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Gupta P, Jindal M, Garg S, Garg K. Occupational Nerve Injuries due to Metallic Foreign Bodies: A Case Series of Eighteen Patients. Malays Orthop J 2024; 18:84-90. [PMID: 38638651 PMCID: PMC11023338 DOI: 10.5704/moj.2403.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/22/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction Peripheral nerve injuries (PNIs) remain an important health problem. PNIs mostly affect young men as this age group is mostly involved in road traffic accidents and other injuries at workplace. PNI can occur from foreign bodies like metal chips while working in industries using lathe machines. Among PNI's, injuries to the ulnar nerve, the brachial plexus and the median nerve are the most frequent lesions encountered. Materials and methods This presentation is on a series of 18 cases of nerve injuries among industrial workers located from finger level up to the arm excluding the brachial plexus due to metallic foreign bodies entering while operating lathe machines over a period of two years with patients being followed-up over a one year period. Results Mean age in this series was 31.3 years with age range 16-40 years and all were males. Two patients had more than one nerve involvement and one patient had associated vascular injury. All the patients showed functional improvement. Most common nerve injured was median nerve. Most common site for nerve injury was forearm. Combined lesions most commonly involved the ulnar and median nerves. Conclusion Social cost of traumatic peripheral nerve injuries is significant since it has a higher incidence in young, previously healthy, and economically active people.
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Affiliation(s)
- P Gupta
- Department of Orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, India
| | - M Jindal
- Department of Orthopaedics, Kalpana Chawla Govt Medical College and Hospital, Karnal, India
| | - S Garg
- Department of Radiotherapy, Guru Gobind Singh Medical College and Hospital, Faridkot, India
| | - K Garg
- Department of Anaesthesiology, Kalpana Chawla Govt Medical College and Hospital, Karnal, India
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Khyati, Manchanda V, Pumma P, Chawla R, Garg S, Saxena S. Diagnostic performance of saliva RT-PCR test as a diagnostic tool and its utility in the detection of SARS-CoV-2 shedding with different patient characteristics: Prospective observational study. Indian J Med Microbiol 2024; 47:100490. [PMID: 37890412 DOI: 10.1016/j.ijmmb.2023.100490] [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: 04/16/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Salivary shedding of SARS-CoV-2 is a known entity and its role has been established in transmission of the disease. The present study was performed to evaluate the duration of viral shedding in saliva in COVID-19 patients and its variation among symptomatic and asymptomatic patients with or without co-morbidities. METHODS The present prospective observational study was conducted at the COVID-19 care hospital associated with primary to tertiary care in New Delhi, India. A total of 124 COVID-19 confirmed cases enrolled in two phases (January-March 2021; April-June 2021) who consented for 48hrly saliva and nasopharyngeal swab (NPS) specimens till discharge from the hospital for SARS-CoV-2 detection were included. The specimens obtained were tested for SARS-CoV-2 by Real-Time PCR. RESULTS The sensitivity and the specificity of RT-PCR on saliva were 81.7 % and 85.0 %, respectively. The sensitivity of saliva-based PCR was comparable in symptomatic and asymptomatic patients (81.6 % vs 82.1 %). The sensitivity of saliva-based PCR markedly increased in the second phase of enrollment as compared to the first phase (92.6 % vs 78.5 %) indicating higher level of salivary shedding by the delta variant of SARS-CoV-2. The sensitivity of PCR on saliva was the highest up to day seven of illness. The median duration of RNA shedding in saliva was comparable among the symptomatic and asymptomatic patients. The severity of the disease was not associated with the duration of SARS-CoV-2 shedding in saliva. CONCLUSIONS SARS-CoV-2 shedding in saliva continued till seven days in large number of patients including asymptomatic patients. Saliva is non-inferior to NPS specimen in the diagnosis of SARS-CoV-2. Saliva specimen is recommended as a good alternate to NPS for SARS-CoV-2 testing.
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Affiliation(s)
- Khyati
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - V Manchanda
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India.
| | - P Pumma
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - R Chawla
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
| | - S Garg
- Department of Medicine, Maulana Azad Medical College, 110002, New Delhi, India
| | - S Saxena
- Department of Microbiology, Maulana Azad Medical College, 110002, New Delhi, India
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Sharma P, Garg S, Malani SK. Left atrial strain predicts improvement in left atrial functions of severe rheumatic mitral stenoses undergoing successful percutaneous transmitral commissurotomy. Echocardiography 2023. [PMID: 37270686 DOI: 10.1111/echo.15627] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/06/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023] Open
Abstract
AIMS Chronic rheumatic heart disease (RHD) is prevalent in India. The mitral valve in isolation or combination with the aortic or tricuspid valve is involved in 31.6% and 52.8% of chronic RHD patients, respectively. The left atrium (LA) functions as a reservoir during the cardiac cycle. Therefore, the LA enlargement leads to longitudinal lengthening, measured as a positive strain, permitting the measurement of the longitudinal strain of LA. This study aimed to assess the LA functions using peak atrial longitudinal strain (PALS) in patients with severe rheumatic mitral stenoses (MS) in sinus rhythm who underwent successful percutaneous transvenous mitral commissurotomy (PTMC). MATERIAL AND METHODS We recruited 56 patients with severe rheumatic MS for the study, of which 06 PTMC procedures were considered unsuccessful. So, 50 patients of chronic severe rheumatic MS in sinus rhythm undergoing PTMC were enrolled in a tertiary care centre of the Armed Forces from August 2017 to May 2019. Patients included in the study were not consecutive, and patients with atrial fibrillation (AF) were excluded. RESULTS PALS improved post-PTMC (P < .001) in this study, effectively concluding that PALS is impaired in patients with severe symptomatic MS and is acutely enhanced after treatment. CONCLUSIONS PALS is a good indicator of LA function and may predict the success of PTMC on the rheumatic mitral valve.
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Affiliation(s)
- Prabhat Sharma
- Department of Cardiology, Command Hospital, Udhampur, Jammu and Kashmir, India
| | - Salil Garg
- Department of Cardiology, SGRRIMHS & Mahant Inderish Hospital, Dehradun, India
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Mishra MK, Jha SK, Patra AC, Mishra DG, Sahoo SK, Sahu SK, Verma GP, Saindane SS, Mitra P, Garg S, Pulhani V, Saradhi IV, Choudhury P, Kumar AV, Sapra BK, Kulkarni MS, Aswal DK. Generation of map on natural environmental background absorbed dose rate in India. J Environ Radioact 2023; 262:107146. [PMID: 36898251 DOI: 10.1016/j.jenvrad.2023.107146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/20/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
A systematic mapping of natural absorbed dose rate was carried out to assess the existing exposure situation in India. The mammoth nationwide survey covered the entire terrestrial region of the country comprising of 45127 sampling grids (grid size 36 km2) with more than 100,000 data points. The data was processed using Geographic Information System. This study is based on established national and international approaches to provide linkage with conventional geochemical mapping of soil. Majority (93%) of the absorbed dose rate data was collected using handheld radiation survey meters and remaining were measured using environmental Thermo Luminescent Dosimeters. The mean absorbed dose rate of the entire country including several mineralized regions, was found to be 96 ± 21 nGy/h. The median, Geometric Mean and Geometric Standard Deviation values of absorbed dose rate were 94, 94 and 1.2 nGy/h, respectively. Among the High Background Radiation Areas of the country, absorbed dose rate varied from 700 to 9562 nGy/h in Karunagappally area of Kollam district, Kerala. The absorbed dose rate in the present nationwide study is comparable with the global database.
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Affiliation(s)
- Manish K Mishra
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - S K Jha
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India.
| | - Aditi C Patra
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - D G Mishra
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - S K Sahoo
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - S K Sahu
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Gopal P Verma
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Shashank S Saindane
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Pratip Mitra
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - S Garg
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Vandana Pulhani
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - I V Saradhi
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Probal Choudhury
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - A Vinod Kumar
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - B K Sapra
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - M S Kulkarni
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - D K Aswal
- Health, Safety and Environment Group, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
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Godfrey S, Araj F, Hendren N, Amin A, Hardin E, Garg S, Grodin J, Morlend R, Thibodeau J, Peltz M, Drazner M, Farr M, Mammen P. Survival of the Unfittest: The Longest Living LVAD-Supported Patient with DMD-Associated Cardiomyopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Hofmeyer M, Haas G, Kransdorf E, Ewald G, Morris A, Owens A, Lowes B, Stoller D, Tang W, Garg S, Trachtenberg B, Shah P, Pamboukian S, Sweitzer N, Wheeler M, Wilcox J, Katz S, Pan S, Jimenez J, Smart F, Wang J, Gottlieb S, Judge D, Moore C, Huggins G, Jordan E, Kinnamon D, Ni H, Hershberger R. Genetic Signature of Dilated Cardiomyopathy Severity: The DCM Precision Medicine Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Gogia PG, Garg S, Bhatnagar T, Chopra K, Singuri R, Gildea M, Bhargavi K. Management of bronchopleural fistula using Amplatzer duct occluder device. Lung India 2023; 40:86-88. [PMID: 36695266 PMCID: PMC9894275 DOI: 10.4103/lungindia.lungindia_244_22] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 01/01/2023] Open
Affiliation(s)
- Pratibha G. Gogia
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - Salil Garg
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - Taurn Bhatnagar
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - Karan Chopra
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - Ritesh Singuri
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - M. Gildea
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - K Bhargavi
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 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9
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Hu S, Metcalf E, Mahat DB, Chan L, Sohal N, Chakraborty M, Hamilton M, Singh A, Singh A, Lees JA, Sharp PA, Garg S. Transcription factor antagonism regulates heterogeneity in embryonic stem cell states. Mol Cell 2022; 82:4410-4427.e12. [PMID: 36356583 PMCID: PMC9722640 DOI: 10.1016/j.molcel.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022]
Abstract
Gene expression heterogeneity underlies cell states and contributes to developmental robustness. While heterogeneity can arise from stochastic transcriptional processes, the extent to which it is regulated is unclear. Here, we characterize the regulatory program underlying heterogeneity in murine embryonic stem cell (mESC) states. We identify differentially active and transcribed enhancers (DATEs) across states. DATEs regulate differentially expressed genes and are distinguished by co-binding of transcription factors Klf4 and Zfp281. In contrast to other factors that interact in a positive feedback network stabilizing mESC cell-type identity, Klf4 and Zfp281 drive opposing transcriptional and chromatin programs. Abrogation of factor binding to DATEs dampens variation in gene expression, and factor loss alters kinetics of switching between states. These results show antagonism between factors at enhancers results in gene expression heterogeneity and formation of cell states, with implications for the generation of diverse cell types during development.
