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Sharma K, Bhat S, Bhat SM. Causes of stillbirth in ethnically diverse women in a Perth metropolitan hospital: A retrospective study. Aust N Z J Obstet Gynaecol 2024; 64:141-146. [PMID: 37905931 DOI: 10.1111/ajo.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Most published reports analysing the differences in causation of stillbirth between different ethnic groups focus on stillbirth risk factors, with a paucity of data comparing actual causes of stillbirth. AIMS To determine whether causes of stillbirth differ between Caucasian and non-Caucasian ethnic groups in an Australian context. MATERIALS AND METHODS Data from all stillbirths occurring at 20 or more completed weeks of gestation between 1 January 2010 and 31 December 2020 at a secondary level, outer metropolitan hospital, were analysed in this retrospective case series. Causes of stillbirth as determined by perinatal autopsy and placental histopathology were categorised using the Perinatal Society of Australia and New Zealand Perinatal Death Classification and compared between Caucasian and non-Caucasian groups. RESULTS Ninety-two stillbirths (0.7% of all births) were identified during the study period. A greater proportion of non-Caucasian women had small for gestation age placentas compared to Caucasian women (n = 22/43 (51%) vs n = 12/49 (24%); P = 0.025). A greater proportion of stillbirths were caused by hypoxic peripartum death in non-Caucasian than in Caucasian women (n = 4/43 (9%) vs n = 0/49 (0%); P = 0.044), and a greater prevalence of placental dysfunction was seen in the non-Caucasian cohort compared to Caucasian women (n = 14/43 (33%) vs n = 8/49 (16%); P = 0.057). CONCLUSIONS The differences observed in causes of stillbirth between Caucasian and non-Caucasian women are hypothesis generating and warrant further larger-scale, multi-centred studies using standardised definitions and classification systems to determine whether these differences persist in a more representative sample.
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Affiliation(s)
- Kriti Sharma
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Saiuj Bhat
- Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Sangeeta Malla Bhat
- Department of Obstetrics and Gynaecology, Armadale Health Service, Perth, Western Australia, Australia
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Bhat S, Chia B, Barry IP, Panayi AC, Orgill DP. Free Tissue Transfer in Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis. Eur J Vasc Endovasc Surg 2023; 66:670-677. [PMID: 37500000 DOI: 10.1016/j.ejvs.2023.07.031] [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: 02/20/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Free tissue transfer is a powerful reconstructive method for patients with substantial diabetic foot ulcers. This study aimed to perform an updated systematic review and meta-analysis investigating the flap characteristics, concurrent revascularisation rates, complications, and outcomes associated with free tissue transfer in diabetic foot ulcers. METHODS Two reviewers performed a systematic review of various databases since their inception, with no language restriction. Only data for free tissue transfer in non-traumatic diabetic foot ulcer patients were extracted from included studies where a heterogeneous population was studied. Outcome data were pooled using random effects meta-analysis for binomial data. RESULTS Of 632 studies identified, 67 studies encompassing 1 846 patients and 1 871 free flaps were included. A median of 18 patients [IQR 9, 37] per study, with a median age of 58.5 years [56, 63], were followed up for a median of 15 months [7, 25]. Most studies had serious risk of bias (n = 47 studies, 70%); sixteen (24%) had moderate risk of bias; and four (6%) had low risk of bias. The proportion of patients who underwent revascularisation was 75% (95% CI 60 - 87%; n = 36 studies) with a median time of 8 days between procedures. The pooled complete flap survival, major amputation, and ambulation rates were 88% (85 - 92%, n = 49 studies), 10% (7 - 14%, n = 50 studies), and 87% (80 - 92%, n = 36 studies), respectively. Death at individual study follow up was 6% (3 - 10%, n = 26 studies). The overall certainty of evidence was very low. CONCLUSION Free tissue transfer may be a useful treatment modality for recalcitrant diabetic foot ulcers in selected patients. Future studies should investigate long term functional outcomes and aim to develop patient selection algorithms to select the most suitable candidates for this procedure.
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Affiliation(s)
- Saiuj Bhat
- Department of Plastic and Reconstructive Surgery, Royal Perth Hospital, Perth, Australia; School of Medicine, The University of Western Australia, Crawley, Australia.
| | - Benjamin Chia
- Department of Plastic and Reconstructive Surgery, Royal Perth Hospital, Perth, Australia
| | - Ian P Barry
- Department of Plastic and Reconstructive Surgery, Royal Perth Hospital, Perth, Australia
| | - Adriana C Panayi
- Department of Hand, Plastic and Reconstructive Surgery, Burn Centre, BG Trauma Centre Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany; Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dennis P Orgill
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Bhat S, Chia B, Babidge W, Maddern GJ. Assessing performance in ageing surgeons: systematic review. Br J Surg 2023; 110:1425-1427. [PMID: 37260108 PMCID: PMC10564395 DOI: 10.1093/bjs/znad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/08/2023] [Accepted: 05/04/2023] [Indexed: 06/02/2023]
Affiliation(s)
- Saiuj Bhat
- Department of Plastic and Reconstructive Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Benjamin Chia
- Department of Plastic and Reconstructive Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Wendy Babidge
- Research, Audit, and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
- Discipline of Surgery, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Guy J Maddern
- Research, Audit, and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
- Discipline of Surgery, Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia, Australia
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Bhat S, Xu W, Varghese C, Dubey N, Wells CI, Harmston C, O'Grady G, Bissett IP, Lin AY. Efficacy of different surgical treatments for management of anal fistula: a network meta-analysis. Tech Coloproctol 2023; 27:827-845. [PMID: 37460830 PMCID: PMC10485107 DOI: 10.1007/s10151-023-02845-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Currently, the anal fistula treatment which optimises healing and preserves bowel continence remains unclear. The aim of our study was to compare the relative efficacy of different surgical treatments for AF through a network meta-analysis. METHODS Systematic searches of MEDLINE, EMBASE and CENTRAL databases up to October 2022 identified randomised controlled trials (RCTs) comparing surgical treatments for anal fistulae. Fistulae were classified as simple (inter-sphincteric or low trans-sphincteric fistulae crossing less than 30% of the external anal sphincter (EAS)) and complex (high trans-sphincteric fistulae involving more than 30% of the EAS). Treatments evaluated in only one trial were excluded from the primary analyses to minimise bias. The primary outcomes were rates of success in achieving AF healing and bowel incontinence. RESULTS Fifty-two RCTs were included. Of the 14 treatments considered, there were no significant differences regarding short-term (6 months or less postoperatively) and long-term (more than 6 months postoperatively) success rates between any of the treatments in patients with both simple and complex anal fistula. Ligation of the inter-sphincteric fistula tract (LIFT) ranked best for minimising bowel incontinence in simple (99.1% of comparisons; 3 trials, n = 70 patients) and complex anal fistula (86.2% of comparisons; 3 trials, n = 102 patients). CONCLUSIONS There is insufficient evidence in existing RCTs to recommend one treatment over another regarding their short and long-term efficacy in successfully facilitating healing of both simple and complex anal fistulae. However, LIFT appears to be associated with the least impairment of bowel continence, irrespective of AF classification.
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Affiliation(s)
- S Bhat
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
- Department of Surgery, Te Whatu Ora MidCentral, Palmerston North, New Zealand
| | - W Xu
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
- Department of Surgery, Te Whatu Ora Te Toka Tumai, Whangārei, New Zealand
| | - C Varghese
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - N Dubey
- Department of General Medicine, Tauranga Hospital, Te Whatu Ora, Tauranga, New Zealand
| | - C I Wells
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
- Department of Surgery, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
| | - C Harmston
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
- Department of Surgery, Te Whatu Ora Te Toka Tumai, Whangārei, New Zealand
| | - G O'Grady
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - I P Bissett
- Surgical and Translational Research Centre, Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - A Y Lin
- Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.
- Department of Surgery, Wellington Regional Hospital, Te Whatu Ora, Wellington, New Zealand.
