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Leiby A, Albenberg L, Langseder A, Kennedy M, Pressman N, Chiu S, Rosh JR. A prospective, controlled multisite trial of yoga in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2024; 78:272-279. [PMID: 38327225 DOI: 10.1002/jpn3.12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/24/2023] [Accepted: 11/18/2023] [Indexed: 02/09/2024]
Abstract
AIM To investigate whether a structured yoga program improves health-related quality of life (HRQOL) and self-efficacy in pediatric patients receiving care for inflammatory bowel disease (IBD). METHODS IBD patients who were 10-17 years old participated in a 12 week, in-person yoga intervention at two clinical sites. Outcomes were measured at time of consent (T0), start of yoga (T1), and completion of yoga (T2) and 3 months after yoga completion (T3) using the IMPACT-III, Pediatric Quality of Life Inventory (PedsQL), and General Self Efficacy (GSE) scales. RESULTS Seventy-eight patients were enrolled. Fifty-six patients completed nine or more classes. 73.2% had Crohn's disease and 26.8% ulcerative colitis or IBD-unclassified. A significant increase in IMPACT-III was seen from T1 to T3 (mean change of 5.22, SD = 14.33, p = 0.010), in the PedsQL (mean change = 2.3, SD = 10.24, p = 0.050), and GSE (mean change = 1, SD = 3.60, p = 0.046). 85.2% of patients reported yoga helped them to control stress. Long-term data was available for 47 subjects with 31.9% (n = 15) continuing to practice yoga one to 3 years after study completion. CONCLUSION This structured 12-week yoga program showed significant improvements in HRQOL and general self-efficacy, particularly 3 months after classes were concluded suggesting that yoga's benefits may persist. Yoga is a safe and effective adjunct to standard medical care to improve QOL and self-efficacy in youth with IBD.
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Affiliation(s)
- Alycia Leiby
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lindsey Albenberg
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Annette Langseder
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
| | - Mary Kennedy
- Division of Pediatric Gastroenterology and Nutrition, Atlantic Children's Health-Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey, USA
| | - Naomi Pressman
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System, Morristown, New Jersey, USA
| | - Joel R Rosh
- Division of Pediatric Gastroenterology, Liver Disease and Nutrition, The Steven and Alexandra Cohen Children's Medical Center of New York, New York City, New York, USA
- Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, New York, USA
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Cooper L, Kowalski MO, Plantamura CM, Chiu S. Reducing Anxiety Among Nurse Leaders Through Virtual Animal-Related Engagement. J Nurs Adm 2024; 54:E5-E7. [PMID: 38117156 DOI: 10.1097/nna.0000000000001380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
This project explored the relationship between virtual animal-related engagement (ARE) and anxiety in nurse leaders. A quality improvement project used a valid and reliable visual analog scale from 0 to 100 for self-reporting of anxiety in nurse leaders. Baseline and intervention group data were collected for 2 weeks at 15 and 5 minutes before the daily leadership huddle. Differences in anxiety levels 5 minutes before the huddle for baseline with the use of the intervention were significant. Within the intervention group, anxiety levels at 15 and 5 minutes were significant. Project outcomes suggest a difference in self-reported anxiety of nurse leaders based on ARE.
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Affiliation(s)
- Lise Cooper
- Author Affiliations: Research Nurse (Dr Cooper), Nurse Manager (Dr Kowalski), and Soothing Paws Program Manager (Plantamura), Center for Nursing Innovation and Research, Morristown Medical Center, Atlantic Health System; and Statistician (Chiu), Atlantic Center for Research, Morristown, New Jersey
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Katragkou A, Sheth A, Gagliardo C, Aquino J, Shah N, Nwaobasi-Iwuh E, Melchionne C, Black P, Chiu S, Di Pentima C. Human Parechovirus Central Nervous System Infection in a Young Infant Cohort. Pediatr Infect Dis J 2023; 42:e490-e492. [PMID: 37851979 PMCID: PMC10629600 DOI: 10.1097/inf.0000000000004122] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/20/2023]
Abstract
In 2022, a surge in cases of pediatric human parechovirus (HPeV) central nervous system infections in young infants was seen at our institution. Despite the dramatic increase in the number of cases seen that year, the clinical features of the illness were similar to prior years. The recent pediatric HPeV surge highlights the need to evaluate treatment options and standardize follow-up to better understand the long-term prognosis of infants with HPeV infection.
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Affiliation(s)
- Aspasia Katragkou
- From the Infectious Diseases Division, Department of Pediatrics, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University[aff_start], [/aff_end]Philadelphia, Pennsylvania
| | | | - Christina Gagliardo
- From the Infectious Diseases Division, Department of Pediatrics, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University[aff_start], [/aff_end]Philadelphia, Pennsylvania
| | - Jessica Aquino
- Emergency Department, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
| | | | | | - Christina Melchionne
- Emergency Department, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
| | | | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System[aff_start], [/aff_end]Morristown, New Jersey
| | - Cecilia Di Pentima
- From the Infectious Diseases Division, Department of Pediatrics, Atlantic Health System, Goryeb Children's Hospital, Morristown, New Jersey
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University[aff_start], [/aff_end]Philadelphia, Pennsylvania
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Ferguson JK, Chiu S, Oldmeadow C, Deane J, Munnoch S, Fraser N. VRE acquisition in hospital and its association with hospital antimicrobial usage -a non-linear analysis of an extended time series. Infect Dis Health 2023; 28:151-158. [PMID: 36803829 DOI: 10.1016/j.idh.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Vancomycin resistant enterococci (VRE) have become endemic pathogens in many Australian hospitals causing significant morbidity. There are few observational studies that have evaluated the effect of antibiotic usage on VRE acquisition. This study examined VRE acquisition and its association with antimicrobial use. The setting was a NSW tertiary hospital with 800 beds over a 63 month period up to March 2020, straddling piperacillin-tazobactam (PT) shortages that occurred from in September 2017. METHODS The primary outcome was monthly inpatient hospital onset Vancomycin-resistant Enterococci (VRE) acquisitions. Multivariate adaptive regression splines (MARS) were used to estimate hypothetical thresholds, where antimicrobial use above threshold is associated with increased incidence of hospital onset VRE acquisition. Specific antimicrobials and categorised usage (broad, less broad and narrow spectrum) were modelled. RESULTS There were 846 hospital onset VRE detections over the study period. Hospital onset vanB and vanA VRE acquisitions fell significantly by 64% and 36% respectively after the PT shortage. MARS modelling indicated that PT usage was the only antibiotic found to exhibit a meaningful threshold. PT usage greater than 17.4 defined daily doses/1000 occupied bed-days (95%C I: 13.4, 20.5) was associated with higher onset of hospital VRE. CONCLUSIONS This paper highlights the large, sustained impact that reduced broad spectrum antimicrobial use had on VRE acquisition and showed that PT use in particular was a major driver with a relatively low threshold. It raises the question as to whether hospitals should be determining local antimicrobial usage targets based on direct evidence from local data analysed with non-linear methods.
