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Nault D, Machingo TA, Shipper AG, Antiporta DA, Hamel C, Nourouzpour S, Konstantinidis M, Phillips E, Lipski EA, Wieland LS. Zinc for prevention and treatment of the common cold. Cochrane Database Syst Rev 2024; 5:CD014914. [PMID: 38719213 PMCID: PMC11078591 DOI: 10.1002/14651858.cd014914.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND The common cold is an acute, self-limiting viral respiratory illness. Symptoms include nasal congestion and mucus discharge, sneezing, sore throat, cough, and general malaise. Given the frequency of colds, they are a public health burden and a significant cause of lost work productivity and school absenteeism. There are no established interventions to prevent colds or shorten their duration. However, zinc supplements are commonly recommended and taken for this purpose. OBJECTIVES To assess the effectiveness and safety of zinc for the prevention and treatment of the common cold. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, and LILACS to 22 May 2023, and searched Web of Science Core Collection and two trials registries to 14 June 2023. We also used reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) in children or adults that tested any form of zinc against placebo to prevent or treat the common cold or upper respiratory infection (URTI). We excluded zinc interventions in which zinc was combined with other minerals, vitamins, or herbs (e.g. a multivitamin, or mineral supplement containing zinc). DATA COLLECTION AND ANALYSIS We used the Cochrane risk of bias tool to assess risks of bias, and GRADE to assess the certainty of the evidence. We independently extracted data. When necessary, we contacted study authors for additional information. We assessed zinc (type and route) with placebo in the prevention and treatment of the common cold. Primary outcomes included the proportion of participants developing colds (for analyses of prevention trials only), duration of cold (measured in days from start to resolution of the cold), adverse events potentially due to zinc supplements (e.g. unpleasant taste, loss of smell, vomiting, stomach cramps, and diarrhoea), and adverse events considered to be potential complications of the common cold (e.g. respiratory bacterial infections). MAIN RESULTS We included 34 studies (15 prevention, 19 treatment) involving 8526 participants. Twenty-two studies were conducted on adults and 12 studies were conducted on children. Most trials were conducted in the USA (n = 18), followed by India, Indonesia, Iran, and Turkey (two studies each), and Australia, Burkina Faso, Colombia, Denmark, Finland, Tanzania, Thailand, and the UK (one study each). The 15 prevention studies identified the condition as either common cold (n = 8) or URTI (n = 7). However, almost all therapeutic studies (17/19) focused on the common cold. Most studies (17/34) evaluated the effectiveness of zinc administered as lozenges (3 prevention; 14 treatment) in acetate, gluconate, and orotate forms; gluconate lozenges were the most common (9/17). Zinc gluconate was given at doses between 45 and 276 mg/day for between 4.5 and 21 days. Five (5/17) lozenge studies gave acetate lozenges and two (2/17) gave both acetate and gluconate lozenges. One (1/17) lozenge study administered intranasal (gluconate) and lozenge (orotate) zinc in tandem for cold treatment. Of the 17/34 studies that did not use lozenges, 1/17 gave capsules, 3/17 administered dissolved powders, 5/17 gave tablets, 4/17 used syrups, and 4/17 used intranasal administration. Most studies were at unclear or high risk of bias in at least one domain. There may be little or no reduction in the risk of developing a cold with zinc compared to placebo (risk ratio (RR) 0.93, 95% CI 0.85 to 1.01; I2 = 20%; 9 studies, 1449 participants; low-certainty evidence). There may be little or no reduction in the mean number of colds that occur over five to 18 months of follow-up (mean difference (MD) -0.90, 95% CI -1.93 to 0.12; I2 = 96%; 2 studies, 1284 participants; low-certainty evidence). When colds occur, there is probably little or no difference in the duration of colds in days (MD -0.63, 95% CI -1.29 to 0.04; I² = 77%; 3 studies, 740 participants; moderate-certainty evidence), and there may be little or no difference in global symptom severity (standardised mean difference (SMD) 0.04, 95% CI -0.35 to 0.43; I² = 0%; 2 studies, 101 participants; low-certainty evidence). When zinc is used for cold treatment, there may be a reduction in the mean duration of the cold in days (MD -2.37, 95% CI -4.21 to -0.53; I² = 97%; 8 studies, 972 participants; low-certainty evidence), although it is uncertain whether there is a reduction in the risk of having an ongoing cold at the end of follow-up (RR 0.52, 95% CI 0.21 to 1.27; I² = 65%; 5 studies, 357 participants; very low-certainty evidence), or global symptom severity (SMD -0.03, 95% CI -0.56 to 0.50; I² = 78%; 2 studies, 261 participants; very low-certainty evidence), and there may be little or no difference in the risk of a change in global symptom severity (RR 1.02, 95% CI 0.85 to 1.23; 1 study, 114 participants; low-certainty evidence). Thirty-one studies reported non-serious adverse events (2422 participants). It is uncertain whether there is a difference in the risk of adverse events with zinc used for cold prevention (RR 1.11, 95% CI 0.84 to 1.47; I2 = 0%; 7 studies, 1517 participants; very low-certainty evidence) or an increase in the risk of serious adverse events (RR 1.67, 95% CI 0.78 to 3.57; I2 = 0%; 3 studies, 1563 participants; low-certainty evidence). There is probably an increase in the risk of non-serious adverse events when zinc is used for cold treatment (RR 1.34, 95% CI 1.15 to 1.55; I2 = 44%; 2084 participants, 16 studies; moderate-certainty evidence); no treatment study provided information on serious adverse events. No study provided clear information about adverse events considered to be potential complications of the common cold. AUTHORS' CONCLUSIONS The findings suggest that zinc supplementation may have little or no effect on the prevention of colds but may reduce the duration of ongoing colds, with an increase in non-serious adverse events. Overall, there was wide variation in interventions (including concomitant therapy) and outcomes across the studies, as well as incomplete reporting of several domains, which should be considered when making conclusions about the efficacy of zinc for the common cold.