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Affiliation(s)
- Sofia Hu
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA
| | - Emily Metcalf
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Dig Bijay Mahat
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Lynette Chan
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Noor Sohal
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Meenakshi Chakraborty
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Maxwell Hamilton
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Arundeep Singh
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Abhyudai Singh
- Department of Electrical and Computer Engineering, University of Delaware, Newark, DE 19716, USA
| | - Jacqueline A Lees
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Phillip A Sharp
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Salil Garg
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA; Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Laboratory Medicine, Yale Stem Cell Center and Center for RNA Science and Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
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10
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Dias-Santagata D, Heist RS, Bard AZ, da Silva AFL, Dagogo-Jack I, Nardi V, Ritterhouse LL, Spring LM, Jessop N, Farahani AA, Mino-Kenudson M, Allen J, Goyal L, Parikh A, Misdraji J, Shankar G, Jordan JT, Martinez-Lage M, Frosch M, Graubert T, Fathi AT, Hobbs GS, Hasserjian RP, Raje N, Abramson J, Schwartz JH, Sullivan RJ, Miller D, Hoang MP, Isakoff S, Ly A, Bouberhan S, Watkins J, Oliva E, Wirth L, Sadow PM, Faquin W, Cote GM, Hung YP, Gao X, Wu CL, Garg S, Rivera M, Le LP, John Iafrate A, Juric D, Hochberg EP, Clark J, Bardia A, Lennerz JK. Implementation and Clinical Adoption of Precision Oncology Workflows Across a Healthcare Network. Oncologist 2022; 27:930-939. [PMID: 35852437 PMCID: PMC9632318 DOI: 10.1093/oncolo/oyac134] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/17/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Precision oncology relies on molecular diagnostics, and the value-proposition of modern healthcare networks promises a higher standard of care across partner sites. We present the results of a clinical pilot to standardize precision oncology workflows. METHODS Workflows are defined as the development, roll-out, and updating of disease-specific molecular order sets. We tracked the timeline, composition, and effort of consensus meetings to define the combination of molecular tests. To assess clinical impact, we examined order set adoption over a two-year period (before and after roll-out) across all gastrointestinal and hepatopancreatobiliary (GI) malignancies, and by provider location within the network. RESULTS Development of 12 disease center-specific order sets took ~9 months, and the average number of tests per indication changed from 2.9 to 2.8 (P = .74). After roll-out, we identified significant increases in requests for GI patients (17%; P < .001), compliance with testing recommendations (9%; P < .001), and the fraction of "abnormal" results (6%; P < .001). Of 1088 GI patients, only 3 received targeted agents based on findings derived from non-recommended orders (1 before and 2 after roll-out); indicating that our practice did not negatively affect patient treatments. Preliminary analysis showed 99% compliance by providers in network sites, confirming the adoption of the order sets across the network. CONCLUSION Our study details the effort of establishing precision oncology workflows, the adoption pattern, and the absence of harm from the reduction of non-recommended orders. Establishing a modifiable communication tool for molecular testing is an essential component to optimize patient care via precision oncology.
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Affiliation(s)
- Dora Dias-Santagata
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rebecca S Heist
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Adam Z Bard
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Ibiayi Dagogo-Jack
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Laura M Spring
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Nicholas Jessop
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander A Farahani
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jill Allen
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Lipika Goyal
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Aparna Parikh
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Joseph Misdraji
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Present affiliation: Department of Pathology, Yale University, New Haven, CT, USA
| | - Ganesh Shankar
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Justin T Jordan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew Frosch
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Timothy Graubert
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Amir T Fathi
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Gabriela S Hobbs
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Noopur Raje
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jeremy Abramson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Joel H Schwartz
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Ryan J Sullivan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - David Miller
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Mai P Hoang
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven Isakoff
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Amy Ly
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara Bouberhan
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jaclyn Watkins
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Esther Oliva
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lori Wirth
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory M Cote
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Yin P Hung
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Xin Gao
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Chin-Lee Wu
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Salil Garg
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Miguel Rivera
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Long P Le
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Dejan Juric
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Ephraim P Hochberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jeffrey Clark
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Aditya Bardia
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jochen K Lennerz
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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11
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Moiso E, Farahani A, Marble HD, Hendricks A, Mildrum S, Levine S, Lennerz JK, Garg S. Developmental Deconvolution for Classification of Cancer Origin. Cancer Discov 2022; 12:2566-2585. [PMID: 36041084 PMCID: PMC9627133 DOI: 10.1158/2159-8290.cd-21-1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/31/2022] [Accepted: 08/26/2022] [Indexed: 01/12/2023]
Abstract
Cancer is partly a developmental disease, with malignancies named based on cell or tissue of origin. However, a systematic atlas of tumor origins is lacking. Here we map the single-cell organogenesis of 56 developmental trajectories to the transcriptomes of over 10,000 tumors across 33 cancer types. We deconvolute tumor transcriptomes into signals for individual developmental trajectories. Using these signals as inputs, we construct a developmental multilayer perceptron (D-MLP) classifier that outputs cancer origin. D-MLP (ROC-AUC: 0.974 for top prediction) outperforms benchmark classifiers. We analyze tumors from patients with cancer of unknown primary (CUP), selecting the most difficult cases in which extensive multimodal workup yielded no definitive tumor type. Interestingly, CUPs form groups distinguished by developmental trajectories, and classification reveals diagnosis for patient tumors. Our results provide an atlas of tumor developmental origins, provide a tool for diagnostic pathology, and suggest developmental classification may be a useful approach for patient tumors. SIGNIFICANCE Here we map the developmental trajectories of tumors. We deconvolute tumor transcriptomes into signals for mammalian developmental programs and use this information to construct a deep learning classifier that outputs tumor type. We apply the classifier to CUP and reveal the developmental origins of patient tumors. See related commentary by Wang, p. 2498. This article is highlighted in the In This Issue feature, p. 2483.
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Affiliation(s)
- Enrico Moiso
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
- Broad Institute of Harvard-MIT, Cambridge, Massachusetts
| | - Alexander Farahani
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hetal D. Marble
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Austin Hendricks
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Samuel Mildrum
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Stuart Levine
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Jochen K. Lennerz
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Salil Garg
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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12
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Ninomiya K, Serruys PW, Garg S, Gao C, Masuda S, Lunardi M, Burzotta F, Morice MC, Colombo A, Mack MJ, Holmes DR, Davierwala PM, Thuijs D, Onuma Y. Impact of bifurcation lesion on 10-year mortality in the SYNTAX trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with higher rates of adverse events, and currently it is unclear whether PCI or coronary artery bypass grafting (CABG) is the safer treatment for these patients at very long-term follow up.
Objectives
To investigate the impact of bifurcation lesions on observed all-cause 10-year mortality in the SYNTAX trial.
Methods
In the SYNTAX Extended Survival study, 10-year observed mortality was compared among four groups: (a) presence of ≥1 bifurcation lesion and treatment with PCI (n=649), (b) no bifurcation lesion and treatment with PCI (n=248), (c) presence of ≥1 bifurcation lesion and treatment with CABG (n=651), and (d) no bifurcation lesion and treatment with CABG (n=239).
Results
Compared to patients without bifurcations, those with bifurcation lesion(s) treated with PCI had a significantly higher risk of all-cause death (19.8% vs 30.1%; HR: 1.55, 95% CI: 1.12 to 2.14; p=0.007), whereas following CABG, mortality was similar in patients with or without bifurcation lesion(s) (23.3% vs 23.0%; HR: 0.81, 95% CI: 0.59 to 1.12; p=0.207). (Figure1) There was a significant interaction between bifurcation lesion(s) and treatment arm (p for interaction=0.006).
In PCI patients, at 5-years there was no significant difference in mortality between 1- vs 2-stent techniques, whereas at 10-years, a 2-stent technique was associated with higher mortality (33.3% vs 25.9%; HR: 1.51, 95% CI: 1.06 to 2.14; p=0.021, Figure2).
Conclusions
Bifurcation lesion(s) require special attention from the heart team discussion, considering the higher 10-year all-cause mortality associated with PCI. Careful evaluation of bifurcation lesion complexity may be helpful in decision-making.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The SYNTAX Extended Survival study was supported by the German Foundation of Heart Research (Frankfurt am Main, Germany). The SYNTAX trial, during 0-5 years follow-up, was funded by Boston Scientific Corporation (Marlborough, MA, USA). Both sponsors had no role in the study design, data collection, data analyses, and interpretation of the study data, nor were involved in the decision to publish the final manuscript. The principal investigators and authors had complete scientific freedom.
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Affiliation(s)
- K Ninomiya
- National University of Ireland , Galway , Ireland
| | - P W Serruys
- National University of Ireland , Galway , Ireland
| | - S Garg
- Royal Blackburn Hospital , Blackburn , United Kingdom
| | - C Gao
- National University of Ireland , Galway , Ireland
| | - S Masuda
- National University of Ireland , Galway , Ireland
| | - M Lunardi
- National University of Ireland , Galway , Ireland
| | - F Burzotta
- Fondazione Policlinico Universitario A. Gemelli IRCSS , Rome , Italy
| | - M C Morice
- Jacques Cartier Private Hospital , Massy , France
| | - A Colombo
- Humanitas Research Hospital , Milan , Italy
| | - M J Mack
- Baylor University Medical Center , Dallas , United States of America
| | - D R Holmes
- Mayo Clinic , Rochester , United States of America
| | | | - D Thuijs
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - Y Onuma
- National University of Ireland , Galway , Ireland
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13
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Serruys PW, Gao C, Ninomiya K, Hara H, Garg S, Onuma Y, Kappetein AP, Mohr FW, Mack M. Ten years survival benefit of CABG or PCI based on individual prediction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
To compare the observed and individual predicted mortalities according to the SYNTAX score II 2020 (SSII-2020) in the all-comers SYNTAX population, and retrospectively assess the appropriateness of revascularization with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with three vessel disease (3VD) and/or left main disease (LMCAD).
Methods
Internal and external validation of the SSII-2020 to predict 10-year all-cause death was performed in the respective randomized and registry SYNTAX populations. Differences in individual predicted mortalities following CABG or PCI were ranked and displayed with the observed mortalities. The proportions of screened patients deriving a survival benefit from CABG or PCI were determined retrospectively.
Results
A total of 2602 participants (as-treated population) were included in the randomized and registry cohorts. In the randomized cohort, all-cause mortality at 10 years, as an average treatment effect, was 23.8% (199/865) with CABG and 28.6% (249/901) with PCI, with a differential survival benefit of 4.6% (95% CI: 0.58% to 8.7%, log-rank p value=0.023). In the CABG and PCI registries, mortalities were 27.8% (167/644) and 55.4% (99/192), respectively. Calibration and discrimination of the SSII-2020 was helpful in CABG and PCI patients in the randomized and registry cohorts. In the PCI registry, the SSII-2020 underestimated mortality since specific comorbidities that entail high mortality are not included in the formula (C-index: 0.72, intercept: 0.38, slope: 0.66), whilst in the CABG registry, it predicted mortality with a helpful calibration and discrimination (C-index: 0.70, intercept: 0.00, slope: 0.76). The proportions of patients with a predicted survival benefit following CABG and PCI were respectively 78.3% (1383/1766) and 21.7% (383/1766) in the randomized cohort, and 82.4% (2143/2602) and 17.7% (459/2602) in the whole SYNTAX trial population.
