tract gradient) were collected from the time of baseline clinical evaluation. The performance of the HCM Risk-Kids model in predicting risk at 5 years was assessed.
Results
The cohort consisted of 421 patients with a median age at baseline evaluation of 12.3 years (IQR 7.3, 14.4). Over a median total follow up 3.48 years (IQR 1.83, 6.62, range 1 month – 20.7 years). Fourteen patients (3.3%) died and 10 (2.4%) underwent cardiac transplantation. Twenty-three patients (5.4%) met the SCD end-point within 5-years, with an overall incidence rate of 2.03 per 100 patient years (95% CI 1.48–2.78). Model validation showed a Harrell's C-index of 0.745 (95% CI 0.52–0.97) and Uno's C-index 0.714 (95% 0.58–0.85) with a calibration slope of 1.15 (95% 0.51–1.80). Figure 1a describes the agreement between predicted and observed 5-year cumulative proportion of SCD or equivalent events for each tertile of predicted risk in one imputed data set. One hundred and twenty-five (29.7%) patients had a predicted 5-year risk of ≥6%. SCD events occurred in 6 patients (2.0%) with a predicted risk <6% and 17 (13.6%) with a predicted risk ≥6. A 5-year predicted risk threshold of ≥6% identified 17 (73.9%) SCD-events with a corresponding C-statistic of 0.702 (95% CI 0.60–0.81) (Figure 1b).
Conclusions
This study reports the first external validation of the HCM Risk-Kids model in a large and geographically diverse patient population. A 5-year predicted risk of ≥6% identified over 70% of events, confirming that HCM Risk-Kids provides a method for individualised risk predictions and shared decision making in children with HCM. Incorporation of the model into routine clinical care will enable independent prospective model validation and assessment of the effect of its use in clinical practice.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): British Heart FoundationMedical Research Council Observed vs predicted risk by tertilesObserved vs predicted by threshold
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Affiliation(s)
- G Norrish
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
| | - C Qu
- University College London, Department of statistical science, London, United Kingdom
| | - E Field
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
| | - E Cervi
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
| | - P Elliott
- Barts Health NHS Trust, St Bartholomew's Centre for Inherited Cardiovascular Diseases, London, United Kingdom
| | - C Ho
- Brigham and Women's Hospital, Cardiovascular division, Boston, United States of America
| | - R Omar
- University College London, Department of statistical science, London, United Kingdom
| | - J P Kaski
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
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Nur Rafidah M, Mohd Wafi M, Sazlina K, Omar R. Improving management of visually impaired patients from occupational therapy perspective: A case report. Med J Malaysia 2021; 76:578-582. [PMID: 34305123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The ability to detect and recognise visual deficits among visually impaired patients can improve the management of daily living skills and activities of these patients. In this report, the importance of using objective and subjective visual performance measures by occupational therapists in managing visually impaired patients is discussed. We describe a case of a 17-year-old Malay female who had vision impairment due to a cataract, a secondary complication from diabetes mellitus (DM). The Brain Injury Visual Assessment Battery for Adult (biVABA) can provide occupational therapists with additional visual performance information and a better understanding of managing visually impaired patients. The biVABA was used in conjunction with other activities of daily living skills tools such as Modified Barthel Index (MBI), Lawton Instrumental Activities of Daily Living Scale (IADL) and EVS Orientation and Mobility Screening (EVS-O&M) for a more holistic assessment. This approach provides more relevant and essential information in managing visually impaired patient rehabilitation from the occupational therapy perspective.
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Affiliation(s)
- M Nur Rafidah
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Occupational Therapy Program, Kuala Lumpur, Malaysia
| | - M Mohd Wafi
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Occupational Therapy Program, Kuala Lumpur, Malaysia
| | - K Sazlina
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Occupational Therapy Program, Kuala Lumpur, Malaysia
| | - R Omar
- Universiti Kebangsaan Malaysia, Faculty of Health Sciences, Optometry & Vision Science Program, Kuala Lumpur, Malaysia.
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Affiliation(s)
- Orr Zohar
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
| | - Muhammad Khatib
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
| | - Rawan Omar
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
| | - Rotem Vishinkin
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
| | - Yoav Y. Broza
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
| | - Hossam Haick
- Department of Chemical Engineering and the Russell Berrie Nanotechnology Institute Technion–Israel Institute of Technology Haifa Israel
- School of Advanced Materials and Nanotechnology Xidian University Xi'an Shaanxi P. R. China
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Norrish G, Ding T, Field E, O'Mahony C, Elliott P, Omar R, Kaski J. The relationship between left ventricular outflow tract gradient and sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0732] [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
The most common mode of death in childhood hypertrophic cardiomyopathy (HCM) is sudden cardiac death (SCD). Left ventricular outflow tract obstruction (LVOTO) is an established risk factor for SCD in adults with the disease. In contrast, the prognostic implications of LVOTO in childhood disease is unclear, with recent studies suggesting that it may have an inverse relationship with the risk of SCD.