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Barrett EM, Hart AC, Bhat S, Marklund M, Coyle DH, Heenan M, Pettigrew S, Wu JH. The Effect of Retail Food Environment Interventions on Dietary Behavior in Postsecondary Education Settings: A Systematic Review and Meta-analysis. J Nutr 2023; 153:3122-3130. [PMID: 37741633 DOI: 10.1016/j.tjnut.2023.08.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Postsecondary education institutions, where hundreds of millions of people work and study globally, are a key setting for retail food environment interventions. OBJECTIVE We aimed to synthesize the evidence for the effectiveness of retail food environment interventions in improving the healthiness of dietary behavior of students and staff in postsecondary education settings. METHODS Academic databases were searched for randomized controlled trials (RCTs) and quasi-experimental studies published until August 2023. Studies were eligible if they assessed the impact of a retail food environment intervention on healthiness of dietary behavior (purchases or consumption) in students or staff in postsecondary education settings and targeted one of the following food environment elements: placement, price, product, or promotion. Business-related outcomes (total sales, profit, or revenue) were included as secondary outcomes. Findings were synthesized in narrative form, organized by retail food environment element. Where comparable dietary outcome data were available from ≥10 interventions, findings were pooled using random effects meta-analysis. RESULTS Of 10,126 studies initially identified, 55 (76% quasi-experimental) were included, describing 71 separate interventions (n = 49 single-element and n = 22 multi-element). Two-thirds (n = 47, 66%) of interventions (n = 32 single-element and n = 15 multi-element) demonstrated significant improvements in dietary behavior. Single-element interventions targeting placement (n = 1) and price (n = 3) improved dietary behavior. Most (n = 9/10, 90%) interventions targeting product availability or convenience (product element) improved dietary behavior, while n = 19/35 (54%) targeting promotion did. Pooled findings from 12 interventions reporting changes in energy content demonstrated a significant decrease in purchased or consumed energy (-7.9%; 95% confidence interval: -10.3%, -5.6%). Almost all interventions (n = 11/12, 92%) that evaluated the impact on business-related outcomes found either a significant increase or no change following the intervention. CONCLUSIONS We established encouraging evidence supporting the role of retail food environment interventions in postsecondary education settings to support healthy dietary behaviors of students and staff. REGISTRY PROSPERO (International Prospective Register of Systematic Reviews, URL: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295836; registration number CRD42022295836).
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Affiliation(s)
- Eden M Barrett
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | - Ashleigh C Hart
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Saiuj Bhat
- Royal Perth Hospital, Victoria Square, Perth, Western Australia; School of Medicine, The University of Western Australia, Crawley, Western Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Department of Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Maddie Heenan
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Wee J, Sukudom S, Bhat S, Marklund M, Peiris NJ, Hoyos CM, Patel S, Naismith SL, Dwivedi G, Misra A. The relationship between midlife dyslipidemia and lifetime incidence of dementia: A systematic review and meta-analysis of cohort studies. Alzheimers Dement (Amst) 2023; 15:e12395. [PMID: 36911359 PMCID: PMC9993469 DOI: 10.1002/dad2.12395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 03/14/2023]
Abstract
Introduction We conducted a systematic review and meta-analysis to review the relationship between midlife dyslipidemia and lifetime incident dementia. Methods The databases Medline, Embase, Scopus, Web of Science, and Cochrane were searched from inception to February 20, 2022. Longitudinal studies examining the relationship between midlife lipid levels on dementia, dementia subtypes, and/or cognitive impairment were pooled using inverse-variance weighted random-effects meta-analysis. Results Seventeen studies (1.2 million participants) were included. Midlife hypercholesterolemia was associated with increased incidence of mild cognitive impairment (effect size [ES] = 2.01; 95% confidence interval [CI] 1.19 to 2.84; I2 = 0.0%) and all-cause dementia (ES = 1.14; 95% CI: 1.07 to 1.21; I2 = 0.0%). Each 1 mmol/L increase in low-density lipoprotein was associated with an 8% increase (ES = 1.08, 95% CI: 1.03 to 1.14; I2 = 0.3%) in incidence of all-cause dementia. Discussion Midlife dyslipidemia is associated with an increased risk of cognitive impairment in later life.
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Affiliation(s)
- Jason Wee
- Fiona Stanley Hospital South Metropolitan Health Service Perth Western Australia Australia
| | - Sara Sukudom
- University of Western Australia Perth Western Australia Australia.,Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Saiuj Bhat
- Royal Perth Hospital Perth Western Australia Australia
| | - Matti Marklund
- The George Institute for Global Health University of New South Wales Sydney New South Wales Australia.,Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.,Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Niridu Jude Peiris
- Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Camilla M Hoyos
- Faculty of Science and School of Psychology and Centre for Sleep and Chronobiology Woolcock Institute of Medical Research The University of Sydney Sydney New South Wales Australia
| | - Sanjay Patel
- Heart Research Institute Sydney New South Wales Australia
| | - Sharon L Naismith
- Faculty of Science and School of Psychology Charles Perkins Centre University of Sydney Sydney New South Wales Australia
| | - Girish Dwivedi
- University of Western Australia Perth Western Australia Australia
| | - Ashish Misra
- Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia.,Heart Research Institute Sydney New South Wales Australia
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Kumar V, Nayak S, Rathore V, Bhat S, jindal A, Siddiqui S, Dola J, sahu A, Galhotra A, nagarkar N, Behera A. POS-027 COMPARISON OF CLINICAL OUTCOMES OF FIRST, SECOND, AND THIRD WAVES OF COVID19 AMONG CKD PATIENTS REQUIRING RRT IN A TERTIARY CARE HOSPITAL IN CENTRAL INDIA. Kidney Int Rep 2022. [PMCID: PMC9475100 DOI: 10.1016/j.ekir.2022.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Matsunaga F, Bhat S, Amann N, Johnson S, Chen D. Abstract No. 21 Transcatheter arterial embolization outcomes in pediatric pelvic fractures: a National Trauma Data Bank analysis. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bhat S, Laffin L, Kondoleon N, Van Iterson E. The effect of hemoglobin level on the prognostic value of peak exercise oxygen uptake differs between obese and non-obese patients with heart failure. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.201] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Obesity and low hemoglobin content (Hgb <13 and <12 g/dL, men/women, respectively) are commonly observed in patients with heart failure and reduced ejection fraction (HFrEF). This overlap typically yields reductions in peak exercise oxygen uptake (V̇O2peak) which exceed those observed in both non-obese and obese patients exhibiting normal Hgb levels. However, when matched for body size, non-obese patients exhibiting low Hgb levels also demonstrate worse V̇O2peak impairment than normal Hgb level counterparts. To date, it is unclear whether the effect of Hgb level on V̇O2peak also affects the association between V̇O2peak and mortality risk in both non-obese and obese patients.
Purpose
To assess whether V̇O2peak that is predictive of mortality risk is directly impacted by Hgb level regardless of whether a patient is non-obese or obese.
Methods
Adults with HFrEF (n=346; LVEF ≤40%; 76% men) completed cardiopulmonary exercise testing (CPET) as part of routine clinical management. The majority of patients performed Naughton or Modified Naughton CPET protocols. Patients with a BMI ≥30 kg/m2 were classified as obese (n=135; 81% men). Patients were followed up to one-year for the endpoint of all-cause mortality.
Results
Age (63±7 vs 61±8 yrs), total body weight (77±13 vs 107±15 kg), BMI (25.2±3.0 vs 34.5±4.0 kg/m2), and Hgb (12.6±1.8 vs 13.1±1.8 g/dL) differed between non-obese and obese patients (all P<0.01), respectively. There were no significant differences between non-obese and obese patients for % men (73 vs 81 %), % ischemic etiology (46 vs 42 %), and LVEF (23±8 vs 24±9 % (all P>0.05), respectively. Peak exercise RER (1.13±0.12 vs 1.10±0.11), V̇O2peak (13.0±3.8 vs 11.9±3.3 mL/kg/min), and absolute V̇O2peak (1.01±0.37 vs 1.28±0.40 L/min) differed between non-obese and obese patients (all P<0.02), respectively. Over the 1-year tracking period, 25 and 13 deaths were observed and crude survival was 85% and 88% in non-obese and obese patients (Log-rank, P=0.465), respectively. In obese patients, V̇O2peak and Hgb interacted (χ2=4.855, P=0.028), resulting in up to a 22% reduction in all-cause mortality risk per 1.0 mL/kg/min rise in V̇O2peak for Hgb levels ≤13.1 g/dL. In non-obese patients, V̇O2peak and Hgb did not interact (χ2=0.001, P=0.977), and when Hgb was removed from the Cox regression, this resulted in up to a 29% reduction in all-cause mortality risk per 1.0 mL/kg/min rise in V̇O2peak (χ2=23.618, P<0.001).
Conclusion
Demonstrating low Hgb and V̇O2peak levels yields comparable effects on all-cause mortality risk in non-obese and obese patients. However, at normal Hgb levels, V̇O2peak loses prognostic value in the obese, suggesting for these patients other CPET variables should be used to complement V̇O2peak when CPET is built into risk stratification models.