Conclusion
In the randomized and registry cohort of this all-comers population with 3VD and/or LMCAD, there was reasonable agreement between the individual predicted and observed mortalities after CABG or PCI, such that the predicted 10-year survival benefit might be helpful in determining the appropriateness of each modality of revascularization.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The SYNTAX Extended Survival study was supported by the German Foundation of Heart Research (Frankfurt am Main, Germany). The SYNTAX trial, during 0-5 years follow-up, was funded by Boston Scientific Corporation (Marlborough, MA, USA). Both sponsors had no role in the study design, data collection, data analyses, and interpretation of the study data, nor were involved in the decision to publish the final manuscript. The principal investigators and authors had complete scientific freedom.
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Affiliation(s)
- P W Serruys
- National University of Ireland , Galway , Ireland
| | - C Gao
- National University of Ireland , Galway , Ireland
| | - K Ninomiya
- National University of Ireland , Galway , Ireland
| | - H Hara
- National University of Ireland , Galway , Ireland
| | - S Garg
- Royal Blackburn Hospital , Blackburn , United Kingdom
| | - Y Onuma
- National University of Ireland , Galway , Ireland
| | - A P Kappetein
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - F W Mohr
- Heart Center of Leipzig , Leipzig , Germany
| | - M Mack
- Baylor Scott and White The Heart Hospital , Plano , United States of America
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14
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Abdelshafy M, Soliman O, Kim W, Ruck A, Elkoumy A, Elzomor H, Wang R, Tao L, Garg S, Mylotte D, Onuma Y, Serruys P. Quantitative angiographic assessment of aortic regurgitation post 11 different types of TAVI devices a multicentre pooled analysis of 2665 valves. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Regurgitation following TAVR impacts all-cause mortality. So far, no quantitative comparison of regurgitation by the same core lab has been performed among the various commercially available transcatheter heart valves (THV) We aimed to compare quantitative angiographic aortic regurgitation (AR) of 11 different types of THVs.
Method
This is a multicentre retrospective corelab pooled analysis of aortograms from 2704 consecutive patients treated with 11 different THV devices. Analysis was done by quantitative videodensitometric aortography (LVOT-AR), which is an objective, accurate, and reproducible tool for assessment of AR following TAVR. This method relies on time density changes in contrast medium after injection in the ascending aorta and its regurgitation (and subsequent density increase) in the LVOT. The ratio between the areas under the two-time density curves of these regions quantifies the AR in absolute percentage. The valves evaluated include ACURATE neo2 (n=120), Lotus (n=546), Myval (n=108), VitaFlow (n=105), Evolut PRO (n=95), SAPIEN 3 (n=397), Evolut R (n=295), SAPIEN XT (n=239), ACURATE neo (n=120), Venus-A (n=113) and CoreValve (n=532). Stratification of continuous variable regurgitation into categorical variables was performed according to the following pre-determined threshold criteria: 1) none/trace regurgitation (LVOT-AR<6%); 2) mild (6%≤ LVOT-AR ≤17%); and 3) moderate or severe (LVOT-AR >17%).
Results
The addition of anti PVR sealing features to the new generations ACURATE neo2 THV proved to be effective in reduction the incidence of significant PVR In comparison with the first generation ACURATE neo.
Myval, VitaFlow and Venus-A THVs are showing promising results.
Although the incidence of moderate/severe AR has regressed over time with new generations of THVs, the incidence of mild AR is still prominent with all THVs still exhibiting mild AR with an incidence ranging between 30% and 50% with the exception of the Lotus valve that had an 19% incidence of mild AR
Conclusion
ACURATE neo2 had the lowest severe/moderate percentage of AR showing significant improvements in comparison to ACURATE neo. Myval, VitaFlow and Venus-A are promising options in the THV armamentarium. These results should be confirmed in prospective randomized, head-to-head comparisons between THVs.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Abdelshafy
- National University of Ireland , Galway , Ireland
| | - O Soliman
- National University of Ireland , Galway , Ireland
| | - W Kim
- Kerckhoff Heart and Thorax Center , Bad Nauheim , Germany
| | - A Ruck
- Karolinska Institute , Stockholm , Sweden
| | - A Elkoumy
- National University of Ireland , Galway , Ireland
| | - H Elzomor
- National University of Ireland , Galway , Ireland
| | - R Wang
- Xijing Hospital of the Fourth Military Medical University , Xi'an , China
| | - L Tao
- Xijing Hospital of the Fourth Military Medical University , Xi'an , China
| | - S Garg
- Royal Blackburn Hospital , Blackburn , United Kingdom
| | - D Mylotte
- National University of Ireland , Galway , Ireland
| | - Y Onuma
- National University of Ireland , Galway , Ireland
| | - P Serruys
- National University of Ireland , Galway , Ireland
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Moiso E, Farahani A, Marble H, Hendricks A, Mildrum S, Levine S, Lennerz J, Garg S. Abstract 4100: Developmental deconvolution for classification of cancer origin. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-4100] [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: 11/16/2022]
Abstract
Abstract
Cancer is a disease manifesting in abrogation of developmental programs, and malignancies are namedbased on their cell or tissue of origin. However, a systematic atlas of tumor origins is lacking. Here we map the single cell organogenesis of 56 developmental trajectories to the transcriptomes of over 10,000 tumors across 33 cancer types. We use this map to deconvolute individual tumors into their constituent developmental components. Based on these deconvoluted developmental programs, we construct a Developmental Machine Learning Perceptron (D-MLP) classifier that outputs cancer origin. The D-MLP classifier (ROC-AUC: 0.974 for top prediction) outperforms classification based on expression of either oncogenes or highly variable genes. We analyze tumors from patients with cancer of unknown primary (CUP), selecting the most difficult cases where extensive multimodal workup yielded no definitive tumor type. D-MLP revealed insights into developmental origins and diagnosis for most patient tumors. Our results provide a map of tumor developmental origins, provide a tool for diagnostic pathology, and suggest developmental classification may be a useful approach for otherwise unclassified patient tumors.
Citation Format: Enrico Moiso, Alexander Farahani, Hetal Marble, Austin Hendricks, Samuel Mildrum, Stuart Levine, Jochen Lennerz, Salil Garg. Developmental deconvolution for classification of cancer origin [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 4100.
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Affiliation(s)
- Enrico Moiso
- 1Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA
| | - Alexander Farahani
- 2Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Hetal Marble
- 2Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Austin Hendricks
- 1Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA
| | - Samuel Mildrum
- 1Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA
| | - Stuart Levine
- 1Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA
| | - Jochen Lennerz
- 2Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Salil Garg
- 1Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA
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Gale D, Heider K, Ruiz-Valdepenas A, Hackinger S, Perry M, Marsico G, Rundell V, Wulff J, Sharma G, Knock H, Castedo J, Cooper W, Zhao H, Smith CG, Garg S, Anand S, Howarth K, Gilligan D, Harden SV, Rassl DM, Rintoul RC, Rosenfeld N. Residual ctDNA after treatment predicts early relapse in patients with early-stage non-small cell lung cancer. Ann Oncol 2022; 33:500-510. [PMID: 35306155 PMCID: PMC9067454 DOI: 10.1016/j.annonc.2022.02.007] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Identification of residual disease in patients with localized non-small cell lung cancer (NSCLC) following treatment with curative intent holds promise to identify patients at risk of relapse. New methods can detect circulating tumour DNA (ctDNA) in plasma to fractional concentrations as low as a few parts per million, and clinical evidence is required to inform their use. PATIENTS AND METHODS We analyzed 363 serial plasma samples from 88 patients with early-stage NSCLC (48.9%/28.4%/22.7% at stage I/II/III), predominantly adenocarcinomas (62.5%), treated with curative intent by surgery (n = 61), surgery and adjuvant chemotherapy/radiotherapy (n = 8), or chemoradiotherapy (n = 19). Tumour exome sequencing identified somatic mutations and plasma was analyzed using patient-specific RaDaR™ assays with up to 48 amplicons targeting tumour-specific variants unique to each patient. RESULTS ctDNA was detected before treatment in 24%, 77% and 87% of patients with stage I, II and III disease, respectively, and in 26% of all longitudinal samples. The median tumour fraction detected was 0.042%, with 63% of samples <0.1% and 36% of samples <0.01%. ctDNA detection had clinical specificity >98.5% and preceded clinical detection of recurrence of the primary tumour by a median of 212.5 days. ctDNA was detected after treatment in 18/28 (64.3%) of patients who had clinical recurrence of their primary tumour. Detection within the landmark timepoint 2 weeks to 4 months after treatment end occurred in 17% of patients, and was associated with shorter recurrence-free survival [hazard ratio (HR): 14.8, P <0.00001] and overall survival (HR: 5.48, P <0.0003). ctDNA was detected 1-3 days after surgery in 25% of patients yet was not associated with disease recurrence. Detection before treatment was associated with shorter overall survival and recurrence-free survival (HR: 2.97 and 3.14, P values 0.01 and 0.003, respectively). CONCLUSIONS ctDNA detection after initial treatment of patients with early-stage NSCLC using sensitive patient-specific assays has potential to identify patients who may benefit from further therapeutic intervention.
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Affiliation(s)
- D Gale
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - K Heider
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - A Ruiz-Valdepenas
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - S Hackinger
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - M Perry
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - G Marsico
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - V Rundell
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - J Wulff
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - G Sharma
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - H Knock
- Cambridge Clinical Trials Unit - Cancer Theme, Cambridge, UK
| | - J Castedo
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - W Cooper
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - H Zhao
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - C G Smith
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK
| | - S Garg
- Cancer Molecular Diagnostics Laboratory, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - S Anand
- Cancer Molecular Diagnostics Laboratory, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - K Howarth
- Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK
| | - D Gilligan
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; Addenbrooke's Hospital, Cambridge, UK
| | | | - D M Rassl
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - R C Rintoul
- Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK; Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Cambridge Biomedical Campus, Cambridge, UK.
| | - N Rosenfeld
- Cancer Research UK Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK; Cancer Research UK Cambridge Centre - Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Cambridge, UK; Inivata Ltd, The Glenn Berge Building, Babraham Research Park, Babraham, Cambridge, UK.
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Thierauf JC, Farahani AA, Indave BI, Bard AZ, White VA, Smith CR, Marble H, Hyrcza MD, Chan JKC, Bishop J, Shi Q, Ely K, Agaimy A, Martinez-Lage M, Nose V, Rivera M, Nardi V, Dias-Santagata D, Garg S, Sadow P, Le LP, Faquin W, Ritterhouse LL, Cree IA, Iafrate AJ, Lennerz JK. Diagnostic Value of MAML2 Rearrangements in Mucoepidermoid Carcinoma. Int J Mol Sci 2022; 23:4322. [PMID: 35457138 PMCID: PMC9026998 DOI: 10.3390/ijms23084322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is often seen in salivary glands and can harbor MAML2 translocations (MAML2+). The translocation status has diagnostic utility as an objective confirmation of the MEC diagnosis, for example, when distinction from the more aggressive adenosquamous carcinoma (ASC) is not straightforward. To assess the diagnostic relevance of MAML2, we examined our 5-year experience in prospective testing of 8106 solid tumors using RNA-seq panel testing in combinations with a two-round Delphi-based scenario survey. The prevalence of MAML2+ across all tumors was 0.28% (n = 23/8106) and the majority of MAML2+ cases were found in head and neck tumors (78.3%), where the overall prevalence was 5.9% (n = 18/307). The sensitivity of MAML2 for MEC was 60% and most cases (80%) were submitted for diagnostic confirmation; in 24% of cases, the MAML2 results changed the working diagnosis. An independent survey of 15 experts showed relative importance indexes of 0.8 and 0.65 for "confirmatory MAML2 testing" in suspected MEC and ASC, respectively. Real-world evidence confirmed that the added value of MAML2 is a composite of an imperfect confirmation test for MEC and a highly specific exclusion tool for the diagnosis of ASC. Real-world evidence can help move a rare molecular-genetic biomarker from an emerging tool to the clinic.