Purpose
The aim of this study was to explore the role of LVOTO and the risk of SCD in childhood HCM.
Methods
A multi-centre, retrospective, longitudinal cohort of 871 children (diagnosed with HCM <16 years of age) was used to explore the relationship between SCD and LVOTO (LVOT gradient ≥30mmHg).
Results
189 patients (23%) had LVOTO, which was mild (30–50mmHg), moderate (50–100mmHg) or severe (>100mmHg) in 58 (6.7%), 98 (11.3%) and 33 (3.8%), respectively. The risk of SCD showed an inverse relation to LVOT gradient severity compared to those with no obstruction: mild HR 1.75 (95% CI 0.89–3.44), moderate HR 1.04 (95% 0.55–1.98), and severe HR 0.7 (0.36–1.35) [figure].On univariable analysis [table] LVOTO was associated with heart failure symptoms (NYHA>1) [p <0.001], maximal wall thickness (MWT) [p <0.001], left atrial (LA) diameter [p <0.001], and future myectomy occurring during follow up [p <0.001]. The inverse relationship observed was not altered by the presence or absence of other traditional risk factors.
Conclusions
LVOTO appears to have a complex relationship with the risk of SCD in childhood HCM, with multiple contributing factors. The pathophysiological mechanisms behind this observation need further exploration, which may be limited by low patient numbers
Cummulative incidence of SCD by LVOTO
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): British Heart Foundation
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Affiliation(s)
- G Norrish
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
| | - T Ding
- University College London, Department of Statistical Science, London, United Kingdom
| | - E Field
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
| | - C O'Mahony
- Barts Health NHS Trust, London, United Kingdom
| | - P.M Elliott
- Barts Health NHS Trust, London, United Kingdom
| | - R Omar
- University College London, Department of Statistical Science, London, United Kingdom
| | - J.P Kaski
- Great Ormond Street Hospital for Children, Inherited Cardiovascular Disease, London, United Kingdom
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Eldesoky A, Omar R, Elshahat A, Magdy Halim M, Fouda M. Dosimetric evaluation of hypofractionated 3D conformal whole breast radiotherapy (HF-WBRT) with simultaneous integrated boost (SIB) after conservative breast surgery for early stage breast cancer. Breast 2019. [DOI: 10.1016/s0960-9776(19)30293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mohd Thani N, Mustapa Kamal S, Taip F, Sulaiman A, Omar R. Effect of enzyme concentrations on total reducing sugar from leftover croissants and doughnuts via enzymatic hydrolysis. Food Res 2019. [DOI: 10.26656/fr.2017.3(4).140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Björkman A, Shakely D, Ali AS, Morris U, Mkali H, Abbas AK, Al-Mafazy AW, Haji KA, Mcha J, Omar R, Cook J, Elfving K, Petzold M, Sachs MC, Aydin-Schmidt B, Drakeley C, Msellem M, Mårtensson A. From high to low malaria transmission in Zanzibar-challenges and opportunities to achieve elimination. BMC Med 2019; 17:14. [PMID: 30665398 PMCID: PMC6341737 DOI: 10.1186/s12916-018-1243-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substantial global progress in the control of malaria in recent years has led to increased commitment to its potential elimination. Whether this is possible in high transmission areas of sub-Saharan Africa remains unclear. Zanzibar represents a unique case study of such attempt, where modern tools and strategies for malaria treatment and vector control have been deployed since 2003. METHODS We have studied temporal trends of comprehensive malariometric indices in two districts with over 100,000 inhabitants each. The analyses included triangulation of data from annual community-based cross-sectional surveys, health management information systems, vital registry and entomological sentinel surveys. RESULTS The interventions, with sustained high-community uptake, were temporally associated with a major malaria decline, most pronounced between 2004 and 2007 and followed by a sustained state of low transmission. In 2015, the Plasmodium falciparum community prevalence of 0.43% (95% CI 0.23-0.73) by microscopy or rapid diagnostic test represented 96% reduction compared with that in 2003. The P. falciparum and P. malariae prevalence by PCR was 1.8% (95% CI 1.3-2.3), and the annual P. falciparum incidence was estimated to 8 infections including 2.8 clinical episodes per 1000 inhabitants. The total parasite load decreased over 1000-fold (99.9%) between 2003 and 2015. The incidence of symptomatic malaria at health facilities decreased by 94% with a trend towards relatively higher incidence in age groups > 5 years, a more pronounced seasonality and with reported travel history to/from Tanzania mainland as a higher risk factor. All-cause mortality among children < 5 years decreased by 72% between 2002 and 2007 mainly following the introduction of artemisinin-based combination therapies whereas the main reduction in malaria incidence followed upon the vector control interventions from 2006. Human biting rates decreased by 98% with a major shift towards outdoor biting by Anopheles arabiensis. CONCLUSIONS Zanzibar provides new evidence of the feasibility of reaching uniquely significant and sustainable malaria reduction (pre-elimination) in a previously high endemic region in sub-Saharan Africa. The data highlight constraints of optimistic prognostic modelling studies. New challenges, mainly with outdoor transmission, a large asymptomatic parasite reservoir and imported infections, require novel tools and reoriented strategies to prevent a rebound effect and achieve elimination.