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Affiliation(s)
- Daryl Nault
- Maryland University of Integrative Health, Laurel, MD, USA
| | - Taryn A Machingo
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Andrea G Shipper
- Health Sciences and Human Services Library, University of Maryland, Baltimore, Baltimore, MD, USA
| | | | - Candyce Hamel
- Canadian Association of Radiologists, Ottawa, Canada
| | | | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Erica Phillips
- Department of Nutritional Sciences, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | | | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Veroniki AA, Thirugnanasampanthar SS, Konstantinidis M, Dourka J, Ghassemi M, Neupane D, Khan P, Nincic V, Corry M, Robson R, Parker A, Soobiah C, Sinilaite A, Doyon-Plourde P, Gil A, Siu W, Moqueet N, Stevens A, English K, Florez ID, Yepes-Nuñez JJ, Hutton B, Muller M, Moja L, Straus S, Tricco AC. Trivalent and quadrivalent seasonal influenza vaccine in adults aged 60 and older: a systematic review and network meta-analysis. BMJ Evid Based Med 2024:bmjebm-2023-112767. [PMID: 38604619 DOI: 10.1136/bmjebm-2023-112767] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To compare the efficacy of influenza vaccines of any valency for adults 60 years and older. DESIGN AND SETTING Systematic review with network meta-analysis (NMA) of randomised controlled trials (RCTs). MEDLINE, EMBASE, JBI Evidence-Based Practice (EBP) Database, PsycINFO, and Cochrane Evidence -Based Medicine database were searched from inception to 20 June 20, 2022. Two reviewers screened, abstracted, and appraised articles (Cochrane Risk of Bias (ROB) 2.0 tool) independently. We assessed certainty of findings using Confidence in Network Meta-Analysis and Grading of Recommendations, Assessment, Development and Evaluations approaches. We performed random-effects meta-analysis and network meta-analysis (NMA), and estimated odds ratios (ORs) for dichotomous outcomes and incidence rate ratios (IRRs) for count outcomes along with their corresponding 95% confidence intervals (CIs) and prediction intervals. PARTICIPANTS Older adults (≥60 years old) receiving an influenza vaccine licensed in Canada or the USA (vs placebo, no vaccine, or any other licensed vaccine), at any dose. MAIN OUTCOME MEASURES Laboratory-confirmed influenza (LCI) and influenza-like illness (ILI). Secondary outcomes were the number of vascular adverse events, hospitalisation for acute respiratory infection (ARI) and ILI, inpatient hospitalisation, emergency room (ER) visit for ILI, outpatient visit, and mortality, among others. RESULTS We included 41 RCTs and 15 companion reports comprising 8 vaccine types and 206 032 participants. Vaccines may prevent LCI compared with placebo, with high-dose trivalent inactivated influenza vaccine (IIV3-HD) (NMA: 9 RCTs, 52 202 participants, OR 0.23, 95% confidence interval (CI) (0.11 to 0.51), low certainty of evidence) and recombinant influenza vaccine (RIV) (OR 0.25, 95%CI (0.08 to 0.73), low certainty of evidence) among the most efficacious vaccines. Standard dose trivalent IIV3 (IIV3-SD) may prevent ILI compared with placebo, but the result was imprecise (meta-analysis: 2 RCTs, 854 participants, OR 0.39, 95%CI (0.15 to 1.02), low certainty of evidence). Any HD was associated with prevention of ILI compared with placebo (NMA: 9 RCTs, 65 658 participants, OR 0.38, 95%CI (0.15 to 0.93)). Adjuvanted quadrivalent IIV (IIV4-Adj) may be associated with the least vascular adverse events, but the results were very uncertain (NMA: eight 8 RCTs, 57 677 participants, IRR 0.18, 95%CI (0.07 to 0.43), very low certainty of evidence). RIV on all-cause mortality may be comparable to placebo (NMA: 20 RCTs, 140 577 participants, OR 1.01, 95%CI (0.23 to 4.49), low certainty of evidence). CONCLUSIONS This systematic review demonstrated efficacy associated with IIV3-HD and RIV vaccines in protecting older persons against LCI. RIV vaccine may reduce all-cause mortality when compared with other vaccines, but the evidence is uncertain. Differences in efficacy between influenza vaccines remain uncertain with very low to moderate certainty of evidence. PROSPERO REGISTRATION NUMBER CRD42020177357.
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Affiliation(s)
- Areti Angeliki Veroniki
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sai Surabi Thirugnanasampanthar
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Menelaos Konstantinidis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jasmeen Dourka
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Marco Ghassemi
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Dipika Neupane
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Vera Nincic
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Margarita Corry
- Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland
| | - Reid Robson
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Amanda Parker
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Charlene Soobiah
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Anabel Gil
- Public Health Agency, Ottawa, Ontario, Canada
| | - Winnie Siu
- Public Health Agency, Ottawa, Ontario, Canada
| | | | | | - Kelly English
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), St Michael's Hospital, Toronto, Ontario, Canada
| | - Ivan D Florez
- Department of Pediatrics, University of Antioquia Faculty of Medicine, Medellin, Colombia
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Pediatric Intensive Care Unit, Clinica Las Américas-AUNA, Medellin, Colombia
| | - Juan J Yepes-Nuñez
- University of los Andes Faculty of Medicine, Bogota, Cundinamarca, Colombia
- Pulmonology Service, Internal Medicine Section, University Hospital of the Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Brian Hutton
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthew Muller
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lorenzo Moja
- Department of Biomedical Sciences and Technologies, University of Milan, Milano, Lombardia, Italy
| | - Sharon Straus
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Epidemiology Division & Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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Iyer D, Konstantinidis M, Li H, Bercu Z, Moon J. Impact of drainage catheter material, size, and anti-dislodgement mechanism on percutaneous nephrostomy exchange intervals: a systematic review protocol. F1000Res 2023; 12:1417. [PMID: 38434646 PMCID: PMC10905141 DOI: 10.12688/f1000research.135431.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 03/05/2024] Open
Abstract
Background: Percutaneous nephrostomy (PCN) is a commonly performed procedure by interventional radiology and urology to treat urinary obstruction. In this procedure, a catheter is percutaneously placed into the renal pelvis for urinary diversion or hemorrhagic cystitis. Material type, catheter size, and catheter shape (anti-dislodgement feature) ultimately contribute to the inherent traits of longevity in drainage catheter device. Reviewing the relative strengths or weaknesses of products in the existing clinical market may help clinicians critically appraise the devices they use with evidence-based findings from this review. Furthermore, a deeper understanding of the relative strengths and weaknesses of existing devices may help inform the next generation of drainage catheter devices to prolong the interval between exchanges without detriment to patient safety. Methods: The following electronic databases will be queried: PubMed, Web of Science, Cochrane from their inception to January 2023 to identify randomized controlled trials (RCTs) and cohort studies to investigate the differences that our interventions of catheter material, size, and dislodgement mechanism will have on the exchange interval (standard of care 90 days vs. 60 days vs. 45 days vs. 30 days). The primary outcomes will be the drainage catheter exchange frequency. Ethics and dissemination: We aim to share our findings through high-impact peer reviewed journals. As drainage catheters and minimally invasive interventional radiology procedures become more popular, it is important for healthcare providers taking case of these populations to understand which variables might optimize patient care and minimize emergent exchanges. Data will be made available to readers. Registration: PROSPERO ( CRD42023432788, 16 June 2023).
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Affiliation(s)
- Deepak Iyer
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University, Atlanta, Georgia, USA
| | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Hanzhou Li
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University, Atlanta, Georgia, USA
| | - Zachary Bercu
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University, Atlanta, Georgia, USA
| | - John Moon
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University, Atlanta, Georgia, USA
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4
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Baba A, Webbe J, Butcher NJ, Rodrigues C, Stallwood E, Goren K, Monsour A, Chang ASM, Trivedi A, Manley BJ, McCall E, Bogossian F, Namba F, Schmölzer GM, Harding J, Nguyen KA, Doyle LW, Jardine L, Rysavy MA, Konstantinidis M, Meyer M, Helmi MAM, Lai NM, Hay S, Onland W, Choo YM, Gale C, Soll RF, Offringa M. Heterogeneity and Gaps in Reporting Primary Outcomes From Neonatal Trials. Pediatrics 2023; 152:e2022060751. [PMID: 37641881 DOI: 10.1542/peds.2022-060751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Clear outcome reporting in clinical trials facilitates accurate interpretation and application of findings and improves evidence-informed decision-making. Standardized core outcomes for reporting neonatal trials have been developed, but little is known about how primary outcomes are reported in neonatal trials. Our aim was to identify strengths and weaknesses of primary outcome reporting in recent neonatal trials. METHODS Neonatal trials including ≥100 participants/arm published between 2015 and 2020 with at least 1 primary outcome from a neonatal core outcome set were eligible. Raters recruited from Cochrane Neonatal were trained to evaluate the trials' primary outcome reporting completeness using relevant items from Consolidated Standards of Reporting Trials 2010 and Consolidated Standards of Reporting Trials-Outcomes 2022 pertaining to the reporting of the definition, selection, measurement, analysis, and interpretation of primary trial outcomes. All trial reports were assessed by 3 raters. Assessments and discrepancies between raters were analyzed. RESULTS Outcome-reporting evaluations were completed for 36 included neonatal trials by 39 raters. Levels of outcome reporting completeness were highly variable. All trials fully reported the primary outcome measurement domain, statistical methods used to compare treatment groups, and participant flow. Yet, only 28% of trials fully reported on minimal important difference, 24% on outcome data missingness, 66% on blinding of the outcome assessor, and 42% on handling of outcome multiplicity. CONCLUSIONS Primary outcome reporting in neonatal trials often lacks key information needed for interpretability of results, knowledge synthesis, and evidence-informed decision-making in neonatology. Use of existing outcome-reporting guidelines by trialists, journals, and peer reviewers will enhance transparent reporting of neonatal trials.