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Affiliation(s)
- Julia C. Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital and Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alex A. Farahani
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Adam Z. Bard
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Valerie A. White
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Cameron R. Smith
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Hetal Marble
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB 2500, Canada;
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China;
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital, Atlanta, GA 30322, USA;
| | - Kim Ely
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany;
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- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Vania Nose
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Miguel Rivera
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Salil Garg
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Peter Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Long P. Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Lauren L. Ritterhouse
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Ian A. Cree
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - A. John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Jochen K. Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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Garg S, Truby L, DeFilippis E, Wu E, Topkara V, Peltz M, Drazner M, Bello N, Farr M. Association of Predicted Heart Mass from Mesa and Left Ventricular Mass from Dallas Heart Study with Heart Transplant Outcomes in the New Allocation System. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abraham A, Gift Silva T, Reisch J, Garg S, Fuller L. Effect of Redosing Basiliximab in the Setting of Blood Loss in Heart Transplant Recipients on Infection and Rejection. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1032] [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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Adhikari P, Ajaj R, Auty D, Bina C, Bonivento W, Boulay M, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen Y, Cleveland B, Corning J, Daugherty S, DelGobbo P, Di Stefano P, Doria L, Dunford M, Erlandson A, Farahani S, Fatemighomi N, Fiorillo G, Gallacher D, Garcés E, García Abia P, Garg S, Giampa P, Goeldi D, Gorel P, Graham K, Grobov A, Hallin A, Hamstra M, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings C, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Levashko N, Li X, Litvinov O, Lock J, Longo G, Machulin I, McDonald A, McElroy T, McLaughlin J, Mielnichuk C, Monroe J, Oliviéro G, Pal S, Peeters S, Pesudo V, Piro MC, Pollmann T, Rand E, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Sanchez García E, Sánchez-Pastor T, Santorelli R, Sinclair D, Skensved P, Smith B, Smith N, Sonley T, Stainforth R, Stringer M, Sur B, Vázquez-Jáuregui E, Viel S, Vincent A, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. Erratum: Constraints on dark matter-nucleon effective couplings in the presence of kinematically distinct halo substructures using the DEAP-3600 detector [Phys. Rev. D
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, 082001 (2020)]. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.029901] [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: 11/07/2022]
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Adhikari P, Ajaj R, Alpízar-Venegas M, Auty DJ, Benmansour H, Bina CE, Bonivento W, Boulay MG, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen Y, Cleveland BT, Corning JM, Daugherty S, DelGobbo P, Di Stefano P, Doria L, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Gorel P, Graham K, Grobov A, Hallin AL, Hamstra M, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lissia M, Litvinov O, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McLaughlin JB, Mielnichuk C, Mirasola L, Monroe J, Oliviéro G, Pal S, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Raj N, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sanchez García E, Sánchez-Pastor T, Santorelli R, Seth S, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Stainforth R, Stringer M, Sur B, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. First Direct Detection Constraints on Planck-Scale Mass Dark Matter with Multiple-Scatter Signatures Using the DEAP-3600 Detector. Phys Rev Lett 2022; 128:011801. [PMID: 35061499 DOI: 10.1103/physrevlett.128.011801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Dark matter with Planck-scale mass (≃10^{19} GeV/c^{2}) arises in well-motivated theories and could be produced by several cosmological mechanisms. A search for multiscatter signals from supermassive dark matter was performed with a blind analysis of data collected over a 813 d live time with DEAP-3600, a 3.3 t single-phase liquid argon-based detector at SNOLAB. No candidate signals were observed, leading to the first direct detection constraints on Planck-scale mass dark matter. Leading limits constrain dark matter masses between 8.3×10^{6} and 1.2×10^{19} GeV/c^{2}, and ^{40}Ar-scattering cross sections between 1.0×10^{-23} and 2.4×10^{-18} cm^{2}. These results are interpreted as constraints on composite dark matter models with two different nucleon-to-nuclear cross section scalings.
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Affiliation(s)
- P Adhikari
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - R Ajaj
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - D J Auty
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - H Benmansour
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - C E Bina
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | | | - M G Boulay
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Cadeddu
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - B Cai
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Cavuoti
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- Astronomical Observatory of Capodimonte, Salita Moiariello 16, I-80131 Napoli, Italy
- INFN Napoli, Napoli 80126, Italy
| | - Y Chen
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - B T Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - J M Corning
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - S Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
| | - P DelGobbo
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Di Stefano
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - L Doria
- PRISMA+, Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | - M Dunford
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - E Ellingwood
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - A Erlandson
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - S S Farahani
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - N Fatemighomi
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - G Fiorillo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - D Gallacher
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Garg
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Giampa
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - D Goeldi
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - P Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - K Graham
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Grobov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A L Hallin
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - M Hamstra
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - T Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A Ilyasov
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A Joy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Jigmeddorj
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C J Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - O Kamaev
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - G Kaur
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Kemp
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - I Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - M Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Lai
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - S Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Lehnert
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - A Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Levashko
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - X Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - M Lissia
- INFN Cagliari, Cagliari 09042, Italy
| | - O Litvinov
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - J Lock
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - G Longo
- Physics Department, Università degli Studi "Federico II" di Napoli, Napoli 80126, Italy
- INFN Napoli, Napoli 80126, Italy
| | - I Machulin
- National Research Centre Kurchatov Institute, Moscow 123182, Russia
- National Research Nuclear University MEPhI, Moscow 115409, Russia
| | - A B McDonald
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - T McElroy
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - J B McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - C Mielnichuk
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - L Mirasola
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - J Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - G Oliviéro
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S Pal
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - S J M Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH, United Kingdom
| | - M Perry
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - V Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - E Picciau
- Physics Department, Università degli Studi di Cagliari, Cagliari 09042, Italy
- INFN Cagliari, Cagliari 09042, Italy
| | - M-C Piro
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - T R Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N Raj
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - E T Rand
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - C Rethmeier
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - F Retière
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - I Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - L Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J B Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E Sanchez García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - T Sánchez-Pastor
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - R Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - S Seth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - D Sinclair
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - P Skensved
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - B Smith
- TRIUMF, Vancouver, British Columbia, V6T 2A3, Canada
| | - N J T Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - T Sonley
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - R Stainforth
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - M Stringer
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - B Sur
- Canadian Nuclear Laboratories, Chalk River, Ontario, K0J 1J0, Canada
| | - E Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, Ontario, P3E 2C6, Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
| | - S Viel
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - J Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX, United Kingdom
| | - M Waqar
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen's University, Kingston ON K7L 3N6,Canada
| | - M Ward
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- SNOLAB, Lively, Ontario, P3Y 1N2, Canada
| | - S Westerdale
- Department of Physics, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
- INFN Cagliari, Cagliari 09042, Italy
| | - J Willis
- Department of Physics, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada
| | - A Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A.P. 20-364, México D.F. 01000, México
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Hara H, Shiomi H, Van Klaveren D, Kent D, Steyerberg EW, Garg S, Onuma Y, Kimura T, Serruys PW. Long-term prediction of mortality and comparative treatment benefit following percutaneous or surgical revascularization. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The SYNTAX score II 2020 (SSII-2020), which was derived and externally validated from randomized trials, was designed to predict death following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with three-vessel disease and/or left main disease. We aimed to investigate its value in identifying the safest modality of revascularization in a non-randomized setting.
Methods
Five-year mortality was assessed in 7362 patients with three-vessel disease and/or left main disease enrolled in a Japanese PCI/CABG registry. New-generation drug eluting stents and imaging guidance became the default PCI strategy during enrolment of the last cohort. The discriminative ability of the SSII-2020 for 5-year mortality was assessed using Harrell's C statistic (C-index). Agreement between observed and predicted rates of all-cause mortality following either PCI or CABG and treatment benefit (absolute risk difference) for this outcome were assessed by calibration plots.
Results
The SSII-2020 had helpful discrimination (C-index = 0.72) and good calibration (intercept = −0.11, slope = 0.92) for 5-year mortality. The absolute risk difference in mortality between CABG and PCI (treatment benefit) was well calibrated when the whole population was grouped into quarters according to the predicted absolute risk difference of 5-year mortality. The observed differences in survival in favor of CABG were 4.2% (0.1 to 8.2%, log-rank p=0.05) and 8.5% (3.8 to 13.2%, log-rank p<0.01) in the respective third and fourth quarters. In contrast, the observed differences in survival were not significantly different in either the first (3.0% [−0.8 to 6.8%, log-rank p=0.12]) or the second quarter (1.3% [−2.4 to 5.1%, log-rank p=0.39]).