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Affiliation(s)
- A Björkman
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.
| | - D Shakely
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A S Ali
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - U Morris
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden
| | - H Mkali
- MEASURE Evaluation, Dar es Salaam, Tanzania
| | - A K Abbas
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - A-W Al-Mafazy
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - K A Haji
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - J Mcha
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - R Omar
- Zanzibar Malaria Elimination Programme, Zanzibar, Tanzania
| | - J Cook
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,London School of Hygiene and Tropical Medicine, London, UK
| | - K Elfving
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden.,Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden
| | - M Petzold
- Centre for Applied Biostatistics, University of Gothenburg, Gothenburg, Sweden
| | - M C Sachs
- Biostatistics Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B Aydin-Schmidt
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden
| | - C Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | - M Msellem
- Training and Research, Mnazi Mmoja Hospital, Zanzibar, Tanzania
| | - A Mårtensson
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Khalil M, Sherif H, Mohey A, Omar R. Utility of the Guy’s Stone Score in predicting different aspects of percutaneous nephrolithotomy. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Ramakrishnan N, Muhammad Z, Koh K, Rebo R, Khalea S, Omar R, Hussin A. P4818Role of new oral anticoagulants in left atrial occluder device implants. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4818] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- N Ramakrishnan
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - Z Muhammad
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - K Koh
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - R Rebo
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - S Khalea
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - R Omar
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
| | - A Hussin
- National Heart Institute, Cardiology, Kuala Lumpur, Malaysia
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Alazaby H, Khalil M, Omar R, Mohey A, Gharib T, Abo-Taleb A, El-Barky E. Outcome of retrograde flexible ureterorenoscopy and laser lithotripsy for treatment of multiple renal stones. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.01.002] [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: 10/18/2022] Open
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Hasan P, Sham S, Thambiah S, Samsudin I, Ismail I, Abdul Aziz A, Anthonysamy C, Omar R. Diagnostic Accuracy of an Accelerated Protocol Among Chest Pain Patients in the Emergency Department, Hospital Serdang. Int J Cardiol 2017. [DOI: 10.1016/j.ijcard.2017.09.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Navaratnam R, Bolkim D, Sundram R, Jaafar N, Zaimudin F, Rebo R, Omar R, Narasamuloo K, Wan Rahimi Shah W, Tan B, Krishinan S, Lim M, Tiong L, Ong T, Fong A, Abdul Latif N, Chai H, Tan Y, Lim A, Lim C, Chua A, Ahmad N, Kwong C, Yap L. A Multicentre Experience of Novel Anticoagulation and Warfarin for Use for Stroke Prevention in Atrial Fibrillation. Int J Cardiol 2017. [DOI: 10.1016/j.ijcard.2017.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kelmansky R, Shagan A, Rozenblit B, Omar R, Lufton M, Mizrahi B. In Situ Dual Cross-Linking of Neat Biogel with Controlled Mechanical and Delivery Properties. Mol Pharm 2017; 14:3609-3616. [DOI: 10.1021/acs.molpharmaceut.7b00736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Regina Kelmansky
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
| | - Alona Shagan
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
| | - Boris Rozenblit
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
| | - Rawan Omar
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
| | - Maayan Lufton
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
| | - Boaz Mizrahi
- Faculty of Biotechnology
and Food Engineering, Technion, Haifa 32000, Israel
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Khan S, Chikte UM, Omar R. Outcomes with a posterior reduced dental arch: a randomised controlled trial. J Oral Rehabil 2017; 44:870-878. [DOI: 10.1111/joor.12549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2017] [Indexed: 11/27/2022]
Affiliation(s)
- S. Khan
- Department of Restorative Dentistry; Faculty of Dentistry; University of the Western Cape; Cape Town South Africa
| | - U. M. Chikte
- Department of Community Health; Faculty of Health Sciences; University of Stellenbosch; Cape Town South Africa
| | - R. Omar
- Department of Prosthodontics; Faculty of Dentistry; Kuwait University; Safat Kuwait