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Affiliation(s)
- J K Ferguson
- John Hunter Hospital, Newcastle, NSW, Australia; University of Newcastle, NSW, Australia.
| | - S Chiu
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - C Oldmeadow
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - J Deane
- Infection Prevention Service, Hunter New England Health Service, NSW, Australia
| | - S Munnoch
- Infection Prevention Service, Hunter New England Health Service, NSW, Australia
| | - N Fraser
- Hunter New England Population Health Unit, NSW, Australia
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Kendra ME, Kakwani A, Uppala A, Mansukhani R, Pigott DK, Soubra M, Jacobson J, Cerrone F, Farrell M, Chiu S, Lieder K, Tonzola D, Shah CV, Cherian S. Impact of a COPD care bundle on hospital readmission rates. J Am Pharm Assoc (2003) 2023; 63:269-274. [PMID: 36335072 DOI: 10.1016/j.japh.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/16/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide and contributes considerably to morbidity and health care costs. In October 2014, the Centers for Medicare and Medicaid Services introduced financial penalties followed by bundled payments for care improvement initiatives in patients hospitalized with COPD. OBJECTIVES This study seeks to evaluate whether an evidence-based interprofessional COPD care bundle focused on inpatient, transitional, and outpatient care would reduce hospital readmission rates. METHODS A pre- and postintervention analysis comparing readmission rates after a hospitalization for COPD in subjects who received standard of care versus an interprofessional team-led COPD care bundle was conducted. The primary outcome was 30-day all-cause readmissions; secondary outcomes included 60- and 90-day all-cause readmissions, escalation of pharmacotherapy, interprofessional interventions, and hospital length of stay. RESULTS A total of 189 subjects were included in the control arm and 127 subjects in the COPD care bundle arm. A reduction in 30-day all-cause readmissions between the control arm and COPD care bundle arm (21.7% vs. 11.8%, P = 0.017) was seen. Similar outcomes were seen in 60-day (18% vs. 8.7%, P = 0.013) and 90-day all-cause readmissions (19.6% vs. 4.7%, P < 0.001). Pharmacists consulted with 68.5% of subjects and assisted with access to outpatient medications in 45.7% of subjects in the COPD care bundle arm. An escalation in maintenance therapy occurred more often in the COPD care bundle arm (22.2% vs. 44.9%, P < 0.001) than the control arm. CONCLUSIONS An interprofessional team-led COPD care bundle resulted in significant reductions in all-cause hospital readmissions at 30, 60, and 90 days.
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Green A, Chiu S, Manor E, Smith L, Oyelese Y. The association of gestational age at delivery with neonatal outcomes in prenatally diagnosed vasa previa. J Matern Fetal Neonatal Med 2022; 35:10162-10167. [DOI: 10.1080/14767058.2022.2122040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Audrey Green
- Department of Obstetrics & Gynecology, Morristown Medical Center, Morristown, NJ, USA
| | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System, Morristown, NJ, USA
| | - Einat Manor
- Department of Obstetrics & Gynecology, Morristown Medical Center, Morristown, NJ, USA
| | - Laura Smith
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Yinka Oyelese
- Department of Obstetrics & Gynecology, Morristown Medical Center, Morristown, NJ, USA
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Atlantic Maternal Fetal Medicine, Morristown, NJ, USA
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Truumees M, Kendra M, Tonzola D, Chiu S, Cerrone F, Zimmerman D, Mackwell C, Stevens C, Scannell K, Daley B, Markley D, Shah CV, Mansukhani R. The Impact of a Home Respiratory Therapist to Reduce 30-Day Readmission Rates for Exacerbation of COPD. Respir Care 2022; 67:631-637. [PMID: 34987079 PMCID: PMC9994190 DOI: 10.4187/respcare.08125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND In 2015, the Centers for Medicare and Medicaid Services limited payments to hospitals with high readmission rates for patients admitted with COPD exacerbation. Decreasing readmissions in this patient population improves patient health and decreases health care utilization of resources. We hypothesized a COPD disease management program delivered by a respiratory therapist (RT) in the patient's home may reduce readmission rates for COPD exacerbation. METHODS We performed a pre/post interventional study comparing hospital readmissions for subjects with COPD exacerbation that received standard of care in the home versus an RT-led home COPD disease management program. Subjects discharged home from Atlantic Health System with COPD exacerbation were enrolled in the pre-intervention group. Subsequently, an evidence-based home COPD disease management program was implemented by an RT from At Home Medical in the home. The home COPD Disease Management Program was implemented from April 2017-September 2019, and this served as the post-intervention group. The primary end point was readmission rates at 30 d. Secondary end points included 60-d and 90-d readmission rates. RESULTS A total of 1,093 participants were included in the study, 658 in the pre-intervention cohort and 435 participants in the post-intervention group. Approximately 22.3% (n = 147) of subjects in the pre-intervention group was readmitted within 30 d of discharge compared to 12.2% (n = 53) in the post-intervention group (P < .001). A reduction in 60-d (33.9% vs 12.0%, P < .001) and 90-d all-cause readmissions (43.5% vs 13.1%, P < .001) was also seen. Participation in the COPD Disease Management Program was significantly associated with decreased 30-, 60-, and 90-d readmission rates adjusting for age, gender, race, ethnicity, and smoking status (odds ratio 0.48 [95% CI 0.33-0.70]; odds ratio 0.26 [95% CI 0.18-0.38]; odds ratio 0.20 [95% CI 0.14-0.27];P < .001, for all 3 readmission rates). CONCLUSIONS The COPD Disease Management Program is significantly associated with decreased readmission adjusting for demographics and smoking status.
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Affiliation(s)
- Monica Truumees
- Atlantic Health System/At Home Medical, Morris Plains, New Jersey
| | | | | | - Stephanie Chiu
- Atlantic Health Center of Research, Morristown, New Jersey
| | - Federico Cerrone
- Atlantic Medical Group/Pulmonary and Allergy Associates, Summit, New Jersey
| | | | | | | | | | | | - Daniel Markley
- Atlantic Medical Group/Pulmonary and Allergy Associates, Cedar Knolls, New Jersey
| | - Chirag V Shah
- Atlantic Medical Group/Pulmonary and Allergy Associates, Cedar Knolls, New Jersey
| | - Rupal Mansukhani
- Morristown Medical Center, Morristown, New Jersey; and Rutgers University, Piscataway, New Jersey.
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Granata D, Kendra M, Chiu S. Effects of a Pneumonia Care Bundle in a Sub-Acute Rehabilitation (SAR) Center in Preventing 30-day Hospital Readmissions. J Am Med Dir Assoc 2022. [DOI: 10.1016/j.jamda.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cooper L, Donald B, Osborne K, Roffman M, Chiu S, Kowalski MO, Zaubler T. Subsequent hospital visits after screening, brief intervention, and referral to treatment for substance use disorders. Appl Nurs Res 2022; 65:151573. [DOI: 10.1016/j.apnr.2022.151573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/18/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022]
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Gagliardo C, Nwaobasi-Iwuh EI, Shah N, Prasad A, Kairam N, Chiu S, DeSantis E, Nativ S, Laurie K, Di Pentima MC. 331. Hospitalized COVID-19 infections in Infants < 1 Year of Age. Open Forum Infect Dis 2021. [PMCID: PMC8644763 DOI: 10.1093/ofid/ofab466.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Nearly 4 million children have tested positive for coronavirus disease 2019 (COVID-19) in the United States. Some studies suggest infants might be at increased risk for severe illness and hospitalization from COVID-19. Our objective was to describe the clinical and laboratory features of young infants admitted to a hospital system with COVID-19.
Methods
An observational retrospective study was performed in infants ≤1 year of age admitted with COVID-19 from March 1, 2020 to May 30, 2021. Data was extracted into a REDCap database and analyzed using descriptive statistics.
Results
Sixteen infants < 1 year were hospitalized with COVID-19. Fever, poor feeding, and respiratory symptoms were the most common presenting symptoms (Table 1). Two required pediatric intensive care unit (ICU) care, three required oxygen support, and one was intubated. There were no deaths. Five infants with echocardiograms performed showed normal findings. Four infants received Remdesivir without side effects.
Conclusion
Infants with COVID-19 can present with severe disease requiring ICU care and oxygen support. In our experience, a large proportion of infants developed hematologic abnormalities, but none had cardiac involvement. Preventive measures including vaccination will become critical to decrease transmission and severe disease in this young patient population.
Disclosures
All Authors: No reported disclosures
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Gyurjian K, Chiu S, Hammershaimb B, Nadadur M, Phan P, Shen YJ, Lin B, Lee MS. The association between diabetes and mortality in young adults presenting with myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1262] [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 incidence of diabetes mellitus and coronary artery disease continue to rise and collectively comprise two of the most prevalent and costly diseases worldwide. The goal of this study is to report the prognosis of young patients with diabetes presented with acute myocardial infarction (AMI).