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Affiliation(s)
- S Bhat
- Cleveland Clinic, Cleveland, United States of America
| | - L Laffin
- Cleveland Clinic, Cleveland, United States of America
| | - N Kondoleon
- Cleveland Clinic, Cleveland, United States of America
| | - E Van Iterson
- Cleveland Clinic, Cleveland, United States of America
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Bhat S, Maganja D, Huang L, Wu JHY, Marklund M. Influence of Heating during Cooking on Trans Fatty Acid Content of Edible Oils: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14071489. [PMID: 35406103 PMCID: PMC9002916 DOI: 10.3390/nu14071489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 01/18/2023] Open
Abstract
Consumption of trans fatty acids (TFA) is associated with adverse health outcomes and is a considerable burden on morbidity and mortality globally. TFA may be generated by common cooking practices and hence contribute to daily dietary intake. We performed a systematic review and meta-analysis to investigate the relationship between heating edible oils and change in their TFA content. A systematic search of experimental studies investigating the effect of various methods of heating on TFA content of edible oils was conducted in Medline and Embase since their inception up to 1 October 2020 without language restrictions. Comparable data were analysed using mixed multilevel linear models taking into account individual study variation. Thirty-three studies encompassing twenty-one different oils were included in this review. Overall, heating to temperatures <200 °C had no appreciable impact on different TFA levels. Between 200 and 240 °C, levels of C18:2 t (0.05% increase per 10 °C rise in temperature, 95% CI: 0.02 to 0.05%), C18:3t (0.18%, 95% CI: 0.14 to 0.21%), and total TFA (0.38%, 95% CI: 0.20 to 0.55%) increased with temperature. A further increase in total TFA was observed with prolonged heating between 200 and 240 °C. Our findings suggest that heating edible oils to common cooking temperatures (≤200 °C) has minimal effect on TFA generation whereas heating to higher temperatures can increase TFA level. This provides further evidence in favour of public health advice that heating oils to very high temperatures and prolonged heating of oils should be avoided.
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Affiliation(s)
- Saiuj Bhat
- Department of Vascular Surgery, Royal Perth Hospital, Victoria Square, Perth, WA 6000, Australia;
| | - Damian Maganja
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (D.M.); (L.H.); (J.H.Y.W.)
| | - Liping Huang
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (D.M.); (L.H.); (J.H.Y.W.)
| | - Jason H. Y. Wu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (D.M.); (L.H.); (J.H.Y.W.)
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia; (D.M.); (L.H.); (J.H.Y.W.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Department of Public Health and Caring Sciences, Uppsala University, SE75105 Uppsala, Sweden
- Correspondence:
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Bhat S, Coyle DH, Trieu K, Neal B, Mozaffarian D, Marklund M, Wu JHY. Reply to A Coskun and B Oz. Adv Nutr 2022; 13:692-693. [PMID: 37270210 PMCID: PMC8970822 DOI: 10.1093/advances/nmac005] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Saiuj Bhat
- From the School of Medicine, the University of Western Australia, Crawley, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; School of Public Health, Imperial College London, London, United Kingdom
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, Australia; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
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Covas Moschovas M, Rogers T, Noel J, Abdel J, Bhat S, Patel V. Anatomical robotic-assisted radical prostatectomy: Step-by-step nerve-sparing technique for different grades of preservation. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01293-3] [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: 11/24/2022]
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Bhat S, Birdus N, Bhat SM. Ethnic variation in causes of stillbirth in high income countries: A systematic review and meta-analysis. Int J Gynaecol Obstet 2021; 158:270-277. [PMID: 34767262 DOI: 10.1002/ijgo.14023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/08/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Inequities in stillbirth rate according to ethnicity persist in high income nations. The objective of the present study is to investigate whether causes of stillbirth differ by ethnicity in high-income nations. METHODS The following databases were searched since their inception to 1 February 2021: Medline, Embase, Scopus, CINAHL, Cochrane Library, and Global Health. Cohort, cross-sectional, and retrospective studies were included. Causes of stillbirth were aligned to the International Classification of Disease 10 for Perinatal Mortality (ICD10-PM) and pooled estimates were derived by meta-analysis. RESULTS Fifteen reports from three countries (72 555 stillbirths) were included. Seven ethnic groups - "Caucasian" (n = 11 studies), "African" (n = 11 studies), "Hispanic" (n = 7 studies), "Indigenous Australian" (n = 4 studies), "Asian" (n = 2 studies), "South Asian" (n = 2 studies), and "American Indian" (n = 1 study) - were identified. There was an overall paucity of recent, high-quality data for many ethnicities. For those with the greatest amount of data - Caucasian, African, and Hispanic - no major differences in the causes of stillbirth were identified. CONCLUSION There is a paucity of high-quality information on causes of stillbirth for many ethnicities. Improving investigation and standardizing classification of stillbirths is needed to assess whether causes of stillbirth differ across more diverse ethnic groups.
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Affiliation(s)
- Saiuj Bhat
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Nadya Birdus
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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14
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Bhat S, Covas Moschovas M, Sandri M, Noel J, Rogers T, Pereira R, Reddy S, Roof S, Patel V. Outcomes of Salvage Robot-Assisted Radical Prostatectomy (S-RARP) post focal ablation for prostate cancer in comparison with primary Robot-assisted Radical Prostatectomy (RARP); A matched analysis. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02218-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Covas Moschovas M, Noel J, Bhat S, Rogers T, Mottrie A, Patel V. SP approach to radical prostatectomy: Step-by-step technique comparing the Xi and SP consoles. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02281-3] [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: 11/28/2022] Open
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16
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Covas Moschovas M, Noel J, Bhat S, Sandri M, Kind S, Rogers T, Mottrie A, Patel V. Perioperative outcomes and long-term continence rates comparing the da Vinci SP and Xi consoles approaching radical prostatectomy: A propensity score matching analysis. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02236-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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17
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Bhat S, Coyle DH, Trieu K, Neal B, Mozaffarian D, Marklund M, Wu JHY. Healthy Food Prescription Programs and their Impact on Dietary Behavior and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:1944-1956. [PMID: 33999108 PMCID: PMC8483962 DOI: 10.1093/advances/nmab039] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/21/2020] [Accepted: 03/11/2021] [Indexed: 12/11/2022] Open
Abstract
The enormous burden of diet-related chronic diseases has prompted interest in healthy food prescription programs. Yet, the impact of such programs remains unclear. The aim of this study was to conduct a systematic review of healthy food prescription programs and evaluate their impact on dietary behavior and cardiometabolic parameters by meta-analysis. A systematic search was carried out in Medline, Embase, Scopus, and Cochrane Central Register of Controlled Trials databases since their inception to 3 January, 2020 without language restriction. A systematic search of interventional studies investigating the effect of healthy food prescription on diet quality and/or cardiometabolic risk factors including BMI, systolic (SBP) and diastolic blood pressure (DBP), glycated hemoglobin (HbA1c), or blood lipids was carried out. Thirteen studies were identified for inclusion, most of which were quasi-experimental (pre/post) interventions without a control group (n = 9). Pooled estimates revealed a 22% (95% CI: 12, 32; n = 5 studies, n = 1039 participants; I2 = 97%) increase in fruit and vegetable consumption, corresponding to 0.8 higher daily servings (95% CI: 0.2, 1.4; I2 = 96%). BMI decreased by 0.6 kg/m2 (95% CI: 0.2, 1.1; I2 = 6.4%) and HbA1c by 0.8% (95% CI: 0.1, 1.6; I2 = 92%). No significant change was observed in other cardiometabolic parameters. These findings should be interpreted with caution in light of considerable heterogeneity, methodological limitations of the included studies, and moderate to very low certainty of evidence. Our results support the need for well-designed, large, randomized controlled trials in various settings to further establish the efficacy of healthy food prescription programs on diet quality and cardiometabolic health.