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Lim SM, Thambiah SC, Zahari Sham SY, Omar R, Hambali Z, Samsudin IN. Determination of the 99th percentile upper reference limit for high-sensitivity cardiac troponin I in Malaysian population. Malays J Pathol 2017; 39:135-140. [PMID: 28866694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Introduction of high-sensitivity cardiac troponin I (hscTn I) assays for routine clinical use in Malaysia requires determination of the 99th percentile upper reference limit (URL) for each assay to suit local context. Hence, this study aimed to determine the 99th percentile URL for hscTn I in the Malaysian population. A total of 250 (120 males and 130 females) healthy Malaysian blood donors aged 18 to 60 years old were recruited. Blood samples for hscTn I were measured using Abbott Diagnostics hscTn I assay on Architect i2000sr analyser. The 99th percentile was calculated using a non-parametric method and gender specific results were compared. The 99th percentile URL for hscTn I for the overall population was 23.7 ng/L, with gender specific values being 29.9 ng/L and 18.6 ng/L for male and female, respectively. Females had significantly lower hscTn I compared to males. This study confirms the use of gender specific 99th percentile URL for hscTn I for clinical use in a multi-ethnic Malaysian population.
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Affiliation(s)
- S M Lim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Pathology, Malaysia.
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Omar R, Bardoogo YL, Corem-Salkmon E, Mizrahi B. Amphiphilic star PEG-Camptothecin conjugates for intracellular targeting. J Control Release 2017; 257:76-83. [DOI: 10.1016/j.jconrel.2016.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 09/19/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022]
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Rahimi MA, Omar R, Ethaib S, Siti Mazlina MK, Awang Biak DR, Nor Aisyah R. Microwave-assisted extraction of lipid from fish waste. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1757-899x/206/1/012096] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Phillips K, Santoso T, Sanders P, Alison J, Chan JLK, Pak H, Chandavimol M, Ghamdi MAL, Stein K, Shanker A, Omar R. Percutaneous Left Atrial Appendage Closure with the WATCHMAN Device: 12 Month Outcomes from the WASP Asia-Pacific Registry. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yap LB, Nguyen STB, Qadir F, Ma SK, Muhammad Z, Koh KW, Ali Z, Tay GS, Daud A, Said A, Sahat N, Rebo R, Tamin SS, Hussin A, Kaur S, Omar R. A comparison of long-term outcomes between narrow and broad QRS complex patients treated with cardiac resynchronization therapy. Acta Cardiol 2016; 71:323-330. [PMID: 27594128 DOI: 10.2143/ac.71.3.3152093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Zomer E, Osborn D, Nazareth I, Blackburn R, Burton A, Hardoon S, Holt R, King M, Marston L, Morris S, Omar R, Petersen I, Walters K, Hunter R. Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionCardiovascular risk prediction tools are important for cardiovascular disease (CVD) prevention, however, which algorithms are appropriate for people with severe mental illness (SMI) is unclear.Objectives/aimsTo determine the cost-effectiveness using the net monetary benefit (NMB) approach of two bespoke SMI-specific risk algorithms compared to standard risk algorithms for primary CVD prevention in those with SMI, from an NHS perspective.MethodsA microsimulation model was populated with 1000 individuals with SMI from The Health Improvement Network Database, aged 30–74 years without CVD. Four cardiovascular risk algorithms were assessed; (1) general population lipid, (2) general population BMI, (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those high-risk (> 10%) were assumed to be prescribed statin therapy, others received usual care. Individuals entered the model in a ‘healthy’ free of CVD health state and with each year could retain their current health state, have cardiovascular events (non-fatal/fatal) or die from other causes according to transition probabilities.ResultsThe SMI-specific BMI and general population lipid algorithms had the highest NMB of the four algorithms resulting in 12 additional QALYs and a cost saving of approximately £37,000 (US$ 58,000) per 1000 patients with SMI over 10 years.ConclusionsThe general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of a SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Omar R, Knight VF, Aziz Mohammed MA. Low vision rehabilitation and ocular problems among industrial workers in a developing country. Malays Fam Physician 2014; 9:27-33. [PMID: 26425302 PMCID: PMC4568723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Work-related ocular injuries and illnesses were among the major causes of job absenteeism. This study was conducted to determine if low vision rehabilitation was provided following work-related ocular problems among