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Affiliation(s)
- Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - James Webbe
- Neonatal Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Craig Rodrigues
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Katherine Goren
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Alvin S M Chang
- Quality, Safety and Risk Management, and Department of Neonatology, KK Women's and Children's Hospital, Singapore
- DUKE-NUS Medical School, Singapore
| | - Amit Trivedi
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Emma McCall
- School of Nursing and Midwifery, Queen's University of Belfast, Belfast, Northern Ireland
| | | | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Georg M Schmölzer
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Jane Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Kim An Nguyen
- Claude Bernard University Lyon, Villeurbanne, France
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Matthew A Rysavy
- University of Texas Health Science Centre at Houston, Houston, Texas
| | - Menelaos Konstantinidis
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Nai Ming Lai
- School of Medicine, Taylor's University, Malaysia
| | - Susanne Hay
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Wes Onland
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Yao Mun Choo
- Department of Paediatrics, University Malaya, Malaysia
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Roger F Soll
- Cochrane Neonatal, Burlington, VT
- Division of Neonatal-Perinatal Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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5
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Webbe J, Baba A, Butcher NJ, Rodrigues C, Stallwood E, Goren K, Monsour A, Chang ASM, Trivedi A, Manley BJ, McCall E, Bogossian F, Namba F, Schmölzer GM, Popat H, Nguyen KA, Doyle LW, Jardine L, Rysavy MA, Konstantinidis M, Muhd Helmi MA, Lai NM, Hay S, Onland W, Choo YM, Gale C, Soll RF, Offringa M. Strengthening Reporting of Neonatal Trials. Pediatrics 2023; 152:e2022060765. [PMID: 37641894 DOI: 10.1542/peds.2022-060765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is variability in the selection and reporting of outcomes in neonatal trials with key information frequently omitted. This can impact applicability of trial findings to clinicians, families, and caregivers, and impair evidence synthesis. The Neonatal Core Outcomes Set describes outcomes agreed as clinically important that should be assessed in all neonatal trials, and Consolidated Standards of Reporting Trials (CONSORT)-Outcomes 2022 is a new, harmonized, evidence-based reporting guideline for trial outcomes. We reviewed published trials using CONSORT-Outcomes 2022 guidance to identify exemplars of neonatal core outcome reporting to strengthen description of outcomes in future trial publications. METHODS Neonatal trials including >100 participants per arm published between 2015 to 2020 with a primary outcome included in the Neonatal Core Outcome Set were identified. Primary outcome reporting was reviewed using CONSORT 2010 and CONSORT-Outcomes 2022 guidelines by assessors recruited from Cochrane Neonatal. Examples of clear and complete outcome reporting were identified with verbatim text extracted from trial reports. RESULTS Thirty-six trials were reviewed by 39 assessors. Examples of good reporting for CONSORT 2010 and CONSORT-Outcomes 2022 criteria were identified and subdivided into 3 outcome categories: "survival," "short-term neonatal complications," and "long-term developmental outcomes" depending on the core outcomes to which they relate. These examples are presented to strengthen future research reporting. CONCLUSIONS We have identified examples of good trial outcome reporting. These illustrate how important neonatal outcomes should be reported to meet the CONSORT 2010 and CONSORT-Outcomes 2022 guidelines. Emulating these examples will improve the transmission of information relating to outcomes and reduce associated research waste.
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Affiliation(s)
- James Webbe
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Craig Rodrigues
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Emma Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Katherine Goren
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Andrea Monsour
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Alvin S M Chang
- Quality, Safety and Risk Management (QSRM) and Department of Neonatology, KK Women's and Children's Hospital, Singapore
- DUKE-NUS Medical School, Singapore
| | - Amit Trivedi
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Emma McCall
- School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland
| | | | - Fumihiko Namba
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | - Himanshu Popat
- The Children's Hospital at Westmead, New South Wales, Australia
| | | | - Lex W Doyle
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Luke Jardine
- Department of Neonatology, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Matthew A Rysavy
- University of Texas Health Science Centre at Houston, Houston, Texas
| | - Menelaos Konstantinidis
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Muhd Alwi Muhd Helmi
- Department of Paediatrics, International Islamic University, Kuala Lumpur, Malaysia
| | - Nai Ming Lai
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Selangor, Malaysia
| | - Susanne Hay
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Wes Onland
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Yao Mun Choo
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, United Kingdom
| | - Roger F Soll
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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6
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Hay S, Ovelman C, Zupancic JA, Doyle LW, Onland W, Konstantinidis M, Shah PS, Soll R. Systemic corticosteroids for the prevention of bronchopulmonary dysplasia, a network meta-analysis. Cochrane Database Syst Rev 2023; 8:CD013730. [PMID: 37650547 PMCID: PMC10468918 DOI: 10.1002/14651858.cd013730.pub2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Despite considerable improvement in outcomes for preterm infants, rates of bronchopulmonary dysplasia (BPD) remain high, affecting an estimated 33% of very low birthweight infants, with corresponding long-term respiratory and neurosensory issues. Systemic corticosteroids can address the inflammation underlying BPD, but the optimal regimen for prevention of this disease, balancing of the benefits with the potentially meaningful risks of systemic corticosteroids, continues to be a medical quandary. Numerous studies have shown that systemic corticosteroids, particularly dexamethasone and hydrocortisone, effectively treat or prevent BPD. However, concerning short and long-term side effects have been reported and the optimal approach to corticosteroid treatment remains unclear. OBJECTIVES To determine whether differences in efficacy and safety exist between high-dose dexamethasone, moderate-dose dexamethasone, low-dose dexamethasone, hydrocortisone, and placebo in the prevention of BPD, death, the composite outcome of death or BPD, and other relevant morbidities, in preterm infants through a network meta-analysis, generating both pairwise comparisons between all treatments and rankings of the treatments. SEARCH METHODS We searched the Cochrane Library for all systematic reviews of systemic corticosteroids for the prevention of BPD and searched for completed and ongoing studies in the following databases in January 2023: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and clinical trial databases. SELECTION CRITERIA We included randomized controlled trials (RCTs) in preterm infants (< 37 weeks' gestation) at risk for BPD that evaluated systemic corticosteroids (high-dose [≥ 4 mg/kg cumulative dose] dexamethasone, moderate-dose [≥ 2 to < 4 mg/kg] dexamethasone, low-dose [< 2 mg/kg] dexamethasone, or hydrocortisone) versus control or another systemic corticosteroid. DATA COLLECTION AND ANALYSIS Our main information sources were the systematic reviews, with reference to the original manuscript only for data not included in these reviews. Teams of two paired review authors independently performed data extraction, with disagreements resolved by discussion. Data were entered into Review Manager 5 and exported to R software for network meta-analysis (NMA). NMA was performed using a frequentist model with random-effects. Two separate networks were constructed, one for early (< seven days) initiation of treatment and one for late (≥ seven days) treatment initiation, to reflect the different patient populations evaluated. We assessed the certainty of evidence derived from the NMA for our primary outcomes using principles of the GRADE framework modified for application to NMA. MAIN RESULTS We included 59 studies, involving 6441 infants, in our analyses. Only six of the included studies provided direct