Conclusions
The SSII-2020 is well able to predict death at 5 years – and the mortality difference between PCI and CABG, and therefore has the potential to support decision making on revascularization in patients with three-vessel disease and/or left main coronary artery disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Hara
- Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (The)
| | - H Shiomi
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - D Van Klaveren
- Erasmus University Medical Centre, Rotterdam, Netherlands (The)
| | - D Kent
- Tufts Medical Center, Inc., Boston, United States of America
| | - E W Steyerberg
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - S Garg
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - Y Onuma
- National University of Ireland, Galway, Ireland
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - P W Serruys
- National University of Ireland, Galway, Ireland
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Adhikari P, Ajaj R, Alpízar-Venegas M, Amaudruz PA, Auty DJ, Batygov M, Beltran B, Benmansour H, Bina CE, Bonatt J, Bonivento W, Boulay MG, Broerman B, Bueno JF, Burghardt PM, Butcher A, Cadeddu M, Cai B, Cárdenas-Montes M, Cavuoti S, Chen M, Chen Y, Cleveland BT, Corning JM, Cranshaw D, Daugherty S, DelGobbo P, Dering K, DiGioseffo J, Di Stefano P, Doria L, Duncan FA, Dunford M, Ellingwood E, Erlandson A, Farahani SS, Fatemighomi N, Fiorillo G, Florian S, Flower T, Ford RJ, Gagnon R, Gallacher D, García Abia P, Garg S, Giampa P, Goeldi D, Golovko V, Gorel P, Graham K, Grant DR, Grobov A, Hallin AL, Hamstra M, Harvey PJ, Hearns C, Hugues T, Ilyasov A, Joy A, Jigmeddorj B, Jillings CJ, Kamaev O, Kaur G, Kemp A, Kochanek I, Kuźniak M, Lai M, Langrock S, Lehnert B, Leonhardt A, Levashko N, Li X, Lidgard J, Lindner T, Lissia M, Lock J, Longo G, Machulin I, McDonald AB, McElroy T, McGinn T, McLaughlin JB, Mehdiyev R, Mielnichuk C, Monroe J, Nadeau P, Nantais C, Ng C, Noble AJ, O’Dwyer E, Oliviéro G, Ouellet C, Pal S, Pasuthip P, Peeters SJM, Perry M, Pesudo V, Picciau E, Piro MC, Pollmann TR, Rand ET, Rethmeier C, Retière F, Rodríguez-García I, Roszkowski L, Ruhland JB, Sánchez-García E, Santorelli R, Sinclair D, Skensved P, Smith B, Smith NJT, Sonley T, Soukup J, Stainforth R, Stone C, Strickland V, Stringer M, Sur B, Tang J, Vázquez-Jáuregui E, Viel S, Walding J, Waqar M, Ward M, Westerdale S, Willis J, Zuñiga-Reyes A. Pulse-shape discrimination against low-energy Ar-39 beta decays in liquid argon with 4.5 tonne-years of DEAP-3600 data. Eur Phys J C Part Fields 2021; 81:823. [PMID: 34720726 PMCID: PMC8550104 DOI: 10.1140/epjc/s10052-021-09514-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The DEAP-3600 detector searches for the scintillation signal from dark matter particles scattering on a 3.3 tonne liquid argon target. The largest background comes from 39 Ar beta decays and is suppressed using pulse-shape discrimination (PSD). We use two types of PSD estimator: the prompt-fraction, which considers the fraction of the scintillation signal in a narrow and a wide time window around the event peak, and the log-likelihood-ratio, which compares the observed photon arrival times to a signal and a background model. We furthermore use two algorithms to determine the number of photons detected at a given time: (1) simply dividing the charge of each PMT pulse by the mean single-photoelectron charge, and (2) a likelihood analysis that considers the probability to detect a certain number of photons at a given time, based on a model for the scintillation pulse shape and for afterpulsing in the light detectors. The prompt-fraction performs approximately as well as the log-likelihood-ratio PSD algorithm if the photon detection times are not biased by detector effects. We explain this result using a model for the information carried by scintillation photons as a function of the time when they are detected.
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Affiliation(s)
- P. Adhikari
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. Ajaj
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Alpízar-Venegas
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | | | - D. J. Auty
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Batygov
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - B. Beltran
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - H. Benmansour
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. E. Bina
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Bonatt
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. G. Boulay
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - B. Broerman
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. F. Bueno
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - P. M. Burghardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - A. Butcher
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | | | - B. Cai
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Cárdenas-Montes
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Cavuoti
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
- INAF-Astronomical Observatory of Capodimonte, Salita Moiariello 16, 80131 Naples, Italy
| | - M. Chen
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Y. Chen
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - B. T. Cleveland
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - J. M. Corning
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Cranshaw
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Daugherty
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
| | - P. DelGobbo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Dering
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. DiGioseffo
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Di Stefano
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - L. Doria
- PRISMA+ Cluster of Excellence and Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, 55128 Mainz, Germany
| | | | - M. Dunford
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - E. Ellingwood
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - A. Erlandson
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. S. Farahani
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | | | - G. Fiorillo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - S. Florian
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Flower
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - R. J. Ford
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - R. Gagnon
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - D. Gallacher
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. García Abia
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - S. Garg
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Giampa
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - D. Goeldi
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Golovko
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - P. Gorel
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - K. Graham
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - D. R. Grant
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Grobov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. L. Hallin
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - M. Hamstra
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. J. Harvey
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Hearns
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. Hugues
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
| | - A. Ilyasov
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. Joy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Jigmeddorj
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. J. Jillings
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - O. Kamaev
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - G. Kaur
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - A. Kemp
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, 67100 Assergi, AQ Italy
| | - M. Kuźniak
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Lai
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - S. Langrock
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Lehnert
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Present Address: Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - A. Leonhardt
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - N. Levashko
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - X. Li
- Physics Department, Princeton University, Princeton, NJ 08544 USA
| | - J. Lidgard
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | | | - M. Lissia
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Lock
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - G. Longo
- Physics Department, Università degli Studi “Federico II” di Napoli, 80126 Naples, Italy
- INFN Napoli, 80126 Naples, Italy
| | - I. Machulin
- National Research Centre Kurchatov Institute, Moscow, 123182 Russia
- National Research Nuclear University MEPhI, Moscow, 115409 Russia
| | - A. B. McDonald
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. McElroy
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - T. McGinn
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. B. McLaughlin
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - R. Mehdiyev
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Mielnichuk
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - J. Monroe
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - P. Nadeau
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Nantais
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ng
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. J. Noble
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - E. O’Dwyer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - G. Oliviéro
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - C. Ouellet
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - S. Pal
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - P. Pasuthip
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. J. M. Peeters
- University of Sussex, Sussex House, Brighton, East Sussex BN1 9RH UK
| | - M. Perry
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - V. Pesudo
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - E. Picciau
- Physics Department, Università degli Studi di Cagliari, 09042 Cagliari, Italy
- INFN Cagliari, Cagliari, 09042 Italy
| | - M.-C. Piro
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - T. R. Pollmann
- Department of Physics, Technische Universität München, 80333 Munich, Germany
- Present Address: Nikhef and the University of Amsterdam, Science Park, 1098 XG Amsterdam, The Netherlands
| | - E. T. Rand
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - C. Rethmeier
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | | | - I. Rodríguez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - L. Roszkowski
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Rektorska 4, 00-614 Warsaw, Poland
- BP2, National Centre for Nuclear Research, ul. Pasteura 7, 02-093 Warsaw, Poland
| | - J. B. Ruhland
- Department of Physics, Technische Universität München, 80333 Munich, Germany
| | - E. Sánchez-García
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - R. Santorelli
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, 28040 Madrid, Spain
| | - D. Sinclair
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - P. Skensved
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Smith
- TRIUMF, Vancouver, BC V6T 2A3 Canada
| | - N. J. T. Smith
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- SNOLAB, Lively, ON P3Y 1M3 Canada
| | - T. Sonley
- SNOLAB, Lively, ON P3Y 1M3 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Soukup
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - R. Stainforth
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - C. Stone
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - V. Strickland
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
| | - M. Stringer
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - B. Sur
- Canadian Nuclear Laboratories Ltd, Chalk River, ON K0J 1J0 Canada
| | - J. Tang
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - E. Vázquez-Jáuregui
- Department of Physics and Astronomy, Laurentian University, Sudbury, ON P3E 2C6 Canada
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
| | - S. Viel
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - J. Walding
- Royal Holloway University London, Egham Hill, Egham, Surrey TW20 0EX UK
| | - M. Waqar
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- Arthur B. McDonald Canadian Astroparticle Physics Research Institute, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - M. Ward
- Department of Physics, Engineering Physics and Astronomy, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - S. Westerdale
- Department of Physics, Carleton University, Ottawa, ON K1S 5B6 Canada
- INFN Cagliari, Cagliari, 09042 Italy
| | - J. Willis
- Department of Physics, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - A. Zuñiga-Reyes
- Instituto de Física, Universidad Nacional Autónoma de México, A. P. 20-364, 01000 Mexico, D.F. Mexico
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Madariaga Urrutia A, Bonilla L, King I, Garg S, Bowering V, Dhani N, Milosevic M, Han K, Lajkosz K, Karakasis K, Ghiassi P, Siman S, Rouzbahman M, Downs G, Park N, Sheen C, Udagani S, Stockley T, Oza A, Lheureux S. 805P Clinically actionable alterations in adolescents and young adults (AYA) with gynaecological cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1247] [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] Open
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27
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Puri D, Manchanda V, Saxena S, Garg S. Mortality review of COVID-19 patients: An experience from the largest dedicated COVID hospital in Delhi. Indian J Med Microbiol 2021. [PMCID: PMC8594420 DOI: 10.1016/j.ijmmb.2021.08.215] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Udomlumleart T, Hu S, Garg S. Lineages of embryonic stem cells show non-Markovian state transitions. iScience 2021; 24:102879. [PMID: 34401663 PMCID: PMC8353490 DOI: 10.1016/j.isci.2021.102879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/13/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022] Open
Abstract
Pluripotent embryonic stem cells (ESCs) constitute the cell types of the adult vertebrate through a series of developmental state transitions. These states can be defined by expression levels of marker genes, such as Nanog and Sox2. In culture, ESCs reversibly transition between states. However, whether ESCs retain memory of their previous states or transition in a memoryless (Markovian) process remains relatively unknown. Here, we show some highly dynamic lineages of ESCs do not exhibit the Markovian property: their previous states and kin relations influence future choices. Unexpectedly, the distribution of lineages across their composition between states is constant over time, contrasting with the predictions of a Markov model. Additionally, highly dynamic ESC lineages show skewed cell fate distributions after retinoic acid differentiation. Together, these data suggest ESC lineage is an important variable governing future cell states, with implications for stem cell function and development.
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Affiliation(s)
- Tee Udomlumleart
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Sofia Hu
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Harvard-MIT MD PhD Program, Harvard Medical School, Boston, MA 02115, USA
| | - Salil Garg
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
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Krishna A, Garg S, Gupta S, Bansal H. C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) Trends following Total Hip and Knee Arthroplasties in an Indian Population - A Prospective Study. Malays Orthop J 2021; 15:143-150. [PMID: 34429835 PMCID: PMC8381678 DOI: 10.5704/moj.2107.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 06/25/2021] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION To evaluate the trends of C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) in the first three weeks after uncomplicated total hip (THR) and total knee (TKR) arthroplasty/replacement in the Indian population and to compare it with available literature. MATERIALS AND METHODS A total of 90 patients were enrolled for this prospective study, of which 30 were unilateral THR, 30 were unilateral TKR (U/L TKR) and 30 were simultaneous bilateral TKR (B/L TKR). Serum CRP and ESR were measured on the day before surgery and post-operatively on day 1st, 2nd, 3rd, 7th, 12th, and at the end of 3rd week. RESULTS CRP showed a peak at day 2nd with normalisation to pre-operative value by the end of 3rd week. While ESR showed a peak on day 3rd and continued to remain elevated even at end of 3rd week post-operatively. Both mean CRP and ESR values were higher in THR patients followed by in B/L TKR and then in U/L TKR patients. CONCLUSION CRP persists to be the best acute phase reactant in the early post-operative phase with a relatively typical pattern as compared to ESR. CRP values peak at post-operative day 2nd and then show a gradual decline. However, its normalisation to pre-operative baseline values may vary among different groups of population.