Methods
This is a retrospective observational cohort study that included consecutive patients aged 18–45 years who underwent cardiac catheterization for AMI between 2006 and 2016 in an integrated healthcare system in Southern California. The prognosis of patients with diabetes were compared to those without diabetes.
Results
A total of 1,560 patients (average age 40.2±5.3 years, 25.6% female) presenting with AMI were included. Of these 272 (17.4%) had diabetes. Diabetics were older (41.1±4.4 vs 40.0±5.4 years), more likely to be female (32.4% vs 24.1%, p=0.006), Hispanic (51.5% vs 40.5%, p<0.001), have a higher body mass index (BMI) (33.6±7.1 vs 31.2±6.8kg/m2, p<0.001), have hypertension (HTN) (67.6% vs 23.8%, p<0.001), hyperlipidemia (HLD) (78.3% vs 24.1%, p<0.001), peripheral vascular disease (9.9% vs 1.9%, p<0.001), chronic kidney disease (CKD) (23.2% vs 2.7%, p<0.001), hypothyroidism (7% vs 4%, p=0.034), and prior strokes (4.4% vs 2.2%, p=0.034).
On multivariate analysis accounting for other cardiovascular risk factors, the association remained significant (OR 1.82, 95% CI 1.04–3.19, p=0.036). At a median follow-up of 5.8 years (interquartile range 3.7–8.7 years), diabetes was independently associated with increased all-cause mortality (Hazard ratio [HR] 3.10, 95% CI 1.68–5.69, p<0.001) when adjusting for age, sex, race, BMI, HTN, HLD, CKD, hypothyroidism, prior stroke, and ACS etiology. In a propensity score matched cohort, diabetes remained significantly associated with all-cause mortality (HR 5.29, 95% CI 2.34–12.02, p<0.001).
Conclusion
Diabetes is an independent predictor of increased mortality in young adults <45 years old presenting with AMI.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): KAISER PERMANENTE LOS ANGELES MEDICAL CENTER
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Affiliation(s)
- K Gyurjian
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - S Chiu
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Hammershaimb
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M Nadadur
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - P Phan
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - Y J Shen
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - B Lin
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
| | - M S Lee
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, United States of America
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Amoah A, Chiu S, Quinn SD. Choice of primary and secondary outcomes in randomised controlled trials evaluating treatment for uterine fibroids: a systematic review. BJOG 2021; 129:345-355. [PMID: 34536313 DOI: 10.1111/1471-0528.16933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Core outcome sets aim to reduce research heterogeneity and standardise reporting, allowing meaningful comparisons between studies. OBJECTIVES To report on outcomes used in randomised controlled trials (RCTs) investigating uterine fibroid treatments, towards the development of a core outcome set for fibroid research. SELECTION STRATEGY Database search of MEDLINE, PubMed, EMBASE and CINAHL (inception to July 2021) for all English-language RCTs involving surgical or radiological fibroid treatments. DATA COLLECTION AND ANALYSIS A total of 1885 texts were screened for eligibility by two reviewers independently according to PRISMA methodology. JADAD and Management of Otitis Media with Effusion in Cleft Palate (MOMENT) scores were used to assess methodological and outcome reporting quality of studies, respectively. Outcomes were mapped to nine domains. Non-parametric tests for correlation and to compare group medians were undertaken. MAIN RESULTS There were 23 primary outcomes (23 outcome measures) and 173 secondary outcomes (95 outcome measures) reported in 60 RCTs (5699 participants). The domains with highest frequency of primary outcomes reported were bleeding and quality of life (QoL). The most frequent primary outcomes were postoperative pain, QoL and menstrual bleeding. No primary outcomes were mapped to fertility domains. Median MOMENT outcome score was 5 (interquartile range 3). There was correlation between MOMENT outcome score and JADAD scores (r = 0.491, P = 0.0001), publishing journal impact factor (r = 0.419, P = 0.008) and publication year (r = 0.332, P = 0.01). CONCLUSION There is substantial variation in the outcomes reported in fibroid RCTs. There is a need for a core outcome set for fibroid research, to allow improved understanding regarding the effects of different treatments.
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Affiliation(s)
- A Amoah
- Imperial College London, London, UK
| | - S Chiu
- Imperial College London, London, UK.,Northwick Park Hospital, London Northwest University Healthcare NHS Trust, Harrow, UK
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Chen C, Chen C, Chiang W, Chou N, Lee C, Chiu S, Lu C, Jiang P, Chen T. Bioinspired knobby magnetic beads as an efficient platform for ex vivo activation and expansion of human immune cells. Cytotherapy 2021. [DOI: 10.1016/s1465324921005612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Denny V, Shah N, Petro K, Choksey K, DeSantis E, Hintz M, Rethi S, Sanchez S, Sylla B, Chiu S, Gagliardo C, Kairam N, Nwaobasi-Iwuh E, Di Pentima MC. Impact of outpatient SARS-CoV-2 infections in minority children. Medicine (Baltimore) 2021; 100:e24895. [PMID: 33663120 PMCID: PMC7909106 DOI: 10.1097/md.0000000000024895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023] Open
Abstract
Data regarding COVID-19 in the adult population and hospitalized children is rapidly evolving, but little is known about children infected with severe acute respiratory syndrome coronavirus 2 who do not require hospitalization.In an observational, retrospective study we analyzed risk factors, demographics and clinical course of non-hospitalized patients ≤ 21 years of age with COVID-19 infection.Of the 1,796 patients evaluated, 170 were infected, and 40 participated in a telephone survey. Children older >10 years of age (OR: 2.19), Hispanic ethnicity (OR: 3) and residing in counties with higher rates of poverty (OR: 1.5) were associated with higher risk of infection, while older girls were more likely to experience prolonged duration of symptoms (median: 32 days). Consistent with prior reports, fever and cough were present in most of our patients. Shortness of breath, diarrhea, anosmia, and ageusia were more common in our outpatient population than previously reported.Larger studies addressing the clinical and psychosocial impact of CoVID-19 infection in children living in high-risk environments are warranted.
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Affiliation(s)
- Vanessa Denny
- Department of Pediatrics, Goryeb Children's Hospital
| | - Niva Shah
- Department of Pediatrics, Goryeb Children's Hospital
| | | | | | | | - Molly Hintz
- Department of Pediatrics, Goryeb Children's Hospital
| | - Shruthi Rethi
- Department of Pediatrics, Goryeb Children's Hospital
| | - Sarah Sanchez
- Department of Pediatrics, Goryeb Children's Hospital
| | | | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System, Morristown, New Jersey
| | - Christina Gagliardo
- Department of Pediatrics, Goryeb Children's Hospital
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Neeraja Kairam
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
- Department of Emergency Medicine, Atlantic Health System, Morristown, New Jersey
| | - Eberechi Nwaobasi-Iwuh
- Department of Pediatrics, Goryeb Children's Hospital
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - M. Cecilia Di Pentima
- Department of Pediatrics, Goryeb Children's Hospital
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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Chiu S, Nayak R, Duan L, Shen A, Lee M. Triggers of stress cardiomyopathy and their association with clinical outcomes. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1811] [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
Stress cardiomyopathy can be a result of physical stress, emotional stress, or both. Whether the type of trigger affects clinical outcomes is not well studied.
Purpose
The objectives of this study were to identify the prevalence of emotional and physical stressors and to assess differences in patient characteristics and mortality based on the type of trigger.
Methods
We conducted a retrospective review of 523 consecutive patients who presented to our institution from 2006 to 2016. All patients presented with acute coronary syndrome. Triggers for stress cardiomyopathy were abstracted from reviewing patients' medical records. Patients were categorized into those with 1) physical trigger, 2) emotional trigger, 3) both physical and emotional trigger, or 4) no known trigger. Baseline characteristics and clinical outcomes were reported.