comparisons between any of the treatment (dexamethasone or hydrocortisone) groups, forcing network comparisons between treatments to rely heavily on indirect evidence through comparisons with placebo/no treatment groups. Thirty-one studies evaluated early corticosteroid treatment, 27 evaluated late corticosteroid treatment, and one study evaluated both early and late corticosteroid treatments. Early treatment (prior to seven days after birth): Benefits:NMA for early treatment showed only moderate-dose dexamethasone to decrease the risk of BPD at 36 weeks' postmenstrual age (PMA) compared with control (RR 0.56, 95% CI 0.39 to 0.80; moderate-certainty evidence), although the other dexamethasone dosing regimens may have similar effects compared with control (high-dose dexamethasone, RR 0.71, 95% CI 0.50 to 1.01; low-certainty evidence; low-dose dexamethasone, RR 0.83, 95% CI 0.67 to 1.03; low-certainty evidence). Other early treatment regimens may have little or no effect on the risk of death at 36 weeks' PMA. Only moderate-dose dexamethasone decreased the composite outcome of death or BPD at 36 weeks' PMA compared with control (RR 0.77, 95% CI 0.60 to 0.98; moderate-certainty evidence). HARMS Low-dose dexamethasone increased the risk for cerebral palsy (RR 1.92, 95% CI 1.12 to 3.28; moderate-certainty evidence) compared with control. Hydrocortisone may decrease the risk of major neurosensory disability versus low-dose dexamethasone (RR 0.65, 95% CI 0.41 to 1.01; low-certainty evidence). Late treatment (at seven days or later after birth): Benefits: NMA for late treatment showed high-dose dexamethasone to decrease the risk of BPD both versus hydrocortisone (RR 0.66, 95% CI 0.51 to 0.85; low-certainty evidence) and versus control (RR 0.72, CI 0.59 to 0.87; moderate-certainty evidence). The late treatment regimens evaluated may have little or no effect on the risk of death at 36 weeks' PMA. High-dose dexamethasone decreased risk for the composite outcome of death or BPD compared with all other treatments (control, RR 0.69, 95% CI 0.59 to 0.80, high-certainty evidence; hydrocortisone, RR 0.69, 95% CI 0.58 to 0.84, low-certainty evidence; low-dose dexamethasone, RR 0.73, 95% CI 0.60 to 0.88, low-certainty evidence; moderate-dose dexamethasone, RR 0.76, 95% CI 0.62 to 0.93, low-certainty evidence). HARMS No effect was observed for the outcomes of major neurosensory disability or cerebral palsy. The evidence for the primary outcomes was of overall low certainty, with notable deductions for imprecision and heterogeneity across the networks. AUTHORS' CONCLUSIONS While early treatment with moderate-dose dexamethasone or late treatment with high-dose dexamethasone may lead to the best effects for survival without BPD, the certainty of the evidence is low. There is insufficient evidence to guide this therapy with regard to plausible adverse long-term outcomes. Further RCTs with direct comparisons between systemic corticosteroid treatments are needed to determine the optimal treatment approach, and these studies should be adequately powered to evaluate survival without major neurosensory disability.
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Affiliation(s)
- Susanne Hay
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Colleen Ovelman
- Center for Health Informatics and Evidence Synthesis, RTI International, Durham, NC, USA
| | - John Af Zupancic
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Wes Onland
- Department of Neonatology, Emma Children's Hospital AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Prakeshkumar S Shah
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto Mount Sinai Hospital, Toronto, Canada
| | - Roger Soll
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
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Moon J, Nguyen J, Konstantinidis M, Li H, Bercu Z. Abstract No. 59 Temporal Trends in Cystostomy Exchanges and Placements: A 2000–2014 Analysis of the National Inpatient Sample (NIS) and National Emergency Department Sample (NEDS) of the Healthcare Cost and Utilization Project. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Tran A, Konstantinidis M, Moon J, El Sehemawi N, Ferreira K, Habibollahi P, Odisio BC, Nourouzpour S, Bassir A, Nezami N. Interventions for unresectable intrahepatic cholangiocarcinoma: a network meta‐analysis. Cochrane Database Syst Rev 2022; 2022:CD015159. [PMCID: PMC9730740 DOI: 10.1002/14651858.cd015159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To establish the existence of differences in effectiveness and safety of intra‐arterial therapies (IATs) such as bland embolisation, conventional transarterial chemoembolisation (cTACE), drug‐eluting bead transarterial chemoembolisation (DEBTACE), yttrium‐90 (Y90), hepatic artery infusion (HAI), external beam radiotherapies (EBRTs), and immunotherapy versus systemic chemotherapy for unresectable intrahepatic cholangiocarcinoma through pairwise meta‐analysis and network meta‐analysis with subsequent treatment ranking.
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Affiliation(s)
| | - Andrew Tran
- UT Health McGovern Medical SchoolHoustonTexasUSA
| | - Menelaos Konstantinidis
- Institute of Health Policy, Management and Evaluation, University of TorontoTorontoCanada,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health TorontoTorontoCanada
| | - John Moon
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaGeorgiaUSA
| | | | | | - Peiman Habibollahi
- Department of Interventional RadiologyDivision of Diagnostic Imaging, The University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Bruno C Odisio
- Department of Interventional RadiologyDivision of Diagnostic Imaging, The University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | | | - Ali Bassir
- Department of Radiological SciencesDavid Geffen School of Medicine, University of California Los AngelesLos AngelesCaliforniaUSA
| | - Nariman Nezami
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA,Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer CenterBaltimoreMarylandUSA
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9
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Chockalingam A, Konstantinidis M, Koo B, Moon JT, Tran A, Nourouzpour S, Lawson E, Fox K, Habibollahi P, Odisio B, Loya M, Bassir A, Nezami N. Surgical resection, radiotherapy and percutaneous thermal ablation for treatment of stage 1 non-small cell lung cancer: protocol for a systematic review and network meta-analysis. BMJ Open 2022; 12:e057638. [PMID: 35710245 PMCID: PMC9207751 DOI: 10.1136/bmjopen-2021-057638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Non-small cell lung cancer (NSCLC) makes up the majority of lung cancer cases. Currently, surgical resection is the gold standard of treatment. However, as patients are becoming medically more complex presenting with advanced disease, minimally invasive image-guided percutaneous ablations are gaining popularity. Therefore, comparison of surgical, ablative and second-line external beam therapies will help clinicians, as management of NSCLC changes. We will conduct a meta-analysis, reviewing literature investigating these therapies in adult patients diagnosed with stage 1 NSCLC, with neither hilar nor mediastinal nodal involvement, confirmed either through cytology or histology regardless of type. METHODS AND ANALYSIS We will search electronic databases (MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov, Cochrane) from their inception to January 2021 to identify randomised controlled trials (RCTs), cluster RCTs and cohort studies comparing survival and clinical outcomes between any two interventions (lobectomy, wedge resection, video-assisted thoracoscopic surgery/robot-assisted thoracoscopic surgery, radiofrequency ablation, microwave ablation, cryoablation and consolidated radiation therapies (external beam radiation therapy, stereotactic body radiation therapy, and 3D conformal radiation therapy). The primary outcomes will include cancer-specific survival, lung disease-free survival, locoregional recurrence, death, toxicity and non-target organ injury. We will also search published and unpublished studies in trial registries and will review references of included studies for possible inclusion. Risk of bias will be assessed using tools developed by the Cochrane collaboration. Two reviewers will independently assess the eligibility of studies and conduct the corresponding risk of bias assessments. For each outcome, given enough studies, we will conduct a network meta-analysis. Finally, we will use the Confidence in Network Meta-Analysis tool to assess quality of the evidence for each of the primary outcomes. ETHICS AND DISSEMINATION We aim to share our findings through high-impact peer review. As interventional techniques become more popular, it will be important for providers in multidisciplinary teams caring for these patients to receive continuing medical education related to these interventions. Data will be made available to readers. PROSPERO REGISTRATION NUMBER CRD42021276629.