industrial workers in a developing country. This was a retrospective analysis of case records. METHOD Randomly selected records of all employees from the Social Security Organization (SOCSO) Medical Board for 2004 who suffered from ocular injuries and illnesses were selected. Rates of ocular injuries and illnesses according to age, gender, races, types of injuries, types of industries, visual rehabilitation and types of medical interventions were tabulated and analysed. RESULTS A total of 26 cases of ocular injuries and illnesses were identified where 46.2% suffered from ocular injuries. The remaining 53.8% had ocular and/or systemic diseases. The 40-49-yearold age group suffered the greatest number of injuries (26.92%). Ocular perforating injuries (66.67%) and ocular contusions (33.33%) were the most common types of ocular injury among industrial workers in Kuala Lumpur. Most injuries occurred among workers in the service industry (50%). Almost 60% of these injured workers did not receive any low vision rehabilitation after medical intervention while 25% were given contact lenses or spectacles as rehabilitation and remaining had surgery. CONCLUSION The low vision rehabilitation is still unexplored in the management of ocular injuries and illnesses among industrial workers. Introducing low vision rehabilitation can benefit both workers and employers as it provides care beyond spectacles or contact lens prescriptions.
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Affiliation(s)
- R Omar
- Rokiah Omar BOptom, PhD Optometry & Vision Sciences Programme, Schol of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur Malaysia
| | - V F Knight
- Victor Feizal Knight MBBS, MHP Faculty of Medicine and Health Defence, National Defence University, Kem Sg Besi, Kuala Lumpur, Malaysia
| | - M A Aziz Mohammed
- NMohammed MBBS (UM), LFOM (Ireland), C.I.M.W (ABIME USA), FFOM (Ireland), MBA (OXEL) Social Security Organisations (SOCSO), Menara PERKESO, Jalan Ampang, Kuala Lumpur, Malaysia
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Affiliation(s)
- M.F. Zanil
- UM Power Energy Dedicated Advanced Centre (UMPEDAC), Level 4, Wisma R&D, Malaysia
- Department of Chemical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - A.M. Norhuda
- Department of Chemical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - M.A. Hussain
- UM Power Energy Dedicated Advanced Centre (UMPEDAC), Level 4, Wisma R&D, Malaysia
- Department of Chemical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - R. Omar
- Department of Electrical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Ismail S, Darwish NT, Teoh TC, Abdulla MA, Omar R. Idala: An unnamed Function Peptide Vaccine for Tuberculosis. TROP J PHARM RES 2013. [DOI: 10.4314/tjpr.v11i6.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
AIM To assess clinicians' individual variables that might influence decision-making for the restoration of deep proximal carious lesions in primary molars. METHODS A pre-coded questionnaire that sought participants' treatment choices for a deeply carious second mandibular primary molar, as depicted in a simulated periapical radiograph, along with a specific clinical scenario, was distributed among a random sample of 157 dentists and 15 paediatric dentists. Participants were asked to answer questions. After combining the pulpotomy and pulpectomy treatment choices under a 'pulp therapy' category, a binary dependent variable was constructed. Logistic regression of the ratio of the participants who would restore the questioned tooth by a method in question, was run. RESULTS A total of 155 dentists (116 males and 39 females) completed the survey, giving a response rate of 90%. Of these 53% of dentists recommended pulpotomy followed by definitive restoration and 39% recommended removal of caries and restoration without pulp therapy. In the logistic regression model, males and graduates of English language undergraduate dental programs had higher probabilities of restoring without prior pulp therapy (p<0.03 and p<0.02, respectively). Compared with graduates of Asian programs, dentists who graduated from Eastern Europe and the Middle East, showed lower likelihoods of restoring the tooth without prior pulp therapy (p<0.01 and p<0.004, respectively). Dentists who treated an average of 6-16 child patients during a week had a lower probability of restoring the tooth without prior pulp therapy than those who were not currently involved in treating children (p<0.01). No other measured variables were associated with participant's treatment choices. CONCLUSIONS The lack of agreement among dentists regarding their optimal treatment recommendations for deep proximal carious lesions appears to be due mainly to inter-individual, educational, training and practice characteristic factors.
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Affiliation(s)
- M A Qudeimat
- Dept. Developmental and Preventive Sciences, Kuwait University, Kuwait.