Results
Among 523 patients with stress cardiomyopathy, 151 (28.9%) had a physical trigger, 189 (36.1%) had an emotional trigger, 30 (5.7%) had both physical and emotional triggers, and 153 (29.3%) had no known triggers identified. Men comprised the higher proportion of patients with physical triggers. Comorbidities including diabetes, pulmonary disease, chronic kidney disease and hypothyroidism were more prevalent among patients with physical triggers. Compared to patients with no obvious triggers, patients with a physical trigger had a much higher mortality rate (hazard ratio 2.0, 95% CI 1.2–3.3, p=0.007), whereas patients with an emotional trigger had significantly lower mortality (hazard ratio 0.40, 95% CI 0.21–0.89, p=0.007).
Conclusion
Different triggers for stress cardiomyopathy is associated with different baseline characteristics and clinical outcomes. Overall survival is worst in the group with an identified physical trigger.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Chiu
- Kaiser Permanente Los Angeles Medical Center, Department of Internal Medicine, Los Angeles, United States of America
| | - R Nayak
- Kaiser Permanente Los Angeles Medical Center, Department of Internal Medicine, Los Angeles, United States of America
| | - L Duan
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, United States of America
| | - A Shen
- Kaiser Permanente Los Angeles Medical Center, Division of Cardiology, Los Angeles, United States of America
| | - M Lee
- Kaiser Permanente Los Angeles Medical Center, Division of Cardiology, Los Angeles, United States of America
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Chiu S, Mudhar HS, Harrison B, Spiteri-Cornish K, Sears K. Cystoid Macular Oedema as a Presenting Feature of Vitreoretinal Lymphoma. Ocul Oncol Pathol 2020; 6:318-322. [PMID: 33123523 DOI: 10.1159/000508890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/02/2020] [Indexed: 11/19/2022] Open
Abstract
A 69-year-old female presented with right vitreous cells and cystoid macular oedema (CMO). One year previously, she had received two cycles of attenuated methotrexate-based chemotherapy for primary central nervous system (CNS) lymphoma, abandoned due to toxicity. There was no past ocular history of note aside from mild cataract. Due to her history of previous CNS lymphoma, we suspected vitreoretinal lymphoma (VRL), but the presence of the CMO made this unlikely. She underwent a diagnostic vitrectomy. Histology and immunohistochemistry showed the presence of a high-grade B-cell VRL.
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Affiliation(s)
- Stephanie Chiu
- Department of Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Hardeep Singh Mudhar
- Department of Histopathology, National Specialist Ophthalmic Pathology Service (NSOPS), Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Beth Harrison
- Department of Haematology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - Kurt Spiteri-Cornish
- Department of Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Katharine Sears
- Department of Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Dhariwal L, Chiu S, Salamon C. A urinary catheter valve is non-inferior to continuous bladder drainage with respect to post-operative UTIs: a randomized controlled trial. Int Urogynecol J 2020; 32:1433-1439. [PMID: 32681350 DOI: 10.1007/s00192-020-04436-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/09/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary tract infections (UTIs) are common with indwelling catheter use. Our primary aim was to compare UTI rates in women sent home after surgery with continuous bladder drainage versus a urinary catheter valve. METHODS This was a non-inferiority prospective randomized controlled study between June 2016 to June 2019. Women who were being discharged home with a Foley catheter following urogynecologic surgery due to urinary retention were randomized to a continuous urinary drainage bag or a urinary catheter valve. The primary outcome of this study was post-operative UTI rates within 30 days of surgery. The secondary outcome was patient satisfaction, as determined by a Foley satisfaction questionnaire. RESULTS Out of 97 women, 51 were randomized to continuous drainage and 46 to the urinary catheter valve. Comparing UTI rates, the urinary catheter valve (32.6%) was non-inferior to the continuous urinary drainage bag (33.3%). The upper bound of the 95% CI was less than the predetermined non-inferiority margin (difference 0.7%, 95% CI: -0.195, 0.180), and therefore non-inferiority criteria were met. Patients were more satisfied with the urinary catheter valve than with the continuous drainage bag (p ≤ 0.001). CONCLUSIONS Use of this urinary catheter valve increased patient satisfaction without affecting the post-operative UTI rate. This easy and inexpensive device could help patients have a better catheter experience and should be considered in women being discharged home with a urinary catheter.
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Affiliation(s)
- Laura Dhariwal
- Division of Urogynecology and Female Reconstructive Surgery, Atlantic Health System, Morristown, NJ, USA.
| | - Stephanie Chiu
- Atlantic Center for Research, Atlantic Health System, 435 South Street Suit 370, Morristown, NJ, 07960, USA
| | - Charbel Salamon
- Division of Urogynecology and Female Reconstructive Surgery, Atlantic Health System, Morristown, NJ, USA
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Epstein M, Musa T, Chiu S, Costanzo J, Dunne C, Cerrone F, Capone R. Use of the WatchPAT to detect occult residual sleep-disordered breathing in patients on CPAP for obstructive sleep apnea. J Clin Sleep Med 2020; 16:1073-1080. [PMID: 32118574 DOI: 10.5664/jcsm.8406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES To determine the accuracy of the apnea-hypopnea index (AHI) as measured by continuous positive airway pressure (CPAP) machines by simultaneously employing a home sleep apnea testing device (WatchPAT 200, Itamar Medical, Israel [WPAT]) in patients suspected of having residual sleep-disordered breathing (SDB). METHODS Patients with new, recurrent, or worsening signs, symptoms, or comorbidities associated with obstructive sleep apnea underwent home sleep apnea testing using WPAT while simultaneously using CPAP at their usual prescribed settings. CPAP AHI and WPAT AHI, respiratory disturbance index, and oximetry readings were then compared. RESULTS We identified an elevated AHI with WPAT testing in nearly half of patients with clinically suspected residual SDB and a normal CPAP AHI. WPAT detected additional respiratory events as well, including rapid eye movement-related apneas, respiratory effort-related arousals, and hypoxemia. CONCLUSIONS WPAT AHI was significantly higher than simultaneous CPAP AHI in nearly half of those patients with clinically suspected residual SDB being treated with CPAP. Additional respiratory disturbances, including rapid eye movement-related respiratory events, respiratory effort-related arousals, and hypoxemia, were elucidated only with the use of the WPAT. Residual SDB may have potential clinical consequences, including reduced CPAP adherence, ongoing hypersomnolence, and other health-related sequelae. Simultaneous WPAT testing of patients with a normal CPAP AHI may represent a valuable tool to detect clinically suspected residual SDB or to ensure adequate treatment in high-risk patients with obstructive sleep apnea in general.
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Affiliation(s)
- Matthew Epstein
- Atlantic Health Sleep Centers, Livingston, New Jersey.,Atlantic Health System, Morristown, New Jersey.,New Jersey Medical School, Newark, New Jersey
| | - Tariq Musa
- Atlantic Health System, Morristown, New Jersey
| | | | | | - Christine Dunne
- Atlantic Health Sleep Centers, Livingston, New Jersey.,Atlantic Health System, Morristown, New Jersey
| | - Federico Cerrone
- Atlantic Health Sleep Centers, Livingston, New Jersey.,Atlantic Health System, Morristown, New Jersey
| | - Robert Capone
- Atlantic Health Sleep Centers, Livingston, New Jersey.,Atlantic Health System, Morristown, New Jersey
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Millspaugh J, Errico C, Mortimer S, Kowalski MO, Chiu S, Reifsnyder C. Jin Shin Jyutsu® Self-Help Reduces Nurse Stress: A Randomized Controlled Study. J Holist Nurs 2020; 39:4-15. [PMID: 32649851 DOI: 10.1177/0898010120938922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: The purpose of this research was to explore the impact of Jin Shin Jyutsu (JSJ) Self-Help on personal stress and the caring efficacy of nurses. Design: A randomized, controlled comparison study, with crossover design was conducted. Method: Stress and caring efficacy were measured via surveys at baseline, posteducation, and again 30 to 40 days after completion of the JSJ educational intervention. Self-reported stress was the primary endpoint as measured with the validated Personal and Organizational Quality Assessment-Revised 4 Scale (POQA-R4) survey. Caring Efficacy was measured using the Coates Caring Efficacy Scale. Findings: A total of 41 nurses consented and completed the study; 18 were in the education group and 23 were in the control group. Changes in stress were sustained in the education group for the POQA-R4. Changes observed in the control group were not sustained. Statistical differences were observed when comparing education and control from baseline to final surveys for measures of emotional vitality and buoyancy. Increases in nursing caring efficacy were observed in both groups. Scores were consistently higher in the education group. Statistically significant differences were observed from baseline to final measure for the education group. Conclusions: Results show JSJ as a viable option for stress reduction in nurses.