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Affiliation(s)
| | - Menelaos Konstantinidis
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Brandon Koo
- Brown University, Providence, Rhode Island, USA
| | - John Timothy Moon
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Andrew Tran
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | | | | | - Peiman Habibollahi
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bruno Odisio
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohammed Loya
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ali Bassir
- University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Nariman Nezami
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
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10
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Bhandari AP, Nnate DA, Vasanthan L, Konstantinidis M, Thompson J. Positioning for acute respiratory distress in hospitalised infants and children. Cochrane Database Syst Rev 2022; 6:CD003645. [PMID: 35661343 PMCID: PMC9169533 DOI: 10.1002/14651858.cd003645.pub4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Acute respiratory distress syndrome (ARDS) is a significant cause of hospitalisation and death in young children. Positioning and mechanical ventilation have been regularly used to reduce respiratory distress and improve oxygenation in hospitalised patients. Due to the association of prone positioning (lying on the abdomen) with sudden infant death syndrome (SIDS) within the first six months, it is recommended that young infants be placed on their back (supine). However, prone positioning may be a non-invasive way of increasing oxygenation in individuals with acute respiratory distress, and offers a more significant survival advantage in those who are mechanically ventilated. There are substantial differences in respiratory mechanics between adults and infants. While the respiratory tract undergoes significant development within the first two years of life, differences in airway physiology between adults and children become less prominent by six to eight years old. However, there is a reduced risk of SIDS during artificial ventilation in hospitalised infants. Thus, an updated review focusing on positioning for infants and young children with ARDS is warranted. This is an update of a review published in 2005, 2009, and 2012. OBJECTIVES To compare the effects of different body positions in hospitalised infants and children with acute respiratory distress syndrome aged between four weeks and 16 years. SEARCH METHODS We searched CENTRAL, which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE, Embase, and CINAHL from January 2004 to July 2021. SELECTION CRITERIA Randomised controlled trials (RCTs) or quasi-RCTs comparing two or more positions for the management of infants and children hospitalised with ARDS. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from each study. We resolved differences by consensus, or referred to a third contributor to arbitrate. We analysed bivariate outcomes using an odds ratio (OR) and 95% confidence interval (CI). We analysed continuous outcomes using a mean difference (MD) and 95% CI. We used a fixed-effect model, unless heterogeneity was significant (I2 statistic > 50%), when we used a random-effects model. MAIN RESULTS We included six trials: four cross-over trials, and two parallel randomised trials, with 198 participants aged between 4 weeks and 16 years, all but 15 of whom were mechanically ventilated. Four trials compared prone to supine positions. One trial compared the prone position to good-lung dependent (where the person lies on the side of the healthy lung, e.g. if the right lung was healthy, they were made to lie on the right side), and independent (or non-good-lung independent, where the person lies on the opposite side to the healthy lung, e.g. if the right lung was healthy, they were made to lie on the left side) position. One trial compared good-lung independent to good-lung dependent positions. When the prone (with ventilators) and supine positions were compared, there was no information on episodes of apnoea or mortality due to respiratory events. There was no conclusive result in oxygen saturation (SaO2; MD 0.40 mmHg, 95% CI -1.22 to 2.66; 1 trial, 30 participants; very low certainty evidence); blood gases, PCO2 (MD 3.0 mmHg, 95% CI -1.93 to 7.93; 1 trial, 99 participants; low certainty evidence), or PO2 (MD 2 mmHg, 95% CI -5.29 to 9.29; 1 trial, 99 participants; low certainty evidence); or lung function (PaO2/FiO2 ratio; MD 28.16 mmHg, 95% CI -9.92 to 66.24; 2 trials, 121 participants; very low certainty evidence). However, there was an improvement in oxygenation index (FiO2% X MPAW/ PaO2) with prone positioning in both the parallel trials (MD -2.42, 95% CI -3.60 to -1.25; 2 trials, 121 participants; very low certainty evidence), and the cross-over study (MD -8.13, 95% CI -15.01 to -1.25; 1 study, 20 participants). Derived indices of respiratory mechanics, such as tidal volume, respiratory rate, and positive end-expiratory pressure (PEEP) were reported. There was an apparent decrease in tidal volume between prone and supine groups in a parallel study (MD -0.60, 95% CI -1.05 to -0.15; 1 study, 84 participants; very low certainty evidence). When prone and supine positions were compared in a cross-over study, there were no conclusive results in respiratory compliance (MD 0.07, 95% CI -0.10 to 0.24; 1 study, 10 participants); changes in PEEP (MD -0.70 cm H2O, 95% CI -2.72 to 1.32; 1 study, 10 participants); or resistance (MD -0.00, 95% CI -0.05 to 0.04; 1 study, 10 participants). One study reported adverse events. There were no conclusive results for potential harm between groups in extubation (OR 0.57, 95% CI 0.13 to 2.54; 1 trial, 102 participants; very low certainty evidence); obstructions of the endotracheal tube (OR 5.20, 95% CI 0.24 to 111.09; 1 trial, 102 participants; very low certainty evidence); pressure ulcers (OR 1.00, 95% CI 0.41 to 2.44; 1 trial, 102 participants; very low certainty evidence); and hypercapnia (high levels of arterial carbon dioxide; OR 3.06, 95% CI 0.12 to 76.88; 1 trial, 102 participants; very low certainty evidence). One study (50 participants) compared supine positions to good-lung dependent and independent positions. There was no conclusive evidence that PaO2 was different between supine and good-lung dependent positioning (MD 3.44 mm Hg, 95% CI -23.12 to 30.00; 1 trial, 25 participants; very low certainty evidence). There was also no conclusive evidence for supine position and good-lung independent positioning (MD -2.78 mmHg, 95% CI -28.84, 23.28; 25 participants; very low certainty evidence); or between good-lung dependent and independent positioning (MD 6.22, 95% CI -21.25 to 33.69; 1 trial, 25 participants; very low certainty evidence). As most trials did not describe how possible biases were addressed, the potential for bias in these findings is unclear. AUTHORS' CONCLUSIONS Although included studies suggest that prone positioning may offer some advantage, there was little evidence to make definitive recommendations. There appears to be low certainty evidence that positioning improves oxygenation in mechanically ventilated children with ARDS. Due to the increased risk of SIDS with prone positioning and lung injury with artificial ventilation, it is recommended that hospitalised infants and children should only be placed in this position while under continuous cardiorespiratory monitoring.