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Affiliation(s)
- Saiuj Bhat
- School of Medicine, The University of Western Australia, Crawley, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jason H Y Wu
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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18
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Jin JZ, Bhat S, Lee KT, Xia W, Hill AG. Interventional treatments for prolapsing haemorrhoids: network meta-analysis. BJS Open 2021; 5:6388197. [PMID: 34633439 PMCID: PMC8504447 DOI: 10.1093/bjsopen/zrab091] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/11/2021] [Indexed: 12/29/2022] Open
Abstract
Background Multiple treatments for early–moderate grade symptomatic haemorrhoids currently exist, each associated with their respective efficacy, complications, and risks. The aim of this study was to compare the relative clinical outcomes and effectiveness of interventional treatments for grade II–III haemorrhoids. Methods A systematic review was conducted according to PRISMA criteria for all the RCTs published between 1980 and 2020; manuscripts were identified using the MEDLINE, Embase, and CENTRAL databases. Inclusion criteria were RCTs comparing procedural interventions for grade II–III haemorrhoids. Primary outcomes of interest were: symptom recurrence at a minimum follow-up of 6 weeks, postprocedural pain measured on a visual analogue scale (VAS) on day 1, and postprocedural complications (bleeding, urinary retention, and bowel incontinence). After bias assessment and heterogeneity analysis, a Bayesian network meta-analysis was performed. Results Seventy-nine RCTs were identified, including 9232 patients. Fourteen different treatments were analysed in the network meta-analysis. Overall, there were 59 RCTs (73 per cent) judged as being at high risk of bias, and the greatest risk was in the domain measurement of outcome. Variable amounts of heterogeneity were detected in direct treatment comparisons, in particular for symptom recurrence and postprocedural pain. Recurrence of haemorrhoidal symptoms was reported by 54 studies, involving 7026 patients and 14 treatments. Closed haemorrhoidectomy had the lowest recurrence risk, followed by open haemorrhoidectomy, suture ligation with mucopexy, stapled haemorrhoidopexy, and Doppler-guided haemorrhoid artery ligation (DG-HAL) with mucopexy. Pain was reported in 34 studies involving 3812 patients and 11 treatments. Direct current electrotherapy, DG-HAL with mucopexy, and infrared coagulation yielded the lowest pain scores. Postprocedural bleeding was recorded in 46 studies involving 5696 patients and 14 treatments. Open haemorrhoidectomy had the greatest risk of postprocedural bleeding, followed by stapled haemorrhoidopexy and closed haemorrhoidectomy. Urinary retention was reported in 30 studies comparing 10 treatments involving 3116 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had significantly higher odds of urinary retention than rubber band ligation and DG-HAL with mucopexy. Nine studies reported bowel incontinence comparing five treatments involving 1269 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had the highest probability of bowel incontinence. Conclusion Open and closed haemorrhoidectomy, and stapled haemorrhoidopexy were associated with worse pain, and more postprocedural bleeding, urinary retention, and bowel incontinence, but had the lowest rates of symptom recurrence. The risks and benefits of each treatment should be discussed with patients before a decision is made.
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Affiliation(s)
- J Z Jin
- Correspondence to: South Auckland Clinical Campus, PO Box 93311 Otahuhu, Auckland 1640, New Zealand (e-mail: )
| | - S Bhat
- Department of Surgery, South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - K -T Lee
- Department of Surgery, South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - W Xia
- Department of Surgery, South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - A G Hill
- Department of Surgery, South Auckland Clinical Campus, University of Auckland, Middlemore Hospital, Auckland, New Zealand
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19
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Trieu K, Bhat S, Dai Z, Leander K, Gigante B, Qian F, Korat AVA, Sun Q, Pan XF, Laguzzi F, Cederholm T, de Faire U, Hellénius ML, Wu JHY, Risérus U, Marklund M. Biomarkers of dairy fat intake, incident cardiovascular disease, and all-cause mortality: A cohort study, systematic review, and meta-analysis. PLoS Med 2021; 18:e1003763. [PMID: 34547017 PMCID: PMC8454979 DOI: 10.1371/journal.pmed.1003763] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/11/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We aimed to investigate the association of serum pentadecanoic acid (15:0), a biomarker of dairy fat intake, with incident cardiovascular disease (CVD) and all-cause mortality in a Swedish cohort study. We also systematically reviewed studies of the association of dairy fat biomarkers (circulating or adipose tissue levels of 15:0, heptadecanoic acid [17:0], and trans-palmitoleic acid [t16:1n-7]) with CVD outcomes or all-cause mortality. METHODS AND FINDINGS We measured 15:0 in serum cholesterol esters at baseline in 4,150 Swedish adults (51% female, median age 60.5 years). During a median follow-up of 16.6 years, 578 incident CVD events and 676 deaths were identified using Swedish registers. In multivariable-adjusted models, higher 15:0 was associated with lower incident CVD risk in a linear dose-response manner (hazard ratio 0.75 per interquintile range; 95% confidence interval 0.61, 0.93, P = 0.009) and nonlinearly with all-cause mortality (P for nonlinearity = 0.03), with a nadir of mortality risk around median 15:0. In meta-analyses including our Swedish cohort and 17 cohort, case-cohort, or nested case-control studies, higher 15:0 and 17:0 but not t16:1n-7 were inversely associated with total CVD, with the relative risk of highest versus lowest tertile being 0.88 (0.78, 0.99), 0.86 (0.79, 0.93), and 1.01 (0.91, 1.12), respectively. Dairy fat biomarkers were not associated with all-cause mortality in meta-analyses, although there were ≤3 studies for each biomarker. Study limitations include the inability of the biomarkers to distinguish different types of dairy foods and that most studies in the meta-analyses (including our novel cohort study) only assessed biomarkers at baseline, which may increase the risk of misclassification of exposure levels. CONCLUSIONS In a meta-analysis of 18 observational studies including our new cohort study, higher levels of 15:0 and 17:0 were associated with lower CVD risk. Our findings support the need for clinical and experimental studies to elucidate the causality of these relationships and relevant biological mechanisms.
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Affiliation(s)
- Kathy Trieu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Saiuj Bhat
- School of Medicine, The University of Western Australia, Crawley, Australia
| | - Zhaoli Dai
- Centre for Health Systems and Safety Research, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
- Sydney Pharmacy School and the Charles Perkins Centre, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia
| | - Karin Leander
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bruna Gigante
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Frank Qian
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Andres V. Ardisson Korat
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xiong-Fei Pan
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Federica Laguzzi
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ulf de Faire
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mai-Lis Hellénius
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jason H. Y. Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
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20
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Singh S, Acharya S, Bhat M, Bhat S, Chakravarthy PK, Kariya P. Health Locus of Control: A Determinant of Oral Health among Tobacco users in Rural India. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i38b32110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose: The concept of health locus of control is important because of its relation with health attitudes, behavior and coping styles. This study was done to compare the locus of control orientation and oral health status of tobacco users with that of non-tobacco users.
Method: This cross-sectional study was conducted on rural population in southern Indian state. All the participants were interviewed to gather data on their socio-demographic correlates, oral health related behavior and health locus of control with the help of a pre-tested questionnaire. Clinical examination was done using WHO oral health assessment form (1997).Main outcome measures were Locus of Control, Oral Health (dental caries status and periodontal status).
Results: Tobacco users were found to score lower on the dimension of Internality and higher on the Chance dimension compared to non-tobacco users. The prevalence and severity of periodontal disease was significantly higher in tobacco users than non-tobacco users irrespective of age and socioeconomic strata.
Conclusion: It was also concluded that non-tobacco users had internal orientation to health locus of control thereby being important behavioral factor controlling health in this group.Findings also demonstrated significant association between tobacco usage and adverse periodontal health.
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21
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Vidya GB, Bhat S, Kavitha L. A study of second to fourth digit ratio in relation to verbal and numerical intelligence among medical students. Biomedicine (Taipei) 2021. [DOI: 10.51248/.v41i2.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Prenatal androgens are believed to be one of the probable etiological factors influencing intellectual development of an individual. In-utero testosterone exposure has been thought to affect the digit ratio which is the ratio of lengths of index finger and ring finger (2D:4D). In the present work we intended to study the correlation of 2D:4D with numerical and verbal intelligence believed to be variable among genders. The aim of our study was to find the association of 2D:4D with Verbal Intelligence and Numerical Intelligence in a sample of medical students.
Materials and Methods: This study was conducted in a sample of medical students. 44 female and 44 male students participated in the study. 2D:4D measurements were made using standard procedure after which the participants completed a questionnaire containing 20 questions each to test numerical and verbal intelligence.
Results: In this study, Males were found to have a lower 2D:4D when compared to females. Individuals with lower 2D:4D in their right-hand were seen to have lower verbal intelligence and higher numerical intelligence thus suggesting that males are born with better numerical intelligence and females with greater verbal intelligence.
Conclusion: Digit ratio can be considered as a valuable indicator of individual differences in terms of intelligence, although the exact role of testosterone on brain to cause variation in these cognitive domains is yet to be clearly understood.