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Condurache CI, Chiu S, Chotiyarnwong P, Johansson H, Shepstone L, Lenaghan E, Cooper C, Clarke S, Khioe RFS, Fordham R, Gittoes N, Harvey I, Harvey NC, Heawood A, Holland R, Howe A, Kanis JA, Marshall T, O'Neill TW, Peters TJ, Redmond NM, Torgerson D, Turner D, McCloskey E. Screening for high hip fracture risk does not impact on falls risk: a post hoc analysis from the SCOOP study. Osteoporos Int 2020; 31:457-464. [PMID: 31960099 DOI: 10.1007/s00198-019-05270-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/17/2019] [Indexed: 12/30/2022]
Abstract
UNLABELLED A reduction in hip fracture incidence following population screening might reflect the effectiveness of anti-osteoporosis therapy, behaviour change to reduce falls, or both. This post hoc analysis demonstrates that identifying high hip fracture risk by FRAX was not associated with any alteration in falls risk. INTRODUCTION To investigate whether effectiveness of an osteoporosis screening programme to reduce hip fractures was mediated by modification of falls risk in the screening arm. METHODS The SCOOP study recruited 12,483 women aged 70-85 years, individually randomised to a control (n = 6250) or screening (n = 6233) arm; in the latter, osteoporosis treatment was recommended to women at high risk of hip fracture, while the control arm received usual care. Falls were captured by self-reported questionnaire. We determined the influence of baseline risk factors on future falls, and then examined for differences in falls risk between the randomisation groups, particularly in those at high fracture risk. RESULTS Women sustaining one or more falls were slightly older at baseline than those remaining falls free during follow-up (mean difference 0.70 years, 95%CI 0.55-0.85, p < 0.001). A higher FRAX 10-year probability of hip fracture was associated with increased likelihood of falling, with fall risk increasing by 1-2% for every 1% increase in hip fracture probability. However, falls risk factors were well balanced between the study arms and, importantly, there was no evidence of a difference in falls occurrence. In particular, there was no evidence of interaction (p = 0.18) between baseline FRAX hip fracture probabilities and falls risk in the two arms, consistent with no impact of screening on falls in women informed to be at high risk of hip fracture. CONCLUSION Effectiveness of screening for high FRAX hip fracture probability to reduce hip fracture risk was not mediated by a reduction in falls.
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Affiliation(s)
- C I Condurache
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
| | - S Chiu
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
| | - P Chotiyarnwong
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK
- Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - H Johansson
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Centre for Bone and Arthritis Research (CBAR), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - L Shepstone
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - E Lenaghan
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - S Clarke
- Department of Rheumatology, University Hospitals Bristol, Bristol, UK
| | - R F S Khioe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Fordham
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - N Gittoes
- Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital, Birmingham, UK
| | - I Harvey
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Heawood
- Bristol Medical School, University of Bristol, Bristol, UK
| | - R Holland
- Leicester Medical School, Centre for Medicine, University of Leicester, Leicester, UK
| | - A Howe
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - T Marshall
- Norfolk and Norwich University Hospital, Norwich, UK
| | - T W O'Neill
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
| | - T J Peters
- Bristol Medical School, University of Bristol, Bristol, UK
| | - N M Redmond
- Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation, Bristol, UK
| | - D Torgerson
- Department of Health Sciences, University of York, York, UK
| | - D Turner
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - E McCloskey
- Centre for Integrated Research in Musculoskeletal Aging, University of Sheffield Medical School, Sheffield, UK.
- Department of Oncology and Metabolism, Academic Unit of Bone Metabolism, The Mellanby Centre For Bone Research, University of Sheffield, Sheffield, UK.
- Centre for Metabolic Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
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Wilshire C, Henson C, Chiu S, Gilbert C, Vallieres E, Gorden J. P1.11-29 Relationship Between Lung Cancer Screening Centers in the United States and High-Risk Individuals. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1102] [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: 10/25/2022]
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Banerjee P, Neely R, Pattman S, Artham S, Carey P, Kamaruddin S, Mada S, Weaver J, Chiu S. Audit of pcsk9 inhibitor prescribing in the north east of england. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Khan A, Chiu S. Sublimed Sulfur (SULMEDOL) for the Activation of Endogenous Lactase and Restoration of Lactose Tolerance. Am J Transl Res 2018. [DOI: 10.1055/s-0038-1644933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Khan
- Clinical Faculty, Consultant in Internal Medicine, Schulich School of Medicine, London ON
| | - S Chiu
- Department of Psychiatry, Schulich school of Medicine, London ON
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Chiu S, Mahmoud K, Shoreibah M, Moawad S, Massoud M, Kim S, Ertel N, Oser R, Saddekni S, Hamed B, Massoud O, Aal AA. 4:12 PM Abstract No. 290 Changes in kidney function and model of end-stage liver disease score in diabetic patients undergoing the transjugular intrahepatic portosystemic shunt procedure. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.322] [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: 10/17/2022] Open
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Singh N, Moody AR, Zhang B, Kaminski I, Kapur K, Chiu S, Tyrrell PN. Age-Specific Sex Differences in Magnetic Resonance Imaging-Depicted Carotid Intraplaque Hemorrhage. Stroke 2017; 48:2129-2135. [PMID: 28706117 DOI: 10.1161/strokeaha.117.017877] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/29/2017] [Accepted: 06/12/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Stroke rates are higher in men compared with women in the fourth through seventh decades of life, and higher rates may result from differences in carotid intraplaque hemorrhage (IPH), an unstable atherosclerotic plaque component. We report age-specific sex differences in the presence of magnetic resonance imaging-depicted carotid IPH. METHODS Patients (n=1115) underwent magnetic resonance imaging for carotid IPH between 2005 and 2014. Low-grade carotid stenosis patients (n=906) without prior endarterectomy were eligible for this cross-sectional study. RESULTS Of the 906 patients included (mean age±SD in years, 66.98±15.15), 63 (6.95%) had carotid IPH. In men and women, carotid IPH was present in 11.43% (48 of 420) and 3.09% (15 of 486), respectively (P<0.0001). Multivariable logistic regression analysis confirmed greater odds of carotid IPH in men for all ages: 45 to 54 (odds ratio=45.45; 95% confidence interval, 3.43-500), 55 to 64 years (odds ratio=21.74; 95% confidence interval, 3.21-142.86), 65 to 74 years (odds ratio=10.42; 95% confidence interval, 2.91-37.04), and ≥75 years (odds ratio=5.00; 95% confidence interval, 2.31-10.75). Male sex modified the effect of age on the presence of carotid IPH (β=0.074; SE=0.036; P=0.0411). CONCLUSIONS Men have greater age-specific odds of magnetic resonance imaging-depicted carotid IPH compared with women. With increasing age post-menopause, the odds of carotid IPH in women becomes closer to that of men. Delayed onset of carotid IPH in women, an unstable plaque component, may partly explain differential stroke rates between sexes, and further studies are warranted.