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Affiliation(s)
- Abhishta P Bhandari
- Townsville University Hospital, Townsville, Australia
- School of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Daniel A Nnate
- Countess of Chester Hospital NHS Foundation Trust, Chester, UK
| | - Lenny Vasanthan
- Physiotherapy Unit, Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India
| | | | - Jacqueline Thompson
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Lalla EA, Konstantinidis M, Veneranda M, Daly MG, Manrique JA, Lymer EA, Freemantle J, Cloutis EA, Stromberg JM, Shkolyar S, Caudill C, Applin D, Vago JL, Rull F, Lopez-Reyes G. Raman Characterization of the CanMars Rover Field Campaign Samples Using the Raman Laser Spectrometer ExoMars Simulator: Implications for Mars and Planetary Exploration. Astrobiology 2022; 22:416-438. [PMID: 35041521 DOI: 10.1089/ast.2021.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The Mars 2020 Perseverance rover landed on February 18, 2021, and has started ground operations. The ExoMars Rosalind Franklin rover will touch down on June 10, 2023. Perseverance will be the first-ever Mars sample caching mission-a first step in sample return to Earth. SuperCam and Scanning Habitable Environments with Raman & Luminescence for Organics & Chemicals (SHERLOC) on Perseverance, and Raman Laser Spectrometer (RLS) on Rosalind Franklin, will comprise the first ever in situ planetary mission Raman spectroscopy instruments to identify rocks, minerals, and potential organic biosignatures on Mars' surface. There are many challenges associated when using Raman instruments and the optimization and quantitative analysis of resulting data. To understand how best to overcome them, we performed a comprehensive Raman analysis campaign on CanMars, a Mars sample caching rover analog mission undertaken in Hanksville, Utah, USA, in 2016. The Hanksville region presents many similarities to Oxia Planum's past habitable conditions, including liquid water, flocculent, and elemental compounds (such as clays), catalysts, substrates, and energy/food sources for life. We sampled and conducted a complete band analysis of Raman spectra as mission validation analysis with the RLS ExoMars Simulator or RLS Sim, a breadboard setup representative of the ExoMars RLS instrument. RLS Sim emulates the operational behavior of RLS on the Rosalind Franklin rover. Given the high fidelity of the Mars analog site and the RLS Sim, the results presented here may provide important information useful for guiding in situ analysis and sample triage for caching relevant for the Perseverance and Rosalind Franklin missions. By using the RLS Sim on CanMars samples, our measurements detected oxides, sulfates, nitrates, carbonates, feldspars, and carotenoids, many with a higher degree of sensitivity than past results. Future work with the RLS Sim will aim to continue developing and improving the capability of the RLS system in the future ExoMars mission.
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Affiliation(s)
- Emmanuel A Lalla
- Centre for Research in Earth and Space Science, Lassonde School of Engineering, York University, Toronto, Canada
| | - Menelaos Konstantinidis
- Centre for Research in Earth and Space Science, Lassonde School of Engineering, York University, Toronto, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Marco Veneranda
- Unidad Asociada Universidad de Valladolid-CSIC-CAB, Boecillo, Spain
| | - Michael G Daly
- Centre for Research in Earth and Space Science, Lassonde School of Engineering, York University, Toronto, Canada
| | | | - Elizabeth A Lymer
- Centre for Research in Earth and Space Science, Lassonde School of Engineering, York University, Toronto, Canada
| | - James Freemantle
- Centre for Research in Earth and Space Science, Lassonde School of Engineering, York University, Toronto, Canada
| | - Edward A Cloutis
- Department of Geography, University of Winnipeg, Winnipeg, Canada
| | - Jessica M Stromberg
- Department of Geography, University of Winnipeg, Winnipeg, Canada
- CSIRO Mineral Resources, Kensington, Australia
| | - Svetlana Shkolyar
- Universities Space Research Association, Columbia, Maryland, USA
- NASA Goddard Space Flight Center, Greenbelt, Maryland, USA
- Blue Marble Space Institute of Science, Seattle, Washington, USA
| | - Christy Caudill
- Centre for Planetary Science and Exploration/Department of Earth Sciences, University of Western Ontario, London, Canada
| | - Daniel Applin
- Department of Geography, University of Winnipeg, Winnipeg, Canada
| | - Jorge L Vago
- European Space Agency, ESA/ESTEC (SCI-S), Noordwijk, The Netherlands
| | - Fernando Rull
- Unidad Asociada Universidad de Valladolid-CSIC-CAB, Boecillo, Spain
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Lymer EA, Konstantinidis M, Lalla EA, Daly MG, Tait KT. UV Time-Resolved Laser-Induced Fluorescence Spectroscopy of Amino Acids Found in Meteorites: Implications for Space Science and Exploration. Astrobiology 2021; 21:1350-1362. [PMID: 34314603 DOI: 10.1089/ast.2021.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Laser-induced fluorescence spectroscopy is a useful laboratory and in situ technique for planetary exploration, with applications in biosignature detection and the search for life on Mars. However, little work has been completed on the utility of fluorescence spectroscopy techniques on asteroid relevant material. In preparation for asteroid sample return missions such as NASA's OSIRIS-REx and JAXA's Hayabusa2, we conducted UV time resolved laser-induced fluorescence spectroscopy (TR-LIF) analysis of 10 amino acids, all of which have been found in the carbonaceous meteorites Murchison and Allende. We present the calculation of decay rates of each amino acid (1.55-3.56 ns) and compare with those of relevant homogeneous minerals (15-70 ns). Moreover, we demonstrate a linear relationship between calculated lifetimes and elemental abundance of nitrogen and carbon (p < 0.025). The quantitative and qualitative fluorescence analyses presented in this work will lead to more reliable identification of organic material within meteorites and asteroids in a time-efficient, minimally destructive way.
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Affiliation(s)
- Elizabeth A Lymer
- Centre for Research in Earth and Space Science, York University, Toronto, Canada
| | - Menelaos Konstantinidis
- Centre for Research in Earth and Space Science, York University, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Emmanuel A Lalla
- Centre for Research in Earth and Space Science, York University, Toronto, Canada
| | - Michael G Daly
- Centre for Research in Earth and Space Science, York University, Toronto, Canada
| | - Kimberly T Tait
- Department of Natural History, Centre for Applied Planetary Mineralogy, Royal Ontario Museum, Toronto, Canada
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Nezami N, VAN Breugel JMM, Konstantinidis M, Chapiro J, Savic LJ, Miszczuk MA, Rexha I, Lin M, Hong K, Georgiades C. Lipiodol Deposition and Washout in Primary and Metastatic Liver Tumors After Chemoembolization. In Vivo 2021; 35:3261-3270. [PMID: 34697157 DOI: 10.21873/invivo.12621] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIM Lipiodol is the key component of conventional trans-arterial chemoembolization. Our aim was to evaluate lipiodol deposition and washout rate after conventional trans-arterial chemoembolization in intrahepatic cholangiocarcinoma and hepatic metastases originating from neuroendocrine tumors and colorectal carcinoma. PATIENTS AND METHODS This was a retrospective analysis of 44 patients with intrahepatic cholangiocarcinoma and liver metastasis from neuroendocrine tumors or colorectal carcinoma who underwent conventional trans-arterial chemoembolization. Lipiodol volume (cm3) was analyzed on non-contrast computed tomography imaging obtained within 24 h post conventional trans-arterial chemoembolization, and 40-220 days after conventional trans-arterial chemoembolization using volumetric image analysis software. Tumor response was assessed on contrast-enhanced magnetic resonance imaging 1 month after conventional trans-arterial chemoembolization. RESULTS The washout rate was longer for neuroendocrine tumors compared to colorectal carcinoma, with half-lives of 54.61 days (p<0.00001) and 19.39 days (p<0.001), respectively, with no exponential washout among intrahepatic cholangiocarcinomas (p=0.83). The half-life for lipiodol washout was longer in tumors larger than 300 cm3 compared to smaller tumors (25.43 vs. 22.71 days). Lipiodol wash out half-life was 54.76 days (p<0.01) and 29.45 days (p<0.00001) for tumors with a contrast enhancement burden of 60% or more and less than 60%, respectively. A negative exponential relationship for lipiodol washout was observed in non-responders (p<0.00001). CONCLUSION Lipiodol washout is a time-dependent process, and occurs faster in colorectal carcinoma tumors, tumors smaller than 300 cm3, tumors with baseline contrast enhancement burden of less than 60%, and non-responding target lesions.