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Covas Moschovas M, Chew C, Bhat S, Sandri M, Rogers T, Dell’oglio P, Roof S, Reddy S, Chiara Sighinolfi M, Rocco B, Patel V. Association between Oncotype DX Genomic Prostate Score (GPS) and adverse tumor pathology after radical prostatectomy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01393-2] [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: 11/25/2022]
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23
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Noël J, Helman T, Moschovas M, Helman R, Bhat S, Reddy S, Rogers T, Patel V. Patient surgical satisfaction following da vinci single port and multi port robotic-assisted radical prostatectomy: A propensity score matched analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01486-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Covas Moschovas M, Bhat S, Rogers T, Reddy S, Noel J, Chew C, Mazzone E, Mottrie A, Patel V. Technical details comparing the da Vinci SP and da Vinci Xi approach to radical prostatectomy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01664-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Covas Moschovas M, Bhat S, Sandri M, Rogers T, Mazzone E, Roof S, Mottrie A, Patel V. Comparing the approach to radical prostatectomy using the Da Vinci Xi and Da Vinci Single Port: A propensity score analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01485-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Trieu K, Bhat S, Dai Z, Leander K, Gigante B, Qian F, Ardisson Korat A, Sun Q, Pan X, Laguzzi F, Cederholm T, De Faire U, Hellenius ML, Wu JH, Risérus U, Marklund M. Abstract 026: Biomarkers Of Dairy Fat Intake Associated With Lower Cardiovascular Disease Risk: A Cohort Study And Meta-analysis. Circulation 2021. [DOI: 10.1161/circ.143.suppl_1.026] [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: 11/16/2022]
Abstract
Introduction:
Dietary recommendations promote low-fat rather than full fat dairy consumption. Emerging evidence, however, has raised doubts if avoidance of dairy fat will lower CVD risk. Traditionally, self-reported estimates of dairy fat intake were used to study its relationship with CVD, which are subject to recall biases and measurement error. Here, we employed circulating levels of pentadecanoic acid [15:0] as a biomarker of dairy fat intake to examine its association with CVD incidence and all-cause mortality in a Swedish population-based cohort. We also conducted a systematic review of prospective studies that assessed 15:0, and other dairy fat biomarkers (heptadecanoic acid [17:0] and
trans
-palmitoleic acid [
t
16n-7]) and their associations with CVD and all-cause mortality.
Hypothesis:
We assessed the hypothesis that higher levels of dairy fat biomarkers 15:0, 17:0 and
t
16n-7 would be associated with lower risk of incident CVD events and all-cause mortality.
Methods:
In a cohort of 60-year old Swedish women (n=2133) and men (n=2017), we measured 15:0 in serum cholesterol esters at baseline in 1997-99. Cox proportional hazard models were used to assess the associations between serum 15:0 with CVD outcomes and all-cause mortality, after adjusting for demographics and CVD risk factors. In the meta-analysis, five databases were searched to include prospective observational studies that examined the associations between circulating or adipose tissues levels of 15:0, 17:0 and
t
16n-7 and CVD and mortality risks. Pooled associations of each dairy fat biomarker with incidence of CVD and all-cause mortality were estimated using a random-effects model.
Results:
During a median follow-up of 16.6 years, 578 incident CVD events and 676 deaths were identified using national registers. In multivariable-adjusted models, higher serum 15:0 was associated with lower incidence of CVD in a linear dose-response manner [HR: 0.75 per interquintile range; 95% CI: 0.61, 0.93), but in a non-linear relationship with all-cause mortality (P
nonlinearity
= 0.03); with a nadir of mortality risk around the median level of 15:0. In the meta-analysis including our Swedish cohort and 17 other studies, the relative risk of total CVD comparing the highest versus the lowest tertile was 0.88 (0.78, 0.99) for 15:0 (n=17), 0.86 (0.79, 0.93) for 17:0 (n=12), and 1.01 (0.91, 1.12) for t16n-7 (n=6). In meta-analyses of ≤3 studies, there was little evidence that dairy fat biomarkers were associated with all-cause mortality.
Conclusion:
In conclusion, our de novo Swedish cohort study and an updated systematic review including 18 studies suggests that higher levels of dairy fat biomarkers (15:0 and 17:0) were associated with a lower risk of CVD incidence. These results justify further investigation in interventional and experimental studies to elucidate the potential causality of these relationships and relevant mechanisms.
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Affiliation(s)
- Kathy Trieu
- The George Institute for Global Health, Newtown, Australia
| | - Saiuj Bhat
- The Univ of Western Australia, Crawley, Australia
| | | | | | - Bruna Gigante
- Institute for Environmental Medicine, Stockholm, Sweden
| | | | | | - Qi Sun
- Harvard T.H. Chan Sch of Public Health, Boston, Australia
| | - Xiongfei Pan
- The George Institute for Global Health, Newtown, Australia
| | | | | | | | | | - Jason H Wu
- The George Institute for Global Health, Newtown, Australia
| | | | - Matti Marklund
- The George Institute for Global Health, Newtown, Australia
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Varghese C, Bhat S, Wang THH, O'Grady G, Pandanaboyana S. Impact of gastric resection and enteric anastomotic configuration on delayed gastric emptying after pancreaticoduodenectomy: a network meta-analysis of randomized trials. BJS Open 2021; 5:6275938. [PMID: 33989392 PMCID: PMC8121488 DOI: 10.1093/bjsopen/zrab035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction Delayed gastric emptying (DGE) is frequent after pancreaticoduodenectomy (PD). Several RCTs have explored operative strategies to minimize DGE, however, the optimal combination of gastric resection approach, anastomotic route, configuration and the use of enteroenterostomy remains unclear. Methods MEDLINE, Embase and CENTRAL databases were systematically searched for RCTs comparing gastric resection (classic Whipple, pylorus-resecting, pylorus-preserving), anastomotic route (antecolic, retrocolic), configuration (loop gastroenterostomy/Billroth II, Roux-en-Y), and use of enteroenterostomy (Braun). A random-effects, Bayesian network meta-analysis with non-informative priors was conducted to determine the optimal combination of approaches to PD for minimizing DGE. Results Twenty-four RCTs, including 2526 patients and 14 approaches were included. There was some heterogeneity, although inconsistency was low. The overall incidence of DGE was 25.6 per cent (647 patients). Pylorus-resecting, antecolic, Billroth II with Braun enteroenterostomy was associated with the lowest rates of DGE and ranked the best in 35 per cent of comparisons. Classic Whipple, retrocolic, Billroth II with Braun ranked the worst for DGE in 32 per cent of comparisons. Pairwise meta-analysis of retrocolic versus antecolic route for gastrojejunostomy found increased risk of DGE with the retrocolic route (odds ratio 2.10, 95 per cent credibility interval (cr.i.) 0.92 to 4.70). Pairwise meta-analysis of enteroenterostomy found a trend towards lower DGE rates when this was used (odds ratio 1.90, 95 per cent cr.i. 0.92 to 3.90). Having a Braun enteroenterostomy ranked the best in 96 per cent of comparisons. Conclusion Based on existing RCT evidence, a pylorus-resecting, antecolic, Billroth II with Braun enteroenterostomy seems to be associated with the lowest rates of DGE. Preregistration PROSPERO submitted 23 December 2020. CRD42021227637
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Affiliation(s)
- C Varghese
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - S Bhat
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - T H-H Wang
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - G O'Grady
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - S Pandanaboyana
- HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Duart-Castells L, Nadal-Gratacós N, Muralter M, Puster B, Berzosa X, Estrada-Tejedor R, Niello M, Bhat S, Pubill D, Camarasa J, Sitte HH, Escubedo E, López-Arnau R. Role of amino terminal substitutions in the pharmacological, rewarding and psychostimulant profiles of novel synthetic cathinones. Neuropharmacology 2021; 186:108475. [PMID: 33529677 DOI: 10.1016/j.neuropharm.2021.108475] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 01/01/2023]
Abstract
The emergence of new synthetic cathinones continues to be a matter of public health concern. In fact, they are quickly replaced by new structurally related alternatives. The main goal of the present study was to characterize the pharmacological profile, the psychostimulant and rewarding properties of novel cathinones (pentedrone, N-ethyl-pentedrone, α-PVP, N,N-diethyl-pentedrone and α-PpVP) which only differs in their amino terminal substitution. Rat synaptosomes were used for [3H]dopamine uptake experiments. HEK293 transfected cells (hDAT, hSERT, hOCT; human dopamine, serotonin and organic cation transporter) were also used for [3H]monoamine uptake and transporter binding assays. Molecular docking was used to investigate the effect of the amino substitutions on the biological activity. Hyperlocomotion and conditioned place preference paradigm were used in order to study the psychostimulant and rewarding effects in mice. All compounds tested are potent inhibitors of DAT with very low affinity for SERT, hOCT-2 and -3, and their potency for inhibiting DAT increased when the amino-substituent expanded from a methyl to either an ethyl-, a pyrrolidine- or a piperidine-ring. Regarding the in vivo results, all the compounds induced an increase in locomotor activity and possess rewarding properties. Results also showed a significant correlation between predicted binding affinities by molecular docking and affinity constants (Ki) for hDAT as well as the cLogP of their amino-substituent with their hDAT/hSERT ratios. Our study demonstrates the role of the amino-substituent in the pharmacological profile of novel synthetic cathinones as well as their potency inhibiting DA uptake and ability to induce psychostimulant and rewarding effects in mice.