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Affiliation(s)
- Navneet Singh
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Alan R Moody
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.).
| | - Bowen Zhang
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Isabella Kaminski
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Kush Kapur
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Stephanie Chiu
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
| | - Pascal N Tyrrell
- From the Department of Medical Imaging, Faculty of Medicine (N.S., A.R.M., B.Z., I.K., S.C., P.N.T.) and Department of Statistical Sciences (P.N.T.), University of Toronto, Ontario, Canada; and Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA (K.K.)
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Desiderio MC, De Milt D, Griffith K, Kowalski M, Pendexter B, Chiu S, Juliano N, Safirstein J. ADDITION OF MULTIMEDIA TO POST-PCI EDUCATION: PATIENT PERCEPTION VERSUS PERFORMANCE. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35900-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chiu S, Skura B, Petric M, McIntyre L, Gamage B, Isaac-Renton J. Efficacy of common disinfectant/cleaning agents in inactivating murine norovirus and feline calicivirus as surrogate viruses for human norovirus. Am J Infect Control 2015; 43:1208-12. [PMID: 26254499 DOI: 10.1016/j.ajic.2015.06.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/21/2015] [Accepted: 06/22/2015] [Indexed: 01/26/2023]
Abstract
BACKGROUND The efficacies of disinfection by sodium hypochlorite, accelerated hydrogen peroxide (AHP), and quaternary ammonium compound (QUAT) commonly used in health care facilities were determined using the surrogate viruses murine norovirus (MNV-1) and feline calicivirus (FCV). METHODS A virus suspension of known concentration (with or without a soil load) was deposited onto stainless steel discs under wet or dry load conditions and exposed to defined concentrations of the disinfectant/cleaning agent for 1-, 5-, or 10-minute contact time using the quantitative carrier test (QCT-2) method. Virus inactivation was determined by plaque assay. RESULTS At an exposure time of 1 minute, sodium hypochlorite at 2,700 ppm was able to inactivate MNV-1 and FCV with a >5 log10 reduction. After 10 minutes, MNV-1 was inactivated by AHP at 35,000 ppm, whereas FCV was inactivated at 3,500 ppm. MNV-1 was not inactivated by QUAT at 2,800 ppm. A QUAT-alcohol formulation containing 2,000 ppm QUAT and 70% ethanol was effective in inactivating MNV-1 after 5 minutes, but resulted in only a <3 log10 reduction of FCV after 10 minutes. CONCLUSIONS AHP and QUAT products were less effective than sodium hypochlorite for the inactivation of MNV-1 and FCV.
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Affiliation(s)
- Stephanie Chiu
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada.
| | - Brenton Skura
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
| | - Martin Petric
- British Columbia Public Health Microbiology and Reference Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Bruce Gamage
- Provincial Infection Control Network, Vancouver, British Columbia, Canada
| | - Judith Isaac-Renton
- British Columbia Public Health Microbiology and Reference Laboratory, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Bell ET, Devi JL, Chiu S, Zahra P, Whittem T. The pharmacokinetics of pimobendan enantiomers after oral and intravenous administration of racemate pimobendan formulations in healthy dogs. J Vet Pharmacol Ther 2015; 39:54-61. [PMID: 25989021 DOI: 10.1111/jvp.12235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 04/22/2015] [Indexed: 11/26/2022]
Abstract
Pimobendan is a benzimidazole-pyridazinone derivative, marketed as a racemic mixture for the management of canine heart failure. Pharmacokinetics of the enantiomers of pimobendan and its oral bioavailability have not been described in dogs. The aim of this study was to describe pharmacokinetics of three formulations of pimobendan in healthy dogs: the licensed capsule product, and novel liquid and intravenous formulations. A three-period, nested randomized two-treatment crossover design was used. Pimobendan was administered p.o. at 0.25 and i.v. at 0.125 mg/kg. Blood and plasma samples were analysed by liquid chromatography-mass spectrometry. Noncompartmental modelling was used to describe the pharmacokinetics. Parameters were compared between formulations using a general linear model. Bioequivalence of the oral formulations was tested using CI90 for AUC(0-∞) and Cmax . Bioavailability of pimobendan after oral dosing was 70%. Liquid and capsule formulations were bioequivalent only for AUC. The positive enantiomer of pimobendan (PE) had a larger volume of distribution than the negative enantiomer (NE) (281 ± 48 vs. 215 ± 68 mL/kg; P = 0.003) and a shorter half-life (21.7 vs. 29.9 min; P = 0.004). The NE was distributed more quickly than the PE into blood cells. Enantiomers of pimobendan have differing absorption, distribution and elimination. The pharmacokinetics of pimobendan in healthy dogs was described.
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Affiliation(s)
- E T Bell
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Vic., Australia
| | - J L Devi
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Vic., Australia
| | - S Chiu
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Vic., Australia
| | - P Zahra
- Racing Analytical Services Ltd, Flemington, Vic., Australia
| | - T Whittem
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Vic., Australia
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Esau M, Rozema M, Zhang TH, Zeng D, Chiu S, Kwan R, Moorhouse C, Murray C, Tseng NT, Ridgway D, Sauvageau D, Ellison M. Solving a four-destination traveling salesman problem using Escherichia coli cells as biocomputers. ACS Synth Biol 2014; 3:972-5. [PMID: 25524102 DOI: 10.1021/sb5000466] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Traveling Salesman Problem involves finding the shortest possible route visiting all destinations on a map only once before returning to the point of origin. The present study demonstrates a strategy for solving Traveling Salesman Problems using modified E. coli cells as processors for massively parallel computing. Sequential, combinatorial DNA assembly was used to generate routes, in the form of plasmids made up of marker genes, each representing a path between destinations, and short connecting linkers, each representing a given destination. Upon growth of the population of modified E. coli, phenotypic selection was used to eliminate invalid routes, and statistical analysis was performed to successfully identify the optimal solution. The strategy was successfully employed to solve a four-destination test problem.
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Affiliation(s)
- Michael Esau
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Mark Rozema
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | | | - Dawson Zeng
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Stephanie Chiu
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Rachel Kwan
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | | | - Cameron Murray
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Nien-Tsu Tseng
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Doug Ridgway
- Genomikon Inc., Edmonton, Alberta T6G 2H7, Canada
| | | | - Michael Ellison
- University of Alberta, Edmonton, Alberta T6G 2R3, Canada
- Genomikon Inc., Edmonton, Alberta T6G 2H7, Canada
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Noel N, Bastek J, Chiu S, Borovsky Y, Butts S. Risks Factors for Hospital Readmission for Patients Undergoing Benign Gynecologic Surgery. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chiu S, Webster L, Kubba H. Can we predict which children will go home the same day after microlaryngoscopy-bronchoscopy? Int J Surg 2014. [DOI: 10.1016/j.ijsu.2014.07.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
BACKGROUND Pictograms have been shown by many studies to be an effective way of conveying information. An easy-to-understand pictorial description is essential for communication of dietary intake in the computer era. OBJECTIVES We proposed a novel approach that represents textual descriptions of dietary intake into a pictorial representation with the concept of pictograms. The computational implementation in terms of a web-based tool was investigated on how well the pictograms carry their intended message. METHODS 1) We investigated how well the pictograms are comprehended in terms of subjects' accuracy rate and response time. In the study (n = 90), pictorial variants with three types of food images (black-and-white sketch, colored sketch, and colored photograph) were tested. 2) We also investigated how well subjects were able to select the standard food size among various food portions with the use of the tool. A comparison was made against the current standard of an educational session taught by a registered dietitian. We recruited 86 university students who were asked to select a standard size out of five different size categories. Three types of shapes were used. The bowl is the container that is widely used in the participants' country. The pork strip was to represent foods with elliptical cross-section. The apple was used to represent a baseball-like size and shape. RESULTS Two pictograms with black-and-white food image were low of less than 50% in accuracy rate. The rest of the twenty-seven pictograms derived from portions of the nine foods were well understood with high accuracy rates (above 85%). Participants in using the tool without the dietitian's session was better than participants in the dietitian education session in selecting a standard portion size of an apple (p < 0.0001; p = 0.0009 after adjustment for gender and age). The rate of correct bowl and pork strip size estimates were similar between the two conditions (p > 0.05). CONCLUSION The development of pictograms could be used as a computational visual aid for comprehending and identifying dietary intake. Broader investigation is required for considering the effectiveness of the pictograms on recall, measurement, or estimation as well as for further evaluation in the clinical practice.