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Affiliation(s)
- Nariman Nezami
- Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.; .,Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, U.S.A
| | - Johanna Maria Mijntje VAN Breugel
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.,Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.,Medical faculty, Utrecht University, Utrecht, the Netherlands
| | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Julius Chapiro
- Section of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A
| | - Lynn Jeanette Savic
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.,Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Milena Anna Miszczuk
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A
| | - Irvin Rexha
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, U.S.A.,Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mingde Lin
- Visage Imaging, Inc., San Diego, CA, U.S.A
| | - Kelvin Hong
- Division of Vascular and Interventional Radiology, Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
| | - Christos Georgiades
- Division of Vascular and Interventional Radiology, Russel H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, U.S.A
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Wieland LS, Hamel C, Konstantinidis M, Nourouzpour S, Shipper AG, Lipski E. Zinc for prevention and treatment of the common cold. Hippokratia 2021. [DOI: 10.1002/14651858.cd014914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Susan Wieland
- Center for Integrative Medicine; University of Maryland School of Medicine; Baltimore Maryland USA
| | | | - Menelaos Konstantinidis
- Division of Biostatistics, Dalla Lana School of Public Health; University of Toronto; Toronto Canada
- Child Health Evaluative Sciences; The Hospital for Sick Children; Toronto Canada
| | | | - Andrea G Shipper
- Health Sciences and Human Services Library; University of Maryland, Baltimore; Baltimore MD USA
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15
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Lalla E, Konstantinidis M, Czakler C, Garnitschnig S, Hickson D, Such P, Losiak A, Ercoli M, Frigeri A, Hofmann A, Lucic T, Seikora N, Suchantke I, Gruber S, Groemer G. Remote science activities during the AMADEE-18 Mars analog mission: Preparation and execution during a simulated planetary surface mission. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.jsse.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Lalla EA, Cote K, Hickson D, Garnitschnig S, Konstantinidis M, Such P, Czakler C, Schroder C, Frigeri A, Ercoli M, Losiak A, Gruber S, Groemer G. Laboratory Analysis of Returned Samples from the AMADEE-18 Mars Analog Mission. Astrobiology 2020; 20:1303-1320. [PMID: 33179966 DOI: 10.1089/ast.2019.2038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Between February 1 and 28, 2018, the Austrian Space Forum, in cooperation with the Oman Astronomical Society and research teams from 25 nations, conducted the AMADEE-18 mission, a human-robotic Mars expedition simulation in the Dhofar region in the Sultanate of Oman. As a part of the AMADEE-18 simulated Mars human exploration mission, the Remote Science Support team performed analyses of the Dhofar area (Oman) in an effort to characterize the region as a potential Mars analog site. The main motivation of this research was to study and register selected samples collected by analog astronauts during the AMADEE-18 mission with laboratory analytical methods and techniques comparable with those that are likely to be used on Mars in the future. The 25 samples representing unconsolidated sediments obtained during the simulated mission were studied by using optical microscopy, Raman spectroscopy, X-ray diffraction, laser-induced breakdown spectroscopy, and laser-induced fluorescence spectroscopy. The principal results show the existence of minerals and alteration processes related to volcanism, hydrothermalism, and weathering. The analogy between the Dhofar region and the Eridana Basin region of Mars is clearly noticeable, particularly as an analog for secondary minerals formed in a hydrothermal seafloor volcanic-sedimentary environment. The synergy between the techniques used in the present work provides a solid basis for the geochemical analyses and organic detection in the context of future human-robotic Mars expeditions. AMADEE-18 has been a prime test bed for geoscientific workflows with astrobiological relevance and has provided valuable insights for future space missions.
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Affiliation(s)
- Emmanuel Alexis Lalla
- Centre for Research in Earth and Space Science (CRESS), York University, Toronto, Ontario, Canada
- Austrian Space Forum, Innsbruck, Austria
| | - Kristen Cote
- Centre for Research in Earth and Space Science (CRESS), York University, Toronto, Ontario, Canada
| | - Dylan Hickson
- Centre for Research in Earth and Space Science (CRESS), York University, Toronto, Ontario, Canada
| | | | - Menelaos Konstantinidis
- Centre for Research in Earth and Space Science (CRESS), York University, Toronto, Ontario, Canada
| | - Pamela Such
- Centre for Research in Earth and Space Science (CRESS), York University, Toronto, Ontario, Canada
| | | | - Christian Schroder
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Scotland, United Kingdom
| | - Alessadro Frigeri
- National Institute of Astrophysics, Institute for Space Astrophysics and Planetology IAPS, Rome, Italy
| | - Maurizio Ercoli
- Dipartimento di Fisica e Geologia, Università degli Studi di Perugia, Perugia, Italy
| | - Anna Losiak
- Austrian Space Forum, Innsbruck, Austria
- Institute of Geological Sciences, Polish Academy of Sciences, Wrocław, Poland
- WildFire LabHatherly Laboratories, University of Exeter, Exeter, United Kingdom
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17
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Veneranda M, Lopez-Reyes G, Manrique-Martinez JA, Sanz-Arranz A, Lalla E, Konstantinidis M, Moral A, Medina J, Rull F. ExoMars Raman Laser Spectrometer (RLS): development of chemometric tools to classify ultramafic igneous rocks on Mars. Sci Rep 2020; 10:16954. [PMID: 33046782 PMCID: PMC7550563 DOI: 10.1038/s41598-020-73846-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/07/2020] [Accepted: 09/18/2020] [Indexed: 11/20/2022] Open
Abstract
This work aims to evaluate whether the multi-point analysis the ExoMars Raman Laser Spectrometer (RLS) will perform on powdered samples could serve to classify ultramafic rocks on Mars. To do so, the RLS ExoMars Simulator was used to study terrestrial analogues of Martian peridotites and pyroxenites by applying the operational constraints of the Raman spectrometer onboard the Rosalind Franklin rover. Besides qualitative analysis, RLS-dedicated calibration curves have been built to estimate the relative content of olivine and pyroxenes in the samples. These semi-quantitative results, combined with a rough estimate of the concentration ratio between clino- and ortho-pyroxene mineral phases, were used to classify the terrestrial analogues. XRD data were finally employed as reference to validate Raman results. As this preliminary work suggests, ultramafic rocks on Mars could be effectively classified through the chemometric analysis of RLS data sets. After optimization, the proposed chemometric tools could be applied to the study of the volcanic geological areas detected at the ExoMars landing site (Oxia Planum), whose mineralogical composition and geological evolution have not been fully understood.