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Abstract
This study assessed the awareness, knowledge and practice of evidence-based dentistry (EBD) amongst dentists working in the public sector in Kuwait. Of the 150 randomly selected dentists from all five health districts in Kuwait who had originally been approached, 120 participated by completing a pre-tested, self-administered questionnaire (80% response rate). Whereas 60.9% of the group stated that they practice EBD most of the time, fewer (40.8%) had a reasonable understanding of EBD based upon tested knowledge scores of EBD-related topics. Clinical decisions appeared to be mostly based on the clinician's own judgment (73.3%) rather than on evidence-based sources such as PubMed (28.3%) or the Cochrane Library (6.7%). A number of within-group differences were noted, with women (P<0.05), those working in a particular district (P<0.05), those with <10years' experience (P=0.05), those whose first dental qualification had been obtained in Kuwait (P<0.05), and those who had had any EBD training (P<0.05) showing greater knowledge of EBD. Training in EBD was felt necessary by a majority of the group, and this may be facilitated if dental centres have access to evidence-based sources to remove some of the possible barriers to implementation of EBD.
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Navani N, Lawrence DR, Kolvekar S, McAsey D, Omar R, Morris S, Janes SM. S56 EBUS-TBNA prevents mediastinoscopies in patients with isolated mediastinal lymphadenopathy: A prospective clinical trial and cost minimisation analysis. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.56] [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: 11/03/2022]
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Abstract
This study explored the nature of the unprompted information that clinicians seek before making a treatment decision and whether this decision corresponded with the clinical parameters of the case. Interns, general practitioners (GP) and prosthodontists (n = 70, mean age 33 years, range 23-68) were presented with a written vignette of partial edentulism that included two spaces and were invited to ask any questions for the purpose of making a treatment recommendation. A list of 48 potential question/answer items was available to the interviewer, of which 38 were asked. These were then allotted to four thematic categories. Mean number of questions asked did not differ significantly amongst groups, although prosthodontists asked significantly more questions in the 'clinical and radiographic information' category than GPs (P = 0.0001) and interns (P = 0.003). The relationship between a prescribed treatment and questions asked was tested by dichotomizing all recommendations into 'possible' or 'not possible' based on the authors' knowledge of the actual case history. There were no significant differences amongst the groups in the frequency of prescribing 'possible' treatment (Pearson chi-square 0.083 and 0.108 for upper and lower spaces, respectively), but those who prescribed 'possible' treatment asked significantly more questions in the 'clinical and radiographic information' category, specifically about bone adequacy in the edentulous areas: upper jaw (P = 0.0001) and lower jaw (P = 0.003). It may be concluded that prosthodontists generally opted for more 'possible' treatments, as well as seeking items of information that seemed to improve the chance of making recommendations that conformed to the actual case characteristics.
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Affiliation(s)
- R Omar
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait.
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Gordon E, Rohrer JD, Kim LG, Omar R, Rossor MN, Fox NC, Warren JD. Measuring disease progression in frontotemporal lobar degeneration: a clinical and MRI study. Neurology 2010; 74:666-73. [PMID: 20177120 DOI: 10.1212/wnl.0b013e3181d1a879] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES There is currently much interest in biomarkers of disease activity in frontotemporal lobar degeneration (FTLD). We assessed MRI and behavioral measures of progression in a longitudinal FTLD cohort. METHODS Thirty-two patients with FTLD (11 behavioral variant frontotemporal dementia [bvFTD], 11 semantic dementia [SemD], 10 progressive nonfluent aphasia [PNFA]) and 24 age-matched healthy controls were assessed using volumetric brain MRI and standard behavioral measures (Mini-Mental State Examination, Frontal Assessment Battery, Clinical Dementia Rating Scale, Neuropsychiatric Inventory with Caregiver Distress scale) at baseline and 1 year later. A semi-automated image registration protocol was used to calculate annualized rates of brain atrophy (brain boundary shift integral [BBSI]) and ventricular expansion (ventricular boundary shift integral [VBSI]). Associations between these rates and changes in behavioral indices were investigated. RESULTS Rates of whole brain atrophy were greater in the entire FTLD cohort and in each subgroup compared with controls (all p < or = 0.004). Rates of ventricular expansion were greater in the entire cohort (p < 0.001) and the SemD (p = 0.002) and PNFA (p = 0.05) subgroups compared with controls. Changes in Mini-Mental State Examination, Frontal Assessment Battery, and Clinical Dementia Rating Scale scores were associated with MRI measures of progression, though not uniformly across FTLD subgroups. Both BBSI and VBSI yielded feasible sample size estimates for detecting meaningful treatment effects in SemD and PNFA language subgroups. Sample sizes were substantially larger using MRI biomarkers for the bvFTD subgroup, and using behavioral biomarkers in general. CONCLUSIONS Semi-automated MRI atrophy measures are potentially useful objective biomarkers of progression in frontotemporal lobar degeneration (FTLD); however, careful stratification of FTLD subtypes will be important in future clinical trials of disease-modifying therapies.