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Affiliation(s)
| | | | | | - W-K Chiou
- Wen-Ko Chiou, Chang Gung University, Graduate Institute of Business and Management, 259 Wen-Hwa 1st Rd., 333 Tao-Yuan, Taiwan, E-mail:
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Sadek G, Cernovsky Z, Chiu S, Bureau Y. P-53 * CRIMINAL HISTORY AND OUTCOME OF OPIATE SUBSTITUTIONS TREATMENT IN CANADIAN METHADONE AND SUBOXONE PATIENTS. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu054.53] [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: 11/13/2022] Open
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Chiu S, Sievenpiper JL, de Souza RJ, Cozma AI, Mirrahimi A, Carleton AJ, Ha V, Di Buono M, Jenkins AL, Leiter LA, Wolever TMS, Don-Wauchope AC, Beyene J, Kendall CWC, Jenkins DJA. Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr 2014; 68:416-23. [PMID: 24569542 PMCID: PMC3975811 DOI: 10.1038/ejcn.2014.8] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 10/12/2013] [Accepted: 11/12/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES In the absence of consistent clinical evidence, there are concerns that fructose contributes to non-alcoholic fatty liver disease (NAFLD). To determine the effect of fructose on markers of NAFLD, we conducted a systematic review and meta-analysis of controlled feeding trials. SUBJECTS/METHODS We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library (through 3 September 2013). We included relevant trials that involved a follow-up of ≥ 7 days. Two reviewers independently extracted relevant data. Data were pooled by the generic inverse variance method using random effects models and expressed as standardized mean difference (SMD) for intrahepatocellular lipids (IHCL) and mean difference (MD) for alanine aminotransferase (ALT). Inter-study heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic). RESULTS Eligibility criteria were met by eight reports containing 13 trials in 260 healthy participants: seven isocaloric trials, in which fructose was exchanged isocalorically for other carbohydrates, and six hypercaloric trials, in which the diet was supplemented with excess energy (+21-35% energy) from high-dose fructose (+104-220 g/day). Although there was no effect of fructose in isocaloric trials, fructose in hypercaloric trials increased both IHCL (SMD=0.45 (95% confidence interval (CI): 0.18, 0.72)) and ALT (MD=4.94 U/l (95% CI: 0.03, 9.85)). LIMITATIONS Few trials were available for inclusion, most of which were small, short (≤ 4 weeks), and of poor quality. CONCLUSIONS Isocaloric exchange of fructose for other carbohydrates does not induce NAFLD changes in healthy participants. Fructose providing excess energy at extreme doses, however, does raise IHCL and ALT, an effect that may be more attributable to excess energy than fructose. Larger, longer and higher-quality trials of the effect of fructose on histopathological NAFLD changes are required.
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Affiliation(s)
- S Chiu
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Department of Human Biology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - J L Sievenpiper
- 1] Department of Pathology and Molecular Medicine, Faculty of Health Sciences, Hamilton, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - R J de Souza
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - A I Cozma
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - A Mirrahimi
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - A J Carleton
- 1] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [2] Department of Undergraduate Medical Education (MD Program), Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - V Ha
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - M Di Buono
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Heart and Stroke Foundation of Ontario, Toronto, ON, Canada [3] American Heart Association, Dallas, TX, USA
| | - A L Jenkins
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada
| | - L A Leiter
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - T M S Wolever
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A C Don-Wauchope
- 1] Department of Pathology and Molecular Medicine, Faculty of Health Sciences, Hamilton, ON, Canada [2] Division of Clinical Chemistry and Immunology, Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada
| | - J Beyene
- 1] Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada [2] The Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [3] Child Health Evaluative Sciences (CHES), The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - C W C Kendall
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - D J A Jenkins
- 1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Shinonaga Y, Nishimura T, Chiu S, Chiu H, Abe Y, Arita K. Ability of multi-mineral-ion release from novel apatite-ionomer-cement. Dent Mater 2014. [DOI: 10.1016/j.dental.2014.08.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Le SV, Chiu S, Meineke RC, Williams P, Wongworawat MD. Reply to Wu et al. J Hand Surg Eur Vol 2013; 38:334-5. [PMID: 23565523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Le SV, Chiu S, Meineke RC, Williams P, Wongworawat MD. Number of suture throws and its impact on the biomechanical properties of the four-strand cruciate locked flexor tendon repair with FiberWire. J Hand Surg Eur Vol 2012; 37:826-31. [PMID: 22618562 DOI: 10.1177/1753193412447503] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
FiberWire is a popular suture in flexor tendon repair that allows for early mobilization, but its poor knot-holding properties have raised concerns over the potential effects on tendon healing and strength. We examined how the number of knot throws affects the 2 mm gap force, ultimate tensile strength, and mode of failure in a four-strand cruciate locked tendon repair in porcine flexor tendons in order to elucidate the optimal number of suture throws. There was no effect on the 2 mm gap force with increasing knot throws, but there was a significant increase in ultimate tensile strength. A minimum of six-knot throws prevents unravelling, whereas five out of 10 of repairs unravelled with less than six throws.
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Affiliation(s)
- S V Le
- Department of Orthopaedic Surgery, Loma Linda University, Loma Linda, CA 92354, USA
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Jarboe J, Chiu S, Anderson J, Whitley A, Willey C. Myristoylated Alanine Rich C-kinase Substrate (MARCKS) Can Regulate Glioma Cell Migration, Proliferation, and Radiation Sensitivity. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leusink G, Rempel H, Skura B, Berkyto M, White W, Yang Y, Rhee J, Xuan S, Chiu S, Silversides F, Fitzpatrick S, Diarra M. Growth performance, meat quality, and gut microflora of broiler chickens fed with cranberry extract. Poult Sci 2010; 89:1514-23. [DOI: 10.3382/ps.2009-00364] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tan K, Zhan J, Chiu S, Pasian S, Goyal K, Leung G, Moody A. Abstract No. 337: MRI molecular imaging of VCAM-1. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Roan C, Chien C, Huang B, Chiu S, Cao T. O802 Inevitable uterine cancer with cytologic false negative - report of a case. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61175-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
BACKGROUND This study examined the association between immigrant status and current health in a representative sample of 1189 homeless people in Toronto, Canada. METHODS Multivariate regression analyses were performed to examine the relationship between immigrant status and current health status (assessed using the SF-12) among homeless recent immigrants (< or = 10 years since immigration), non-recent immigrants (>10 years since immigration) and Canadian-born individuals recruited at shelters and meal programmes (response rate 73%). RESULTS After adjusting for demographic characteristics and lifetime duration of homelessness, recent immigrants were significantly less likely to have chronic conditions (RR 0.7, 95% CI 0.5 to 0.9), mental health problems (OR 0.4, 95% CI 0.2 to 0.7), alcohol problems (OR 0.2, 95% CI 0.1 to 0.5) and drug problems (OR 0.2, 95% CI 0.1 to 0.4) than non-recent immigrants and Canadian-born individuals. Recent immigrants were also more likely to have better mental health status (+3.4 points, SE +/-1.6) and physical health status (+2.2 points, SE +/-1.3) on scales with a mean of 50 and a SD of 10 in the general population. CONCLUSION Homeless recent immigrants are a distinct group who are generally healthier and may have very different service needs from other homeless people.