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Affiliation(s)
- A Krishna
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - S Garg
- Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India
| | - S Gupta
- Department of Orthopaedics, Fortis Hospital Mohali, Chandigarh, India
| | - H Bansal
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
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Garg S, Enny L, Singh K, Ramakant P, Mishra A. 146P Impact of breast cancer treatment on sexual health in pre-menopausal women. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Narang N, Thibodeau J, Grodin J, Garg S, McGuire D, Drazner M. Thermodilution Cardiac Index Has Poor Agreement with That Measured by the Direct Fick Method in Low-Output States. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Bhatnagar N, Gangadharan N, Garg S. Participatory disease surveillance in India: A critical interpretative synthesis! Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.989] [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: 10/22/2022] Open
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Goel P, Singh M, Borle A, Garg S. Health preparedness plan to prevent dengue epidemic in an urban area of Delhi. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.711] [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: 10/22/2022] Open
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Madariaga A, Garg S, Oza A, Rouzbahman M, Dhani N, Bonilla L, Croke J, Laframboise S, Bhat G, Kasherman L, McMullen M, Liu S, Wang L, Bowering V, Lheureux S. Treatment and outcome of women with cervical mucinous carcinoma: 10 year experience from a single centre. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.301] [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: 10/23/2022]
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Madariaga A, Garg S, Oza A, Rouzbahman M, Dhani N, Bonilla L, Laframboise S, Croke J, Kasherman L, Liu S, Bhat G, McMullen M, Wang L, Bowering V, Lheureux S. Mucinous ovarian malignancies 10-year overview of treatment and outcome from a single centre. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Raghav P, Gupta MK, Rustagi N, Mishra N, Garg S. Systems approach for assessment of maternal deaths in Rajasthan: A feasibility study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High maternal mortality in the state like Rajasthan, which is at second rank in terms of high Maternal Mortality Ratio (MMR) in India, require concentrated efforts in this direction The objectives of this study were to assess the magnitude and trend of maternal death and underlying factors contributing to maternal deaths in Rajasthan and to identify barriers and challenges in reporting maternal deaths in Rajasthan.
Methods
Data related to maternal deaths, cause of deaths and live births were retrieved from official Government sources and MMR was calculated. To find out the underlying factors contributing to maternal deaths, Verbal Autopsies were conducted through household surveys. In-depth interviews of health care staff were conducted to carry out the 'SWOT' analysis in order to identify the barriers in reporting maternal deaths. Data was analysed using SPSS version 23.
Results
A total of 7185 maternal deaths were reported from Rajasthan in last five years. The mean age of mothers was 25.18±4.98 years. Haemorrhage were reported as most common cause of maternal death (17%) followed by Severe hypertension or fits (8%) and obstructed labour (2%). The median duration of hospital stay was 23 hours (IQR=7.5-70). Maximum deaths were reported during post-partum period (61%), while around one fourth of the deaths happened during delivery.
Conclusions
The discrepancies were observed in the reporting of number and causes of maternal deaths. The trend and forecasted figures were quite different from the published National and State level reports in this regard.
Key messages
need to streamline and strengthen the Maternal Deaths Surveillance and Response to track the number of deaths and get the exact information about the underlying factors contributing to them. Effective strategies can be developed to reduce the Maternal Deaths in the State.
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Affiliation(s)
- P Raghav
- Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - M K Gupta
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - N Rustagi
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - N Mishra
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - S Garg
- Community Medicine, Maulana Azad Medical College, New Delhi, India
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Haas SS, Doucet GE, Garg S, Herrera SN, Sarac C, Bilgrami ZR, Shaik RB, Corcoran CM. Linking language features to clinical symptoms and multimodal imaging in individuals at clinical high risk for psychosis. Eur Psychiatry 2020; 63:e72. [PMID: 32778184 PMCID: PMC7443790 DOI: 10.1192/j.eurpsy.2020.73] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Abnormalities in the semantic and syntactic organization of speech have been reported in individuals at clinical high-risk (CHR) for psychosis. The current study seeks to examine whether such abnormalities are associated with changes in brain structure and functional connectivity in CHR individuals. METHODS Automated natural language processing analysis was applied to speech samples obtained from 46 CHR and 22 healthy individuals. Brain structural and resting-state functional imaging data were also acquired from all participants. Sparse canonical correlation analysis (sCCA) was used to ascertain patterns of covariation between linguistic features, clinical symptoms, and measures of brain morphometry and functional connectivity related to the language network. RESULTS In CHR individuals, we found a significant mode of covariation between linguistic and clinical features (r = 0.73; p = 0.003), with negative symptoms and bizarre thinking covarying mostly with measures of syntactic complexity. In the entire sample, separate sCCAs identified a single mode of covariation linking linguistic features with brain morphometry (r = 0.65; p = 0.05) and resting-state network connectivity (r = 0.63; p = 0.01). In both models, semantic and syntactic features covaried with brain structural and functional connectivity measures of the language network. However, the contribution of diagnosis to both models was negligible. CONCLUSIONS Syntactic complexity appeared sensitive to prodromal symptoms in CHR individuals while the patterns of brain-language covariation seemed preserved. Further studies in larger samples are required to establish the reproducibility of these findings.
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Affiliation(s)
- S S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - G E Doucet
- Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - S Garg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - S N Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - C Sarac
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Z R Bilgrami
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - R B Shaik
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - C M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Thakran R, Baghel S, Khurshid L, Kapoor S, Garg S, Malaviya A. SAT0645-HPR MYTHS AND MISCONCEPTION ABOUT THE ILLNESS AND CONVENTIONAL SYNTHETIC DMARDS (CSDMARDS) IN PATIENTS WITH SYSTEMIC IMMUNO-INFLAMMATORY RHEUMATIC DISEASES (SIRDS): A STUDY BY RHEUMATOLOGY NURSE COUNSELOR. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3099] [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: 11/03/2022]
Abstract
Background:Myths and misconceptions about illness and conventional disease modifying anti-rheumatic drugs directly influence adherence to the prescribed treatment. It is estimated that 30–50% of patients do not adhere to their prescribed treatment due to various reasons where the beliefs of the patients play a crucial role. At our centre we the specialist rheumatology nurse counsel the patients at every visit and try to remove their myths and negative beliefs about the disease as well as the medications.Objectives:•To explore the common myths and misconceptions of regarding their disease and regarding the csDMARDs.•To assess the efficacy of counseling in allaying their unfounded fear.Methods:A total of 450 patients with SIRDs at least 3 times attended the rheumatology out-patient clinic on csDMARDs were enrolled to complete a questionnaire that, besides demographic information, socio-economic status, and co- morbidities, had the following questions:1.Self reported adherence to medication2.Misbelieves regarding food items3.What kind of health-provider was consulted at the onset of the symptoms4.Their belief/knowledge regarding:A. The need for physiotherapy.B. Life style modification requirementC. About osteoarthritisD. Medication requirement during remissionE. Pregnancy and DMARDsF. The need of vaccinationG. Health hazards of smoking and alcohol useH. Harms of discontinuing treatment when they felt wellResults:A total of 450 patients included spondyloarthropathy 150(34%), rheumatoid arthritis 200(45.7%), psoriatic arthritis 45(10%), and others 25(5.5%).The following observations was made:1.Self-reported adherence to medication was in 250 (55%) patients; 200(45%) patient were non-adherent to treatment2.382/450 (85%) patients had misbelieves regarding different food items.3.225/450(50)% of the patients were not doing regular physiotherapy they were totally dependent on medications for symptoms relief.4.387/450 (86%) patients confused the symptoms of osteoarthritis with that of RA.5.315/450 (70 %) patients did not feel the requirement of continuing drugs during remission.6.135/450 (30%) patients believed that while on DMARDs they cannot contemplate pregnancy.7.351/450(78%) patients accept the need for vaccination when staring DMARDs8.360/450 (80%) patients aware about side effect of smoking in disease but only 40 % were able to quit.9.273/450 (60%) patients felt that more expensive medicines e.g.bDMARDs have more effects.10.360/450 (80%) patients believed that DMARDs were ‘steroids’ and they increased weight. On analysis one patient have more than two myths simultaneously.Conclusion:Increased awareness of the patient’s beliefs about medicines is needed among health care providers. We should encourage patients to express their views about medicines as well as disease in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication and follow up.These myths are deeply rooted in our society, single sitting counseling is not enough, and reinforcement is needed.References:[1]Tom Greenhalgh. Facts about rheumatoid arthritis: 7 myths you may encounter. Rheumatology Advisor. March 28, 2019.Acknowledgments:noDisclosure of Interests:None declared
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Thakran R, Baghel S, Messi C, Kumar V, Kapoor S, Garg S, Malaviya A. SAT0644-HPR COMPLIANCE OF BIOLOGIC DISEASES MODIFYING ANTI-RHEUMATIC DRUGS (BDMARDS) WITH SYSTEMIC IMMUNO-INFLAMMATORY RHEUMATIC DISEASES (SIRDS). AN ASSESSMENT OF PATIENTS’ ADHERENCE AND NON- ADHERENCE CONCERNS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3026] [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: 11/03/2022]
Abstract
Background:Patients with systemic immunoinflammatory rheumatic diseases (SIRDs) are often treated with bDMARDs when the response to conventional disease-modifying antirheumatic drugs (csDMARDs) is inadequate.There are, however, concerns about non-adherence to bDMARDs among patient. The non-adherence to bDMARDs may be caused by the various factors.Objectives:1.The main objective of present study was to find out the cause of discontinuation of bDMARDs2.To find out the adherence and non-adherence rate for bDMARDs.3.To identify the factors that are modifiable.Methods:800patients with SIRDs prescribed bDMARDs were interviewed to find out the demographic information, their socioeconomic status,and the disease duration.Additional information gathered included the comorbidities, the time for starting bDMARDs, the route of administration of bDMARDs, beliefs and perceptions about treatment efficacy and side effects if any.This was followed by looking at the adherence of bDMARDs; if they had discontinued then efforts was made to find out the reasons for the same.Based on these findings the patients were classified into adherent and non-adherent categories. The data were analyzed further for1.Factors that associated with persistence of bDMARDs.2.Factors that were associated with discontinuation of bDMARDs.Results:A total of 800 patients were interviewed that included patients with ankylosing spondylitis 430(52.4%), rheumatoid arthritis 300(37.7%), psoriatic arthritis 45(5.2%), and others 25 (0.7%).On analysis 610(76%) patient were compliant but 190(24%) patient had discontinued the bDMARDs on their own. On comparison of both groupsFactors that were significantly related to self-discontinuation were:•Negative beliefs about biologics (37%)•Cost (33%)•Reading side-effect profile on Google search (25%)•Other co-morbidities (6%)Factors that were significantly related to persistence of biologic treatment were:•Good counseling by rheumatologist and rheumatology nurse (60%)•Faith in the treating rheumatologist (25%)•Fear of deformities and pain(15%)On analysis it was found that a good counseling and clarifying the doubts of the patients regarding bDMARDs before starting the treatment encourages the patient to continue the biologic treatment, especially it allays their doubts about the drug adverse effects.Conclusion:Despite negative beliefs and misconceptions about bDMARDs, patient non-adherence at our center is not alarming.A positive reinforcement counseling appears to be the most significant factor to overcome the negative belief of patients.The affordability of the biologic treatment however remains a limiting factor in our centre as in other parts of India.References:[1]Tamas Koncz,MD,Marta,Pentek,Valentin,Brodszky,Katalin Ersek,MSc,Ewaorlewska&Laszlo Gulasi Volume10,2010 –Issue9 Adherence to biologic DMARD therapies in rheumatoid arthritisAcknowledgments:noDisclosure of Interests:None declared