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Affiliation(s)
- E Gordon
- Dementia Research Centre, Institute of Neurology, University College London, UK WC1N 3BG
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Abstract
Based on available investigations and current trends in oral rehabilitation published in the dental literature, an attempt is made to describe the possible future role of complete dentures. For edentulous patients, complete dentures have for long been the only prosthodontic treatment option. Whereas a large number of edentulous patients report satisfaction with denture usage, a smaller number are unable to adapt; for such patients, sophistication of clinical and technical processes or quality of denture-supporting tissues, appear to have little influence on patient-perceived outcomes. Since the 1980s, osseointegrated dental implants have dramatically improved the therapeutic possibilities, especially so for maladaptive patients. Those able to access such treatment can expect significant improvements in oral functional status and quality of life. While there is a downward trend in edentulism in several countries, it is region-specific, confirming the overriding influence of socio-economic factors on health status. In most societies, despite ageing populations, the need for complete dentures is not likely to reduce in the near future. Whereas a two- or even a one-implant overdenture for the edentulous mandible is increasingly regarded as a minimum standard of care in many developed countries, its routine prescription for the majority in the world who are disadvantaged is unrealistic; for them, even 'low-tech' therapies like conventional dentures are beyond their reach. Improving the conventional management of edentulous patients is a necessity and requires a keener focus by researchers, educators and clinicians in the developed world on the needs of populations with fewer resources.
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Affiliation(s)
- G E Carlsson
- Department of Prosthetic Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Omar R, Mohammed Z, Knight VF, Basrul MH. Profile of low vision children in the special education schools in Malaysia. Med J Malaysia 2009; 64:289-293. [PMID: 20954552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study looked at the causes of vision loss, levels of distance, near vision and the use of low vision devices (LVDs) in children studying at special schools in Malaysia. A total of 139 children from two special education schools took part. Visual acuity was measured with and without LVDs. Those who required further assessment were referred to Low Vision Clinic. Near visual acuity in 71 children ranged from N4 to N64. Sixty eight children could not read the N64 chart or they were totally blind. Only eight students were using LVDs before intervention. Seventy one children were referred for low vision assessment and 48 were found to benefit from the LVDs prescribed. The major cause of visual impairment was cataract (17%). Hand held magnifier was the most preferred LVD. Majority of the children attending the blind schools had residual vision but did not have LVDs. LVDs are able to significantly improve near visual acuity and hence there is a need to prescribe and train the children to use the LVDs.
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Affiliation(s)
- R Omar
- Department of Optometry, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
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Abstract
The purpose of this review was to evaluate the literature on the rehabilitation of tooth wear, with some pertinent historical, epidemiological and aetiological aspects of tooth wear provided as background information. In historical skull material, extensive tooth wear, assumed to be the result of coarser diets, was found even in relatively young individuals. Such wear is seldom seen in current populations. Although many of the factors associated with extensive tooth wear in historical material are no longer present or prevalent, new risk factors have emerged. In the young individual, the literature points to a global rise in soft drink consumption as the most significant factor in the development of tooth wear through dental erosion. Among older individuals, lifestyle changes and chronic diseases that are controlled with medications that may, in turn, result in regurgitation and/or dry mouth, are possible reasons amongst others for the widespread clinical impression of an increasing prevalence of tooth wear. The aetiology of tooth wear is multifactorial and the role of bruxism is not known. Clinical controlled trials of restorative and prosthodontic approaches for the range of clinical conditions that wear can give rise to, are limited in number and quality. Equally, the striking lack of evidence regarding the long-term outcomes of treatment methods and materials calls for caution in clinical decision-making. Notwithstanding these observations, clinicians have provided and continue to provide rehabilitative strategies for managing their patients' worn dentitions that range traditionally from extensive prosthodontics to an increasing reliance on adhesive techniques.