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Affiliation(s)
- S Chiu
- Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
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Douplik A, Morofke D, Chiu S, Bouchelev V, Mao L, Yang V, Vitkin A. In vivo real time monitoring of vasoconstriction and vasodilation by a combined diffuse reflectance spectroscopy and Doppler optical coherence tomography approach. Lasers Surg Med 2008; 40:323-31. [DOI: 10.1002/lsm.20637] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Austin Z, Gregory PA, Chiu S. Use of reflection-in-action and self-assessment to promote critical thinking among pharmacy students. Am J Pharm Educ 2008; 72:48. [PMID: 18698383 PMCID: PMC2508711 DOI: 10.5688/aj720348] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2007] [Accepted: 11/03/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To examine whether self-assessment and reflection-in-action improves critical thinking among pharmacy students. METHODS A 24-item standardized test of critical thinking was developed utilizing previously-validated questions. Participants were divided into 2 groups (conditions). Those in condition 1 completed the test with no interference; those in condition 2 completed the test but were prompted at specific points during the test to reflect and self-assess. RESULTS A total of 94 undergraduate (BScPhm) pharmacy students participated in this study. Significant differences (p < 0.05) were observed between those who completed the test under condition 1 and condition 2, suggesting reflection and self-assessment may contribute positively to improvement in critical thinking. CONCLUSIONS Structured opportunities to reflect-in-action and self-assess may be associated with improvements among pharmacy students in performance of tasks related to critical thinking.
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Affiliation(s)
- Zubin Austin
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto ON M5S3M2, Canada.
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Le Pogam S, Seshaadri A, Kosaka A, Chiu S, Kang H, Hu S, Rajyaguru S, Symons J, Cammack N, Najera I. Existence of hepatitis C virus NS5B variants naturally resistant to non-nucleoside, but not to nucleoside, polymerase inhibitors among untreated patients. J Antimicrob Chemother 2008; 61:1205-16. [DOI: 10.1093/jac/dkn085] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Li H, Standish BA, Mariampillai A, Munce NR, Mao Y, Chiu S, Marcon NE, Wilson BC, Vitkin A, Yang VXD. Feasibility of interstitial Doppler optical coherence tomography for in vivo detection of microvascular changes during photodynamic therapy. Lasers Surg Med 2007; 38:754-61. [PMID: 16927368 DOI: 10.1002/lsm.20387] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Doppler optical coherence tomography (DOCT) is an emerging imaging modality that provides subsurface microstructural and microvascular tissue images with near histological resolution and sub-mm/second velocity sensitivity. A key drawback of OCT for some applications is its shallow (1-3 mm) penetration depth. This fundamentally limits DOCT imaging to transparent, near-surface, intravascular, or intracavitary anatomical sites. Consequently, interstitial Doppler OCT (IS-DOCT) was developed for minimally-invasive in vivo imaging of microvasculature and microstructure at greater depths, providing access to deep-seated solid organs. Using Dunning prostate cancer in a rat xenograft model, this study evaluated the feasibility of IS-DOCT monitoring of microvascular changes deep within a tumor caused by photodynamic therapy (PDT). MATERIALS AND METHODS The DOCT interstitial probe was constructed using a 22 G (diameter approximately 0.7 mm) needle, with an echogenic surface finish for enhanced ultrasound visualization. The lens of the probe consisted of a gradient-index fiber, fusion spliced to an angle-polished coreless tip to allow side-view scanning. The lens was then fusion spliced to a single-mode optical fiber that was attached to the linear scanner via catheters and driven along the longitudinal axis of the needle to produce a 2D subsurface DOCT image. The resultant IS-DOCT system was used to monitor microvascular changes deep within the tumor mass in response to PDT in the rat xenograft model of Dunning prostate cancer. Surface PDT was delivered at 635 nm with 40 mW of power, for a total light dose of 76 J/cm(2), using 12.5 mg/kg of Photofrin as the photosensitizer dose. RESULTS IS-DOCT demonstrated its ability to detect microvasculature in vivo and record PDT-induced changes. A reduction of detected vascular cross sectional area during treatment and partial recovery post-treatment were observed. CONCLUSIONS IS-DOCT is a potentially effective tool for real-time visualization and monitoring of the progress of PDT treatments. This capability may play an important role in elucidating the mechanisms of PDT in tumors, pre-treatment planning, feedback control for treatment optimization, determining treatment endpoints and post-treatment assessments.
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Affiliation(s)
- Heng Li
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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Devous MD, Altuna D, Furl N, Cooper W, Gabbert G, Ngai WT, Chiu S, Scott JM, Harris TS, Payne JK, Tobey EA. Maturation of speech and language functional neuroanatomy in pediatric normal controls. J Speech Lang Hear Res 2006; 49:856-66. [PMID: 16908880 DOI: 10.1044/1092-4388(2006/061)] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE This study explores the relationship between age and resting-state regional cerebral blood flow (rCBF) in regions associated with higher order language skills using a population of normal children, adolescents, and young adults. METHOD rCBF was measured in 33 normal participants between the ages of 7 and 19 years using single photon emission computed tomography. Participants' ages were regressed on rCBF values (normalized to whole-brain CBF) in 2 ways: (a) within anatomically defined, language-related regions of interest (ROIs) including Wernicke's area, Broca's area, angular gyrus, planum temporale, and Heschl's gyrus and (b) within clusters of voxels found to be significantly related to age in voxel-wise analyses. RESULTS rCBF in all anatomically defined ROIs except Heschl's gyrus declined as a function of age. Additionally, voxel-wise analyses revealed clusters where rCBF declined with age in left inferior parietal, left superior temporal, and right middle temporal regions-areas often implicated in higher order language functions. CONCLUSIONS These data suggest that ongoing maturation (e.g., dendritic pruning) in higher order cognitive areas (e.g., angular gyrus) continues into adolescence, as reflected by declining rCBF, while the primary auditory area (Heschl's gyrus) has become a stable neuronal population by age 7 years.
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Affiliation(s)
- Michael D Devous
- University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9061, USA.
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Yang VXD, Mao Y, Standish BA, Munce NR, Chiu S, Burnes D, Wilson BC, Vitkin IA, Himmer PA, Dickensheets DL. Doppler optical coherence tomography with a micro-electro-mechanical membrane mirror for high-speed dynamic focus tracking. Opt Lett 2006; 31:1262-4. [PMID: 16642079 DOI: 10.1364/ol.31.001262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
An elliptical microelectromechanical system (MEMS) membrane mirror is electrostatically actuated to dynamically adjust the optical beam focus and track the axial scanning of the coherence gate in a Doppler optical coherence tomography (DOCT) system at 8 kHz. The MEMS mirror is designed to maintain a constant numerical aperture of approximately 0.13 and a spot size of approximately 6.7 microm over an imaging depth of 1mm in water, which improves imaging performance in resolving microspheres in gel samples and Doppler shift estimation precision in a flow phantom. The mirror's small size (1.4 mm x 1 mm) will allow integration with endoscopic MEMS-DOCT for in vivo applications.
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Affiliation(s)
- Victor X D Yang
- Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada.
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Zhang ZY, Ugwu S, Zhang A, Ahmad MU, Ahmad I, Chiu S, Lee RL. A novel cationic cardiolipin analogue for gene delivery. Pharmazie 2006; 61:10-4. [PMID: 16454198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The optically active R and S isomers of cationic cardiolipin analogues (CCA) were synthesized and evaluated as a liposome based transfection reagent. Both isomers form stable liposomes with mean diameters of about 120 nm without any additional lipid ingredients. No significant change in particle size distribution profile was observed over one-month storage at room temperature (20-25 degrees C). The gel to liquid crystalline phase transition temperature (Tm) of cationic liposomes comprised of both R and S isomers was approximately 2 degrees C, as measured by differential scanning calorimetry (DSC). Both isomers also formed stable liposomes when combined with DOPE. In vitro transfection efficiency of the CCA/DOPE liposomes complexed to plasmid DNA was evaluated using a luciferase reporter gene. Both liposomes composed of R and S isomers of the cationic cardiolipin displayed higher transfection efficiency than commercially available Lipofectin. Further in vivo studies are warranted.
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