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Affiliation(s)
- L Duart-Castells
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - N Nadal-Gratacós
- Pharmaceutical Chemistry Group (GQF), IQS School of Engineering, Universitat Ramon Llull, Barcelona, Spain
| | - M Muralter
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - B Puster
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - X Berzosa
- Pharmaceutical Chemistry Group (GQF), IQS School of Engineering, Universitat Ramon Llull, Barcelona, Spain
| | - R Estrada-Tejedor
- Pharmaceutical Chemistry Group (GQF), IQS School of Engineering, Universitat Ramon Llull, Barcelona, Spain
| | - M Niello
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Vienna, Austria, A-1090
| | - S Bhat
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Vienna, Austria, A-1090
| | - D Pubill
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - J Camarasa
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
| | - H H Sitte
- Medical University Vienna, Center for Physiology and Pharmacology, Institute of Pharmacology, Vienna, Austria, A-1090; Center for Addiction Research and Science, Medical University Vienna, Waehringerstrasse 13 A, 1090, Vienna, Austria
| | - E Escubedo
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain.
| | - R López-Arnau
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Pharmacology Section and Institute of Biomedicine (IBUB), Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
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Bhat S, Trieu K, Dai Z, Leander K, Gigante B, Qian F, Korat A, Sun Q, Pan X, Laguzzi F, Cederholm T, de Faire U, Hellénius M, Wu J, Risérus U, Marklund M. Biomarkers of Dairy Fat Intake, Incident Cardiovascular Disease, and All-Cause Mortality: A Systematic Review and Meta-analysis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bhat S, deKemp R, Seto J, Green M, Birnie D, Beanlands R, Chow B, Dwivedi G. Does Left Ventricular Dyssynchrony by Positron Emission Tomography Predict Ventricular Tachyarrhythmia? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Covas Moschovas M, Bhat S, Rogers T, Onol F, Sandri M, Mazzone E, Mottrie A, Patel V. Comparing the approach to radical prostatectomy using the da Vinci Xi and da Vinci single port: A propensity score analysis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35853-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Covas Moschovas M, Bhat S, Rogers T, Onol F, Mottrie A, Patel V. Radical prostatectomy technique using the da Vinci single port. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35873-0] [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: 11/17/2022] Open
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Covas Moschovas M, Bhat S, Rogers T, Onol F, Mazzone E, Mottrie A, Patel V. Comparing the differences in the radical prostatectomy technique using the da Vinci Xi and da Vinci single port. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35874-2] [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: 11/29/2022] Open
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Covas Moschovas M, Bhat S, Rogers T, Onol F, Roof S, Mazzone E, Mottrie A, Patel V. Adoption of a new robotic platform. Key technical modifications: A step-by-step approach to da Vinci SP radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Önol F, Covas Moschovas M, Bhat S, Rogers T, Mazzone E, Mottrie A, Patel V. Technical innovations of modified apical dissection and lateral prostatic fascia preservation improves early postoperative functional recovery in robotic assisted laparoscopic radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33777-0] [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: 10/23/2022] Open
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Bhat M, Bhat S, Brondani M, Mejia GC, Pradhan A, Roberts-Thomson K, Do LG. Prevalence, Extent, and Severity of Oral Health Impacts Among Adults in Rural Karnataka, India. JDR Clin Trans Res 2020; 6:242-250. [PMID: 32516023 DOI: 10.1177/2380084420932163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Oral health affects quality of life. Many studies have investigated the factors associated with oral health-related quality of life (OHRQoL). Little is known about OHRQoL of adults living in rural and remote areas of India, where many have lower levels of education and limited availability of oral health care services. OBJECTIVES To determine the prevalence, extent, and severity of OHRQoL impacts associated with psychosocial factors, functional dentition, and patterns of dental visits among rural Indian adults between the ages of 35 and 54 y. METHODS A cross-sectional study was conducted with a multistage stratified sampling strategy targeting 35- to 54-year-olds. Interviews and oral examinations were performed to collect data on sociodemographic variables, Oral Health Impact Profile-14 (OHIP-14), patterns of dental visits, stress, tobacco and alcohol use, and dentition status. Univariate, bivariate, and multivariable analyses were done to determine the factors associated with prevalence, extent, and severity of OHIP-14 using SAS version 9.3. RESULTS There were 873 participants. Prevalence, extent, and severity of OHIP-14 were 13.4%, 0.5 (0.4-0.7), and 11.8 (11.2-12.5), respectively. The OHIP-14 impacts reported were not severe and mostly affected physical functioning. Levels of education, income, and number of functional teeth (FT) were inversely associated and last dental visit within the previous year was positively associated with prevalence, extent, and severity of OHIP-14. The prevalence of 1 or more oral health impacts was nearly 13% among rural middle-aged adults in India. CONCLUSIONS Low socioeconomic conditions, dental visits, and FT ≤19 were positively associated with prevalence, extent, and severity of oral health impacts. KNOWLEDGE TRANSFER STATEMENT This article provides data regarding OHRQoL of people in rural areas of a developing country. The study was intended to determine the factors associated with OHRQoL in rural people who are less educated and living in areas with minimal oral health care facilities. The findings of this study could potentially facilitate further research and health promotional activities for rural people of developing countries.
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Affiliation(s)
- M Bhat
- Australian Research Centre for Population Oral Health, The University of Adelaide, Australia (ARCPOH)
| | - S Bhat
- Department of Public Health Dentistry, Srinivas Institute of Dental Sciences Mangalore, India
| | - M Brondani
- Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - G C Mejia
- Australian Research Centre for Population Oral Health, The University of Adelaide, Australia (ARCPOH).,SA Aboriginal Chronic Disease Consortium Wardliparingga South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - A Pradhan
- University of Queensland, School of Dentistry, Brisbane, Australia
| | - K Roberts-Thomson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Australia (ARCPOH)
| | - L G Do
- Australian Research Centre for Population Oral Health, The University of Adelaide, Australia (ARCPOH)
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Dwivedi G, Klein R, Bhat S, Dias PS, Dent S. Does Diastolic Dysfunction Precede Systolic Dysfunction Following Contemporary Breast Cancer Therapy? JACC Cardiovasc Imaging 2020; 13:1454-1455. [DOI: 10.1016/j.jcmg.2020.03.019] [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] [Received: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/30/2022]
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Wong J, Gupta D, Nadhim A, Bhat S, Polos P. 0809 A Randomized Double-blind, Placebo Controlled Trial With Cross-over, To Assess The Efficacy Of Correcting Vitamin D Deficiency In Improving The Symptoms Of Restless Legs Syndrome (RLS). Sleep 2020. [DOI: 10.1093/sleep/zsaa056.805] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Recent studies have shown an association of low Vitamin D levels and severity of RLS symptoms. However, effect of treatment of Vit D deficiency on RLS symptoms was not reported, nor were other exacerbating factors for RLS such as iron deficiency or OSA addressed in prior studies, but have been addressed in our study.
Methods
This is an ongoing study at the JFKMC Sleep Clinic. Eligible Patients with RLS include those with vitamin D 25,hydroxy deficiency (<20 ng/ml), or insufficiency (<30 ng/ml). Such patients will be enrolled in the study after comorbid conditions like iron deficiency and OSA have been adequately corrected. Randomization of the patients will be done by the JFK pharmacy so the patient and provider are blinded to the substance. Substance A or B could be either Vitamin D3 Capsule 50,000 IU, or placebo. Each patient takes A for 6 weeks and then crosses over to B for 6 weeks. Weekly iRLS questionnaires will be collected. Actiwatch Device, to assess activity count per minute, will be worn on the ankle at night for one week time periods: at baseline, at end of 6 weeks of taking A and then at the end of 6 weeks of taking B. Vitamin D levels will also be assessed after each course of supplementation and correlated with subjective and objective findings.
Results
Between July 7, 2019 to current, 50 consecutive patients seen in sleep clinic with RLS were assessed for vitamin D levels. Ages ranged from 23-86 years. 27 patients were female (54%). Two patients met inclusion criteria and have started their 13-week study.
Conclusion
This study will help to establish the role of Vitamin D deficiency as a risk factor for RLS, independent of ferritin levels, and comorbid OSA, in affected individuals. This may help to discover a potentially treatable form of RLS.
Support
No financial support.