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Baghel S, Thakran R, Messi C, Yadav V, Kapoor S, Garg S, Kashyap V, Malaviya A. FRI0601-HPR IMPACT OF LIFE STYLE MODIFICATION TECHNIQUE IN SYSTEMIC SCLEROSIS (SSC) PATIENTS: A STUDY BY RHEUMATOLOGY NURSES COUNSELOR. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1552] [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: 11/03/2022]
Abstract
Background:Systemic sclerosis (SSc) is an autoimmune the disease of the connective tissue that is clinically characterized by the involvement of skin (fibrosis, contractures of the finger joints), microvascular abnormalities (Raynaud’s phenomenon and complications), gastrointestinal involvement (gastroesophageal reflux disease - GERD, the lower GI tract involvement), musculoskeletal involvement (polyarthralgia, muscle disease), and involvement of internal organs (especially lungs, heart, and kidneys). Lifestyle modification techniques could have significant impact on various aspects of the disease including early disease control, increased drug adherence, positive attitude towards life, decreased financial burden of treatment, maintaining mobility and joints range of motion, minimizing or delaying joint contractures and decreased dependency with regular physical therapy. Counselling explaining the benefits of lifestyle modification related to these aspects of daily living may make a major difference in the quality of life of the patients with SSc.Objectives:To assess the benefits of lifestyle modification technique in improving the quality of life in patients with SSc.Methods:Patients with SSc attending the Rheumatology clinic of this institution, willing to participate in the survey, were enrolled in this study. All the information including the follow-up details were recorded in a pre-designed form. Their demographic information (age, gender) and disease characteristics (diagnosis, duration, treatment) were recorded, All the patients were explained the lifestyle modifications and their benefits, reinforced at each follow-up visit using posters (visual), written lifestyle modification techniques (using printed material) to raise their awareness of how to improve several of the above manifestations of SSc.Results:One hundred fifty (n=150) consecutive SSc patients were included in the study. It was observed that with repeated counselling 125 (83.3 %) patients adopted the lifestyle modification technique according to the advice imparted and felt a positive benefit in their daily life. However, 25 (16.6%) could not or did not follow the imparted lifestyle change advice on a regular basis. Those who were able to modify the life-style as counselled showed the following results:80 % were able to avoid exposure to cold by adopting the following measures: Wearing gloves and extra woolen socks, using mittens most of the time, wearing woollen undergarments to keep the central regions of the body region warm. These patients noted 55% decrease in the episodes of Raynaud’s phenomenon.Early evening meals and raising the head-end of the bed: 60% decrease in gastrointestinal symptoms.Regular physiotherapy: 65 % decrease dependency on others; 55% could maintain flexibility with physical exercises.Regular application and rubbing of the skin with lanoline-containing skin moisturizers 60 % improve your skin’s health80% were able to avoid active and passive tobacco use.Conclusion:The lifestyle modification techniques are important to control disease and its complications. Thus, after intense and regular counselling by the specialist rheumatology nurses on the lifestyle modification technique (83.3%) adapted the advised lifestyle modifications. The study showed the important role specialist rheumatology nurses can play in educating patients and helping them improving their quality of life.References:[1] Hudson M, Thombs BD, Steele R. at ell. Canadian Scleroderma Research G. QOL in patients with systemic sclerosis compared to the general population and patients with other chronic conditions. J Rheumatol. 2009;36(4):768–72.Disclosure of Interests:None declared
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Kapoor M, Salwan T, Garg S, Puri A, Gupta V. An observational study to determine whether alignment of endotracheal tube indicator line with the vocal cords results in appropriate depth of intubation. Acta Anaest Belg 2020. [DOI: 10.56126/71.2.5] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Background: Inappropriate endotracheal tube placement depth may be associated with complications.
Objective: To determine whether the accurate alignment of the indicator ring on the endotracheal tube at the level of the vocal cords, results in its appropriate placement.
Design: Prospective observational study.
Patients: 98 adult patients scheduled for general anesthesia with orotracheal intubation.
Interventions: The indicator band mark on the endotracheal tube was accurately placed at the vocal cords level under video-laryngoscope view. The tube length at the right upper incisor and the distance between its tip and the carina was measured using fibreoptic bronchoscope. Data to validate methods to predict insertion depth was collected and evaluated.
Main Outcome: To determine the distance between the tip of the endotracheal tube and the carina.
Results: The endotracheal tube tip depth was inap- propriate in 46.94% cases and was <3 cm above the carina in 41.64% cases. This difference in this distance was similar (p = 0.246) in the two genders. A correlation was noted between topographic length and insertion depth in females only (r2 = 0.201 and p = 0.001). The mean tracheal length was 12.66 + 1.35 cm in males and 12.04 + 1.26 cm in females.
Conclusion: We found a high incidence of endo- tracheal tube tip malposition despite the accurate placement of the indicator band at the vocal cords level. We suggest that international endotracheal tube design standards be defined and endotracheal tube manufacturers modify the standard intratracheal length.
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Mishra S, Garg S, Mahajan R, Patil A, Bhatia P, Sharma V. Azathioprine induced pancreatitis, polyarthritis and panniculitis (PPP) syndrome in a patient with Crohn's disease. Acta Gastroenterol Belg 2020; 83:87-89. [PMID: 32233278] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Azathioprine and 6-mercaptopurine have been widely used for maintenance of remission in patients with inflammatory bowel disease. The use of thiopurines is associated with multiple adverse effects including dose dependent cytopenias or idiosyncratic reaction. We report about a case of azathioprine related pancreatitis associated with polyarthralgia and panniculitis. Pancreatitis, polyarthritis and panniculitis (PPP) syndrome is an uncommon phenomenon which may accompany a number of pancreatic diseases including acute or chronic pancreatitis or pancreatic malignancy. To the best of our knowledge, this is the first report of Azathioprine related PPP syndrome.
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Affiliation(s)
- S Mishra
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Garg
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Mahajan
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Patil
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Bhatia
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Sharma
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Arriola CS, Kim L, Langley G, Anderson EJ, Openo K, Martin AM, Lynfield R, Bye E, Como-Sabetti K, Reingold A, Chai S, Daily P, Thomas A, Crawford C, Reed C, Garg S, Chaves SS. Estimated Burden of Community-Onset Respiratory Syncytial Virus-Associated Hospitalizations Among Children Aged <2 Years in the United States, 2014-15. J Pediatric Infect Dis Soc 2019; 9:587-595. [PMID: 31868913 PMCID: PMC7107566 DOI: 10.1093/jpids/piz087] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of hospitalizations in young children. We estimated the burden of community-onset RSV-associated hospitalizations among US children aged <2 years by extrapolating rates of RSV-confirmed hospitalizations in 4 surveillance states and using probabilistic multipliers to adjust for ascertainment biases. METHODS From October 2014 through April 2015, clinician-ordered RSV tests identified laboratory-confirmed RSV hospitalizations among children aged <2 years at 4 influenza hospitalization surveillance network sites. Surveillance populations were used to estimate age-specific rates of RSV-associated hospitalization, after adjusting for detection probabilities. We extrapolated these rates using US census data. RESULTS We identified 1554 RSV-associated hospitalizations in children aged <2 years. Of these, 27% were admitted to an intensive care unit, 6% needed mechanical ventilation, and 5 died. Most cases (1047/1554; 67%) had no underlying condition. Adjusted age-specific RSV hospitalization rates per 100 000 population were 1970 (95% confidence interval [CI],1787 to 2177), 897 (95% CI, 761 to 1073), 531 (95% CI, 459 to 624), and 358 (95% CI, 317 to 405) for ages 0-2, 3-5, 6-11, and 12-23 months, respectively. Extrapolating to the US population, an estimated 49 509-59 867 community-onset RSV-associated hospitalizations among children aged <2 years occurred during the 2014-2015 season. CONCLUSIONS Our findings highlight the importance of RSV as a cause of hospitalization, especially among children aged <2 months. Our approach to estimating RSV-related hospitalizations could be used to provide a US baseline for assessing the impact of future interventions.
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Affiliation(s)
- Carmen S Arriola
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay Kim
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Gayle Langley
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Evan J Anderson
- Departments of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Kyle Openo
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Andrew M Martin
- Georgia Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Erica Bye
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | | | - Arthur Reingold
- California Emerging Infections Program, Oakland, California, USA
| | - Shua Chai
- California Emerging Infections Program, Oakland, California, USA
| | - Pam Daily
- California Emerging Infections Program, Oakland, California, USA
| | - Ann Thomas
- Oregon Public Health Division, Portland, Oregon
| | | | - C Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S Garg
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sandra S Chaves
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Jain K, Kumar V, Chaturvedi A, Misra S, Gupta S, Akhtar N, Garg S, Lakshmanan M. Multidisciplinary management of sarcomas of the head and neck: An institutional experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz433.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Garg S, Chichareon P, Modolo R, Tomaniak M, Serra-Penaranda A, Curello S, Mlodziankowski A, Hamm C, Steg G, Juni P, Vranckx P, Valgimigli M, Windecker S, Onuma Y, Serruys PWJC. 5194Impact of established cardiovascular disease on outcomes in the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0053] [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
Objectives
To investigate the impact of ticagrelor monotherapy following one-month dual antiplatelet therapy (DAPT) on clinical outcomes after percutaneous coronary intervention (PCI) in patients with established cardiovascular disease (CVD) who were enrolled in the Global Leaders Trial.
Background
The impact of prolonged monotherapy with P2Y12 inhibitors after PCI in patients with CVD is undetermined.
Methods
GLOBAL LEADERS was a randomized, superiority, all-comers trial comparing one-month DAPT with ticagrelor and aspirin followed by 23-month ticagrelor monotherapy (experimental treatment) with standard 12-month DAPT followed by 12-month aspirin monotherapy (reference treatment) in patients treated with a biolimus A9-eluting stent. The cohort was stratified according to those with- and without established CVD, defined as a history of ≥1 prior myocardial infarction (MI), PCI, coronary artery bypass operation, stroke or peripheral vascular disease. The degree of CVD was defined according to the number of vascular territories effected (1, 2, ≥3). The primary endpoint was a composite of all-cause death or new Q-wave MI at 2-years. Secondary endpoints were the patient orientated composite endpoint (POCE) of death, stroke, MI and any revascularization; definite stent thrombosis and net adverse cardiovascular events a composite of POCE and BARC 3 or 5 bleeding.
Results
Amongst the 15,761 patients included in this cohort were 6693 patients (42.5%) with- and 9068 patients without established CVD. Patients with CVD were older, and had significantly higher rates of diabetes, hypertension, and hypercholesterolaemia (P<0.01). The incidence of the primary endpoint was significantly higher in patients with established CVD (5.1% vs. 3.3%, P<0.001) as were all secondary endpoints and their individual components. There was a trend for a reduction in the primary endpoint in patients with established CVD receiving the experimental treatment (4.6% vs. 5.6%, HR0.82 [0.66–1.02], p=0.07), which was not seen in those without prior CVD (3.2% vs. 3.3%, HR 0.95 [0.76–1.19, p=0.66; p(interaction)=0.37).
Compared with patients without CVD the incidence of the primary and second endpoints and all their individual components, other than BARC 3/5 bleeding, rose significantly with an increasing degree of CVD.