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Affiliation(s)
- A Johansson
- Department of Clinical Dentistry - Prosthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
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Rohrer JD, McNaught E, Foster J, Clegg SL, Barnes J, Omar R, Warrington EK, Rossor MN, Warren JD, Fox NC. Tracking progression in frontotemporal lobar degeneration: serial MRI in semantic dementia. Neurology 2008; 71:1445-51. [PMID: 18955688 DOI: 10.1212/01.wnl.0000327889.13734.cd] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Semantic dementia is a sporadic neurodegenerative disorder characterized by the progressive erosion of semantic processing and is one of the canonical subtypes of frontotemporal lobar degeneration. This study aimed to characterize the pattern of global and regional longitudinal brain atrophy in semantic dementia and to identify imaging biomarkers that could underpin therapeutic trials. METHODS Twenty-one patients with semantic dementia (including eight pathologically confirmed cases) underwent whole-brain and region-of-interest analyses on volumetric brain MRI scans at two time points. Sample size estimates for trials were subsequently calculated using these data. RESULTS Mean (SD) whole-brain atrophy rate was 39.6 (31.9) mL/y [3.2 (12.0) mL/y in controls], with ventricular enlargement of 8.9 (4.4) mL/y [1.0 (1.0) mL/y in controls]. All patients had a smaller left temporal lobe at baseline [left mean 31.9 (6.9) mL, right mean 49.2 (9.5) mL; p < 0.0001]; however, the mean rate of atrophy was significantly greater in the right temporal lobe [right 3.9 (1.7) mL/y, left 2.8 (1.2) mL/y; p = 0.02]. Similarly, whereas the left hippocampus was smaller at baseline, the mean atrophy rate was significantly greater in the right hippocampus. Using the atrophy rates generated, sample size requirements for clinical trials were found to be smallest for temporal lobe measurement. CONCLUSIONS These findings show that the rate of tissue loss in the right temporal lobe overtakes the left temporal lobe as semantic dementia evolves, consistent with the later development of symptoms attributable to right temporal lobe dysfunction. Furthermore, our findings demonstrate that MRI measures of temporal lobe volume loss could provide a feasible and sensitive index of disease progression in semantic dementia.
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Affiliation(s)
- J D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, Institute of Neurology, University College London, UK
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Abstract
The ethics review system of research is now well-established, at least in the developed world, although there are many differences in how countries view it and go about managing it. The UK specifically is now seeking to revise its system by speeding up the process of ethics approval but only for some studies. It is proposed that only those studies which pose "no material ethical issues" should be "fast-tracked". However, it is unclear what this means, who should decide and what should be included in this category. In this paper, we go some way towards answering these questions. While we are certain that the debate is only just beginning, we are equally certain that it will continue to run long after the system has been reformed. To stimulate this conversation and to inform a pilot project of the new system directly, we review two candidates to help give some substance to the notion of "material" ethical issues. Firstly, material could mean a certain type or degree of risk. Second, material could mean how physically invasive the research is. We conclude that there is still much work to be done on making the system of governing health and social care consistent and practicable.
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Affiliation(s)
- S J L Edwards
- University College London First Floor Maple House, Rosenheim Wing, Ground Floor, 25 Grafton Way, London WC1E5DB, UK.
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Abstract
We describe two patients with isolated brainstem lesions who exhibited behavioural and cognitive changes that are commonly associated with frontal lobe pathology, as leading clinical features. These cases illustrate the role of distributed neural networks in cognitive and behavioural processes. The brainstem, frontal-subcortical and limbic systems are extensively and reciprocally linked via neurotransmitter projection pathways. We argue that cognitive and behavioural features in patients with brainstem lesions reflect remote effects of brainstem structures on frontal lobe and limbic regions, as a consequence of disruption to ascending neurotransmitter pathways.
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Affiliation(s)
- R Omar
- Dementia Research Centre, Institute of Neurology, University College London, Queen Square, London, UK
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Alomari Q, Ajlouni R, Omar R. Managing the polymerization shrinkage of resin composite restorations: a review. SADJ 2007; 62:12, 14, 16 passim. [PMID: 17427725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Polymerization shrinkage (PS) of resin composites almost invariably generates a degree of stress at the tooth/restoration interface. The magnitude of the stresses so produced depends on resin composite composition and its ability to flow before solidification, which is, in turn related to cavity configuration and curing characteristics of the composite. The purpose of the present article is to review the published literature on the management of PS, with special reference to those elements that are under the control of the dentist. Available data from laboratory, finite element analysis and review articles, relating to the methods and techniques that have been proposed for managing the problem of PS, are included. On the basis of the review, it may be concluded that PS has negative effects on the resin composite/tooth interface. The review identifies the preferred handling and/or management techniques that clinicians might employ to reduce the levels of PS that might affect the restorations they place, and consequently reduce its adverse effects.
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Affiliation(s)
- Q Alomari
- Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, P.O. Box 24923 Safat, 13110 Kuwait.
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