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Affiliation(s)
- J Wong
- JFK Medical Center Neuroscience Institute, Edison, NJ
| | - D Gupta
- JFK Medical Center Neuroscience Institute, Edison, NJ
| | - A Nadhim
- JFK Medical Center Neuroscience Institute, Edison, NJ
| | - S Bhat
- JFK Medical Center Neuroscience Institute, Edison, NJ
| | - P Polos
- JFK Medical Center Neuroscience Institute, Edison, NJ
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Nadhim AN, wong J, Gupta D, Suhan L, Siegel M, Bhat S, strauss S, Fourcard F, Pandya V. 1149 A Pilot Quality Improvement (QI) Study To Assess Whether Bilevel Positive Airway Pressure (bipap) Support In Acute Ischemic Stroke Patients With Sleep Disordered Breathing, Can Improve Neurological Recovery During Acute Stroke Care. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1143] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) has been associated with adverse outcomes in patients with stroke. While data is limited, it suggests that treatment of OSA may improve neurological recovery. With this quality improvement (QI) project, we aim to develop an interprofessional-team workflow process for screening and correction of OSA in acute ischemic stroke, with the goal to improve outcomes of neurological recovery.
Methods
This is an ongoing study to screen all eligible patients admitted to JFK Medical Center stroke unit, with MRI-proven Supratentorial acute ischemic stroke. The patients are screened using an overnight Pulse Oximetry test. A 3% oxygen desaturation index (ODI) of ≥10/hr or 4% ODI of ≥ 5/hr is considered at high risk for OSA. Such Patients will receive nocturnal Auto-adjusting BIPAP therapy during their acute care stay, for up to 5 days, for at least 4 hours per night. Eligible Patients who refused BiPAP therapy or were non-compliant will be considered as a controls. Baseline NIH stroke scale (NIHSS), and bilateral MCA mean flow velocity (MFV) in the morning, by transcranial doppler (TCD) will be assessed at baseline for cases and controls, and after BiPAP therapy, for the case group. The two groups of patients will also be compared in terms of Modified Rankin Scale at time of discharge and at phone follow-up after 6 weeks.
Results
Between Oct 17th, 2019 to current, 15 patients were admitted to the stroke unit with MRI confirmed stroke. Ages ranged from 34 - 88 years (average age 66.5 years). 8 patients (60%) were female. Of those, 6 patients consented to being screened for OSA. Of these, 1 had 4%ODI >5/hr, and therefore received treatment with BIPAP. However, compliance was < 4 hrs on 2 consecutive nights.
Conclusion
This is ongoing QI project and results will be available after few more months of continued recruitment.
Support
Auto-adjusting BIPAP machines were provided by RESMED.
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Affiliation(s)
| | - J wong
- JFK Neuroscience institute, Edison, NJ
| | - D Gupta
- JFK Neuroscience institute, Edison, NJ
| | - L Suhan
- JFK Neuroscience institute, Edison, NJ
| | - M Siegel
- JFK Neuroscience institute, Edison, NJ
| | - S Bhat
- JFK Neuroscience institute, Edison, NJ
| | - S strauss
- JFK Neuroscience institute, Edison, NJ
| | - F Fourcard
- JFK Neuroscience institute, perth amboy, NJ
| | - V Pandya
- JFK Neuroscience institute, perth amboy, NJ
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Bhat S, Marklund M, Henry ME, Appel LJ, Croft KD, Neal B, Wu JHY. A Systematic Review of the Sources of Dietary Salt Around the World. Adv Nutr 2020; 11:677-686. [PMID: 31904809 PMCID: PMC7231587 DOI: 10.1093/advances/nmz134] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [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: 07/31/2019] [Revised: 10/11/2019] [Accepted: 12/17/2019] [Indexed: 01/25/2023] Open
Abstract
Excess salt intake contributes to hypertension and increased cardiovascular disease risk. Efforts to implement effective salt-reduction strategies require accurate data on the sources of salt consumption. We therefore performed a systematic review to identify the sources of dietary salt around the world. We systematically searched peer-reviewed and gray literature databases for studies that quantified discretionary (salt added during cooking or at the table) and nondiscretionary sources of salt and those that provided information about the food groups contributing to dietary salt intake. Exploratory linear regression analysis was also conducted to assess whether the proportion of discretionary salt intake is related to the gross domestic product (GDP) per capita of a country. We identified 80 studies conducted in 34 countries between 1975 and 2018. The majority (n = 44, 55%) collected data on dietary salt sources within the past 10 y and were deemed to have a low or moderate risk of bias (n = 75, 94%). Thirty-two (40%) studies were judged to be nationally representative. Populations in Brazil, China, Costa Rica, Guatemala, India, Japan, Mozambique, and Romania received more than half of their daily salt intake from discretionary sources. A significant inverse correlation between discretionary salt intake and a country's per capita GDP was observed (P < 0.0001), such that for every $10,000 increase in per capita GDP, the amount of salt obtained from discretionary sources was lower by 8.7% (95% CI: 5.1%, 12%). Bread products, cereal and grains, meat products, and dairy products were the major contributors to dietary salt intake in most populations. There is marked variation in discretionary salt use around the world that is highly correlated with the level of economic development. Our findings have important implications for the type of salt-reduction strategy likely to be effective in a country.
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Affiliation(s)
- Saiuj Bhat
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Matti Marklund
- The George Institute for Global Health, Newtown, New South Wales, Australia
- The Friedman School of Nutrition and Policy, Tufts University, Boston, MA, USA
| | - Megan E Henry
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Kevin D Croft
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Bruce Neal
- The George Institute for Global Health, Newtown, New South Wales, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Jason H Y Wu
- The George Institute for Global Health, Newtown, New South Wales, Australia
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Gahungu N, Trueick R, Bhat S, Sengupta PP, Dwivedi G. Current Challenges and Recent Updates in Artificial Intelligence and Echocardiography. Curr Cardiovasc Imaging Rep 2020. [DOI: 10.1007/s12410-020-9529-x] [Citation(s) in RCA: 8] [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: 12/22/2022]
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Bhat S, Mocciaro G, Ray S. The association of dietary patterns and carotid intima-media thickness: A synthesis of current evidence. Nutr Metab Cardiovasc Dis 2019; 29:1273-1287. [PMID: 31669106 DOI: 10.1016/j.numecd.2019.08.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 02/06/2023]
Abstract
AIMS Dietary pattern (DP) analysis has emerged as a holistic method to understand the effects of food intake on health outcomes. Though dietary intake has been associated with cardiovascular disease, the association of DPs and carotid intima-media thickness (CIMT), a robust early marker of cardiovascular disease progression has not been comprehensively investigated. This study systematically explores the association of a posteriori and a priori DPs and CIMT. DATA SYNTHESIS Through a systematic search of MEDLINE, CINAHL, and Web of Science, twenty studies that derived DPs using a posteriori or a priori methods with CIMT as an outcome were included. Four cross-sectional studies and 1 cohort paper reported a statistically significant association between increased consumption of 'unhealthy' foods (i.e processed meat, soda drinks and refined grain) and increased CIMT. While four cross-sectional studies reported a statistically significant association of DPs characterized by increased consumption of 'healthy' foods (i.e fruit and vegetables, fish) and decreased CIMT. DPs derived from each study varied depending on derivation method, study design and use of dietary data collection method. CONCLUSION Findings from this review are generally supportive of a trend between DPs with higher consumption of 'healthy' foods and lower consumption of 'unhealthy' foods and decreased CIMT; however, the association was largely not statistically significant. Evidence was overwhelmingly heterogeneous due to differences seen in DPs based on location and culture, sample characteristics and adjustment for confounders. Long-term prospective observational and interventional studies with standardized sample selection and dietary data collection are needed to significantly establish the role of DPs on CIMT.
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Affiliation(s)
- S Bhat
- Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, SE1 1UL, UK; MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK.
| | - G Mocciaro
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK
| | - S Ray
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK
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Bhat S, Gahungu N, Thavendiranathan P, Dwivedi G. The Role of Echocardiography in Cardio-oncology Patients: Contemporary Indications and Future Directions. Curr Cardiovasc Imaging Rep 2019. [DOI: 10.1007/s12410-019-9519-z] [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: 12/14/2022]
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King J, Bhat S, Heath LJ, Derington CG, Yu Z, Clark NP, Witt DM, Reynolds K, Lang DT, Xu S, Bellows BK. P5239Cost-effectiveness of direct oral anticoagulants for cancer-associated venous thromboembolism. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Direct oral anticoagulants (DOACs) are at least as effective as low-molecular weight heparins (LMWH) at preventing recurrence after cancer-associated venous thromboembolism (CA-VTE). DOACs are also oral and far less costly, but they may confer a higher bleeding risk than LMWH.
Purpose
To estimate the cost-effectiveness of DOACs and LMWHs for CA-VTE.