In an unadjusted model, compared with patients without CVD, the hazard ratio for the primary endpoint rose from 1.5 (1.21–1.81) to 3.0 (2.32–4.00) in patients with one and three territories of CVD, respectively. Similar rises were seen in models adjusted by age (1.3 [1.01–1.60] to 2.56 [1.94–3.38]) and age, left ventricular ejection fraction, clinical presentation and anti-platelet strategy (1.4 [1.10–1.68] to 2.26 [1.69–3.02]).
Conclusions
PCI outcomes are poorer in patients with increasing degrees of CVD compared to those without. Prolonged monotherapy with ticagrelor does not mitigate this risk suggesting a greater need to focus on modifiable risk factors
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Affiliation(s)
- S Garg
- Royal Blackburn Hospital, Blackburn, United Kingdom
| | - P Chichareon
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Center, Thoraxcenter, Rotterdam, Netherlands (The)
| | | | - S Curello
- University of Brescia, Brescia, Italy
| | - A Mlodziankowski
- 5 Department of Invasive Cardiology and Angiology,, Mielec, Poland
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - G Steg
- University Paris Diderot, Paris, France
| | - P Juni
- St. Michael's Hospital, Toronto, Canada
| | - P Vranckx
- Virga Jesse Hospital, Hasselt, Belgium
| | | | | | - Y Onuma
- Erasmus Medical Center, Thoraxcenter, Rotterdam, Netherlands (The)
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Mullane KM, Morrison VA, Camacho LH, Arvin A, McNeil SA, Durrand J, Campbell B, Su SC, Chan ISF, Parrino J, Kaplan SS, Popmihajlov Z, Annunziato PW, Cerana S, Dictar MO, Bonvehi P, Tregnaghi JP, Fein L, Ashley D, Singh M, Hayes T, Playford G, Morrissey O, Thaler J, Kuehr T, Greil R, Pecherstorfer M, Duck L, Van Eygen K, Aoun M, De Prijck B, Franke FA, Barrios CHE, Mendes AVA, Serrano SV, Garcia RF, Moore F, Camargo JFC, Pires LA, Alves RS, Radinov A, Oreshkov K, Minchev V, Hubenova AI, Koynova T, Ivanov I, Rabotilova B, Minchev V, Petrov PA, Chilingirov P, Karanikolov S, Raynov J, Grimard D, McNeil S, Kumar D, Larratt LM, Weiss K, Delage R, Diaz-Mitoma FJ, Cano PO, Couture F, Carvajal P, Yepes A, Torres Ulloa R, Fardella P, Caglevic C, Rojas C, Orellana E, Gonzalez P, Acevedo A, Galvez KM, Gonzalez ME, Franco S, Restrepo JG, Rojas CA, Bonilla C, Florez LE, Ospina AV, Manneh R, Zorica R, Vrdoljak DV, Samarzija M, Petruzelka L, Vydra J, Mayer J, Cibula D, Prausova J, Paulson G, Ontaneda M, Palk K, Vahlberg A, Rooneem R, Galtier F, Postil D, Lucht F, Laine F, Launay O, Laurichesse H, Duval X, Cornely OA, Camerer B, Panse J, Zaiss M, Derigs HG, Menzel H, Verbeek M, Georgoulias V, Mavroudis D, Anagnostopoulos A, Terpos E, Cortes D, Umanzor J, Bejarano S, Galeano RW, Wong RSM, Hui P, Pedrazzoli P, Ruggeri L, Aversa F, Bosi A, Gentile G, Rambaldi A, Contu A, Marei L, Abbadi A, Hayajneh W, Kattan J, Farhat F, Chahine G, Rutkauskiene J, Marfil Rivera LJ, Lopez Chuken YA, Franco Villarreal H, Lopez Hernandez J, Blacklock H, Lopez RI, Alvarez R, Gomez AM, Quintana TS, Moreno Larrea MDC, Zorrilla SJ, Alarcon E, Samanez FCA, Caguioa PB, Tiangco BJ, Mora EM, Betancourt-Garcia RD, Hallman-Navarro D, Feliciano-Lopez LJ, Velez-Cortes HA, Cabanillas F, Ganea DE, Ciuleanu TE, Ghizdavescu DG, Miron L, Cebotaru CL, Cainap CI, Anghel R, Dvorkin MV, Gladkov OA, Fadeeva NV, Kuzmin AA, Lipatov ON, Zbarskaya II, Akhmetzyanov FS, Litvinov IV, Afanasyev BV, Cherenkova M, Lioznov D, Lisukov IA, Smirnova YA, Kolomietz S, Halawani H, Goh YT, Drgona L, Chudej J, Matejkova M, Reckova M, Rapoport BL, Szpak WM, Malan DR, Jonas N, Jung CW, Lee DG, Yoon SS, Lopez Jimenez J, Duran Martinez I, Rodriguez Moreno JF, Solano Vercet C, de la Camara R, Batlle Massana M, Yeh SP, Chen CY, Chou HH, Tsai CM, Chiu CH, Siritanaratkul N, Norasetthada L, Sriuranpong V, Seetalarom K, Akan H, Dane F, Ozcan MA, Ozsan GH, Kalayoglu Besisik SF, Cagatay A, Yalcin S, Peniket A, Mullan SR, Dakhil KM, Sivarajan K, Suh JJG, Sehgal A, Marquez F, Gomez EG, Mullane MR, Skinner WL, Behrens RJ, Trevarthe DR, Mazurczak MA, Lambiase EA, Vidal CA, Anac SY, Rodrigues GA, Baltz B, Boccia R, Wertheim MS, Holladay CS, Zenk D, Fusselman W, Wade III JL, Jaslowsk AJ, Keegan J, Robinson MO, Go RS, Farnen J, Amin B, Jurgens D, Risi GF, Beatty PG, Naqvi T, Parshad S, Hansen VL, Ahmed M, Steen PD, Badarinath S, Dekker A, Scouros MA, Young DE, Graydon Harker W, Kendall SD, Citron ML, Chedid S, Posada JG, Gupta MK, Rafiyath S, Buechler-Price J, Sreenivasappa S, Chay CH, Burke JM, Young SE, Mahmood A, Kugler JW, Gerstner G, Fuloria J, Belman ND, Geller R, Nieva J, Whittenberger BP, Wong BMY, Cescon TP, Abesada-Terk G, Guarino MJ, Zweibach A, Ibrahim EN, Takahashi G, Garrison MA, Mowat RB, Choi BS, Oliff IA, Singh J, Guter KA, Ayrons K, Rowland KM, Noga SJ, Rao SB, Columbie A, Nualart MT, Cecchi GR, Campos LT, Mohebtash M, Flores MR, Rothstein-Rubin R, O'Connor BM, Soori G, Knapp M, Miranda FG, Goodgame BW, Kassem M, Belani R, Sharma S, Ortiz T, Sonneborn HL, Markowitz AB, Wilbur D, Meiri E, Koo VS, Jhangiani HS, Wong L, Sanani S, Lawrence SJ, Jones CM, Murray C, Papageorgiou C, Gurtler JS, Ascensao JL, Seetalarom K, Venigalla ML, D'Andrea M, De Las Casas C, Haile DJ, Qazi FU, Santander JL, Thomas MR, Rao VP, Craig M, Garg RJ, Robles R, Lyons RM, Stegemoller RK, Goel S, Garg S, Lowry P, Lynch C, Lash B, Repka T, Baker J, Goueli BS, Campbell TC, Van Echo DA, Lee YJ, Reyes EA, Senecal FM, Donnelly G, Byeff P, Weiss R, Reid T, Roeland E, Goel A, Prow DM, Brandt DS, Kaplan HG, Payne JE, Boeckh MG, Rosen PJ, Mena RR, Khan R, Betts RF, Sharp SA, Morrison VA, Fitz-Patrick D, Congdon J, Erickson N, Abbasi R, Henderson S, Mehdi A, Wos EJ, Rehmus E, Beltzer L, Tamayo RA, Mahmood T, Reboli AC, Moore A, Brown JM, Cruz J, Quick DP, Potz JL, Kotz KW, Hutchins M, Chowhan NM, Devabhaktuni YD, Braly P, Berenguer RA, Shambaugh SC, O'Rourke TJ, Conkright WA, Winkler CF, Addo FEK, Duic JP, High KP, Kutner ME, Collins R, Carrizosa DR, Perry DJ, Kailath E, Rosen N, Sotolongo R, Shoham S, Chen T. Safety and efficacy of inactivated varicella zoster virus vaccine in immunocompromised patients with malignancies: a two-arm, randomised, double-blind, phase 3 trial. The Lancet Infectious Diseases 2019; 19:1001-1012. [DOI: 10.1016/s1473-3099(19)30310-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/25/2022]
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Mohan K, Kaushal T, Garg S, Pannu AK, Bhalla A, Suri V, Kumari S. Primary hyperparathyroid bone disease. QJM 2019; 112:545. [PMID: 30629246 DOI: 10.1093/qjmed/hcz012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Mohan
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - T Kaushal
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - S Garg
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - A K Pannu
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - A Bhalla
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - V Suri
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
| | - S Kumari
- Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, 4th floor, F block, Chandigarh 160012, Punjab, India
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Abstract
This article describes the clinical protocol of using potassium iodide (KI) to reverse staining caused by silver diamine fluoride (SDF). SDF contains silver, fluoride, and ammonia. It has been used to arrest dental caries mainly in pediatric applications. The major drawback of SDF application is the dark staining of both teeth and restorative materials. Hence, its use on adult dentition is limited. Improving the esthetic outcome by stain reduction would greatly enhance the opportunity for SDF's universal use. This case demonstrates how KI can effectively reverse the staining.
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Garg S, Gupta M, Choudhry PN. A rare case of emphysematous osteomyelitis of spine in uncontrolled diabetes mellitus. Med Intensiva 2018; 43:127-128. [PMID: 30292343 DOI: 10.1016/j.medin.2018.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 11/18/2022]
Affiliation(s)
- S Garg
- Department of Critical Care Medicine, Max Super Speciality Hospital, Vaishali, Ghaziabad 201012, India
| | - M Gupta
- Department of Critical Care Medicine, Max Super Speciality Hospital, Vaishali, Ghaziabad 201012, India.
| | - P N Choudhry
- Department of Internal Medicine, Max Super Speciality Hospital, Vaishali, Ghaziabad 201012, India
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Anderson SG, Contractor H, Saluja S, Sarma J, Garg S. 6130Next generation P2Y12 inhibitors improve survival in ACS: An analysis from the British Cardiovascular Intervention Society database. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S G Anderson
- University of Manchester, Institute of Cardiovascular Sciences, Manchester, United Kingdom
| | - H Contractor
- University Hospital of South Manchester NHS Foundation Trust, North West Heart Centre, Manchester, United Kingdom
| | - S Saluja
- University of Manchester, Institute of Cardiovascular Sciences, Manchester, United Kingdom
| | - J Sarma
- University Hospital of South Manchester NHS Foundation Trust, North West Heart Centre, Manchester, United Kingdom
| | - S Garg
- Royal Blackburn Hospital, Blackburn, United Kingdom
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