Methods
We developed a health state transition model to estimate recurrent VTE, bleeding events, quality-adjusted life years (QALY), and direct healthcare costs (2018 United States dollars) associated with DOACs vs. LMWH use. The model had four states: (1) long-term anticoagulation (first 3 months after VTE), (2) extended anticoagulation (more than 3 months after VTE), (3) off anticoagulants, and (4) death. We used a United States healthcare sector perspective, 3-month cycle length, and 1-year time horizon. Event probabilities were derived from the Hokusai Cancer VTE trial and other literature. Event and medication costs were obtained from national sources. We used a threshold of less than $50,000 per QALY gained to define cost-effectiveness.
Results
Compared to LMWH, DOACs were less costly (mean costs: $8,477 vs. $33,917 per year) and similarly effective (mean QALY: 0.616 vs. 0.622). The incremental cost-effectiveness ratio was $4,479,374 per QALY gained with LMWH, indicating that DOACs are cost-effective (Table 1). In threshold analyses, LMWH therapy only became cost-effective when DOAC recurrent VTE risk increased to at least 72% (relative risk vs. LMWH, 6.19) or DOAC clinically relevant bleeding increased to at least 39% (relative risk vs. LMWH, 10.09).
Scenarios Recurrent VTE, % Major bleed, % Mean difference DOAC − LMW ICER DOAC LMWH Relative Risk DOAC LMWH Relative Risk Cost QALY Base case 8.1 11.6 0.71 6.8 4.0 1.75 −$25,440 (−26,496, −24,274) −0.006 (−0.019, 0.008) $4,479,374 DOAC outcome rate threshold at which LMWH becomes cost-effective* Recurrent VTE 71.5 11.7 6.19 – – – −$6,064 (−7,534, −4,627) −0.121 (−0.136, −0.108) $49,886 Major Bleed – – – 38.9 4.0 10.09 −$2,192 (−3,400, −704) −0.044 (−0.056, −0.030) $49,878 DOAC = direct oral anticoagulant, ICER = incremental cost-effectiveness ratio, LMWH = low-molecular-weight heparin, VTE = venous thromboembolism. Values are mean (95% Uncertainty Interval). Uncertainty was derived from 1,000 stochastic model iterations. *Represents the minimum increased risk with DOAC that would result in LMWH achieving an ICER <$50K per QALY gained.
Conclusion
In this simulation study, DOACs were a cost-effective oral alternative to LMWH for the treatment of CA-VTE. For LMWH to be cost-effective, DOAC event rates needed to be far higher than what is likely to be observed in clinical practice.
Acknowledgement/Funding
Agency for Health Research and Quality R18HS026156
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Affiliation(s)
- J King
- University of Utah, Salt Lake City, United States of America
| | - S Bhat
- Boston Medical Center, Boston, United States of America
| | - L J Heath
- University of Utah, Salt Lake City, United States of America
| | - C G Derington
- University of Colorado, Aurora, United States of America
| | - Z Yu
- University of Utah, Salt Lake City, United States of America
| | - N P Clark
- Kaiser Permanente Colorado, Aurora, United States of America
| | - D M Witt
- University of Utah, Salt Lake City, United States of America
| | - K Reynolds
- Kaiser Permanente Southern California, Pasadena, United States of America
| | - D T Lang
- Kaiser Permanente Southern California, Pasadena, United States of America
| | - S Xu
- Kaiser Permanente Colorado, Aurora, United States of America
| | - B K Bellows
- Columbia University Medical Center, New York, United States of America
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45
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Kaushal C, Bhat S, Koundal D, Singla A. Recent Trends in Computer Assisted Diagnosis (CAD) System for Breast Cancer Diagnosis Using Histopathological Images. Ing Rech Biomed 2019. [DOI: 10.1016/j.irbm.2019.06.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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46
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Woyach J, Rogers K, Bhat S, Blachly J, Jianfar M, Hamdy A, Frigault M, Izumi R, Munugalavadla V, Quah C, Wang M, Byrd J. Acalabrutinib With Obinutuzumab in Treatment-Naive and Relapsed/Refractory Chronic Lymphocytic Leukemia: 3-Year Follow-Up. Hematol Oncol 2019. [DOI: 10.1002/hon.26_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J. Woyach
- Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus OH United States
| | - K.A. Rogers
- Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus OH United States
| | - S. Bhat
- Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus OH United States
| | - J. Blachly
- Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus OH United States
| | - M. Jianfar
- Internal Medicine; The Ohio State University Comprehensive Cancer Center; Columbus OH United States
| | - A. Hamdy
- Early Research and Development; Acerta Pharma; South San Francisco CA United States
| | - M.M. Frigault
- Translational Science; Acerta Pharma; South San Francisco CA United States
| | - R. Izumi
- Early Research and Development; Acerta Pharma; South San Francisco CA United States
| | - V. Munugalavadla
- Translational Science; Acerta Pharma; South San Francisco CA United States
| | - C.S. Quah
- Clinical Development; Acerta Pharma; South San Francisco CA United States
| | - M.H. Wang
- Clinical Development; Acerta Pharma; South San Francisco CA United States
| | - J.C. Byrd
- Early Research and Development; Acerta Pharma; South San Francisco CA United States
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47
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Bond D, Huang Y, Fisher J, Ruppert A, Owen D, Bertino E, Rogers K, Bhat S, Jaglowski S, Grever M, Byrd J, Maddocks K, Woyach J. SECOND CANCER INCIDENCE IN CLL PATIENTS RECEIVING BTK INHIBITORS. Hematol Oncol 2019. [DOI: 10.1002/hon.51_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- D.A. Bond
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - Y. Huang
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - J. Fisher
- Division of Epidemiology; The Ohio State University; Columbus United States
| | - A. Ruppert
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - D. Owen
- Division of Oncology; Ohio State Comprehensive Cancer Center; Columbus United States
| | - E. Bertino
- Division of Oncology; Ohio State Comprehensive Cancer Center; Columbus United States
| | - K. Rogers
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - S. Bhat
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - S. Jaglowski
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - M. Grever
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - J. Byrd
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - K. Maddocks
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
| | - J. Woyach
- Division of Hematology; Ohio State University Comprehensive Cancer Center; Columbus United States
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48
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Gahungu N, Chow B, Tewari S, Bhat S, Rankin J, Dwivedi G. Quantified Coronary Plaque Characteristics between Caucasians and Morise Score-Matched South Asian Populations. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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49
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Kane D, Agnew P, McConville R, Bhat S. Percutaneous transhepatic cholangiography for malignant biliary obstruction – A large single centre study. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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50
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Horne DJ, Jones BE, Kamada A, Fukushima K, Winthrop KL, Siegel SAR, Kovacs A, Anthony P, Meekin KA, Bhat S, Kerndt P, Chang A, Koelle DM, Narita M. Multicenter study of QuantiFERON®-TB Gold Plus in patients with active tuberculosis. Int J Tuberc Lung Dis 2018; 22:617-621. [DOI: 10.5588/ijtld.17.0721] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- D. J. Horne
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Department of Global Health, Firland Northwest TB Center, University of Washington, Seattle, Washington
| | - B. E. Jones
- Division of Infectious Diseases, Department of Medicine, University of Southern California, Los Angeles, California, USA
| | - A. Kamada
- National Hospital Organization Hokkaido Medical Center, Sapporo
| | - K. Fukushima
- Division of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - K. L. Winthrop
- Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, School of Public Health, Oregon Health & Science University, Portland State University, Portland, Oregon
| | - S. A. R. Siegel
- School of Public Health, Oregon Health & Science University, Portland State University, Portland, Oregon
| | - A. Kovacs
- Maternal, Child, and Adolescent Virology Research Laboratory, University of Southern California, Los Angeles
| | - P. Anthony
- Maternal, Child, and Adolescent Virology Research Laboratory, University of Southern California, Los Angeles
| | - K. A. Meekin
- Maternal, Child, and Adolescent Virology Research Laboratory, University of Southern California, Los Angeles
| | - S. Bhat
- Division of Infectious Diseases, Department of Medicine, University of Southern California, Los Angeles, California, USA
| | - P. Kerndt
- TB Control Program, Los Angeles County Department of Public Health, Los Angeles, California
| | - A. Chang
- TB Control Program, Los Angeles County Department of Public Health, Los Angeles, California
| | - D. M. Koelle
- Department of Global Health, Division of Allergy and Infectious Diseases, Department of Medicine, Department of Laboratory Medicine, University of Washington, Seattle, Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center,
Seattle, Benaroya Research Institute, Seattle
| | - M. Narita
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Department of Global Health, Firland Northwest TB Center, University of Washington, Seattle, Washington, Benaroya Research Institute, Seattle
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