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Affiliation(s)
- Marco Veneranda
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain.
| | - Guillermo Lopez-Reyes
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain
| | - Jose Antonio Manrique-Martinez
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain
| | - Aurelio Sanz-Arranz
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain
| | - Emmanuel Lalla
- Centre for Research in Earth and Space Science, York University, Toronto, Canada
| | | | - Andoni Moral
- Department of Space Programs, National Institute of Aerospace Technology (INTA), Madrid, Spain
| | - Jesús Medina
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain
| | - Fernando Rull
- Department of Condensed Matter Physics, Crystallography and Mineralogy, University of Valladolid, Ave. Francisco Vallés, 8, 47151, Boecillo, Spain
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Hay S, Ovelman C, Zupancic JAF, Doyle LW, Onland W, Konstantinidis M, Shah PS, Soll R. Systemic corticosteroids for the prevention of bronchopulmonary dysplasia, a network meta-analysis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Susanne Hay
- Department of Neonatology; Beth Israel Deaconess Medical Center, Harvard Medical School; Boston Massachusetts USA
| | - Colleen Ovelman
- Cochrane Neonatal; Larner College of Medicine at the University of Vermont; Burlington Vermont USA
| | - John AF Zupancic
- Department of Neonatology; Beth Israel Deaconess Medical Center, Harvard Medical School; Boston Massachusetts USA
| | - Lex W Doyle
- Department of Obstetrics and Gynaecology; The University of Melbourne; Parkville Australia
| | - Wes Onland
- Department of Neonatology; Emma Children's Hospital AMC, University of Amsterdam; Amsterdam Netherlands
| | | | - Prakeshkumar S Shah
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation; University of Toronto Mount Sinai Hospital; Toronto Canada
| | - Roger Soll
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics; Larner College of Medicine at the University of Vermont; Burlington Vermont USA
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Venekamp RP, van Uum RT, Konstantinidis M, Lutje V, Schilder AGM, Hay AD, Damoiseaux RAMJ, Little P. Non-steroidal anti-inflammatory drugs (NSAIDs) for acute sore throat. Hippokratia 2020. [DOI: 10.1002/14651858.cd013709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Roderick P Venekamp
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht, Utrecht University; Utrecht Netherlands
| | - Rick T van Uum
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht, Utrecht University; Utrecht Netherlands
| | | | - Vittoria Lutje
- Cochrane Infectious Diseases Group; Liverpool School of Tropical Medicine; Liverpool UK
| | | | - Alastair D Hay
- Centre for Academic Primary Care, NIHR School for Primary Care Research, Bristol Medical School: Population Health Sciences; University of Bristol; Bristol UK
| | - Roger AMJ Damoiseaux
- Julius Center for Health Sciences and Primary Care; University Medical Center Utrecht, Utrecht University; Utrecht Netherlands
| | - Paul Little
- Primary Care and Population Sciences, Faculty of Medicine; Aldermoor Health Centre, University of Southampton; Southampton UK
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Antonopoulou K, Konstantinidis M. PARE0012 AWARENESS CAMPAING “LUPUS.GR 2020”. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:LUPUS GR 2020Objectives:To sensitize and educate the wide public about lupusTo contribute to the process of de-stigmatization as the rigid problem of prejudice and stigma prevails.Methods:The campaign “LUPUS GR 2020” consists of photographs, each of which has a different message for Lupus and 2 TV spots. The well know artists participated did not take any fee.The campaign consists of Press Announcements in digital and off digital media, in Social Media (Instagram - Twitter - Facebook), in Eleana Site and in YouTubePost of the artists in their personal social media pagesPress ConferenceDirect mail in international NGOs e.g. Lupus Europe, PAIN ALLIANCE EUROPE, AGORA PLATFORM, etc.Results:We announced the campaign on January 24, 2020. Until end of January, we have 36 press clipping, 3 TV interviews, more than 35.000 views of the post in our fb and increase of telephone calls in our help line about lupusConclusion:The campaign has a high impact in the wide public as well as in all the stakeholders.Figure:Disclosure of Interests:None declared
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Konstantinidis M, Lalla EA. Clinical anisotropy: A case for shared decision making in the age of too much data and patient dis-integration. J Eval Clin Pract 2020; 26:604-609. [PMID: 31822037 DOI: 10.1111/jep.13312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/30/2019] [Accepted: 10/21/2019] [Indexed: 01/16/2023]
Abstract
Today, in the age of big data, we are more capable than ever before. But even having the world at our disposal with naught but the touch of a button, we find ourselves exceedingly vulnerable in the patient chair. With insurmountable amounts of knowledge being published and disseminated around the world, how can clinicians keep up and what can be done about it? And sitting in the patient chair, bewildered by the ever-changing landscape of medicine at the blink of an eye, how can we, as patients, ever hope to be part of the conversations revolving around our own health? In this work, we explore the present-day problems of big data in the clinical context, how failing to integrate patients can result in detrimental outcomes, and what shared decision making can do about it.
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Affiliation(s)
- Menelaos Konstantinidis
- Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada.,Center for Research in Earth and Space Science, York University, Toronto, Ontario, Canada
| | - Emmanuel A Lalla
- Center for Research in Earth and Space Science, York University, Toronto, Ontario, Canada
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22
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Lalla E, Sanz-Arranz A, Lopez-Reyes G, Cote K, Daly M, Konstantinidis M, Rodriguez-Losada JA, Groemer G, Medina J, Martínez-Frías J, Rull-Pérez F. A micro-Raman and X-ray study of erupted submarine pyroclasts from El Hierro (Spain) and its' astrobiological implications. Life Sci Space Res (Amst) 2019; 21:49-64. [PMID: 31101155 DOI: 10.1016/j.lssr.2019.04.003] [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] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/12/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
The pumice volcanic samples could have possible connections to the evolution of life and give us insight about their bio-geochemical processes related. In this regard, the samples from the volcanic eruption from La Restinga (El Hierro, Spain) in 2011 have been mainly studied by means of Raman spectroscopy. The research also includes analysis of XRD, Scanning Electron Microscopy and Optical Microscopy to support the Raman analysis. The results show that the Raman methods and mineral analyses are in strong agreement with the results obtained from other authors and techniques. The internal white foamy core (WFC) of the studied pumice samples shows amorphous silica, Fe-oxides, Ti-oxides, quartz, certain sulfates, carbonates, zeolites and organics. On the other hand, the external part (dark crust - DC) of these samples mainly presents primary-sequence mineralogy combined with some secondary alteration minerals such as olivine, feldspar, pyroxene, amorphous silica, and Fe-oxide. Raman spectroscopy detected other minerals not yet reported on these samples like barite, celestine and lepidocrocite. Also, the different chemometric and calibration methods for Raman spectroscopy in elemental composition, mineral classification and structural characterization has been successfully applied. From the astrobiological perspective, the research was also complemented with comparisons to other similar samples from terrestrial analogs. The main consideration was taking into account the proposed hypothesis regarding the potential behavior of the pumice as a substrate for the evolution of life. Furthermore, the detailed analysis from La Restinga eruption is coherent with the mineral phases and processes discussed from previous literature. The white internal part fulfills the conditions to work as an organic reservoir, confirmed by the detection of organic matter and selected minerals that could be used as energy sources for bacterial communities. The external layers of the samples work as a shielding layer to protect the organics from decay in extreme conditions. Finally, here we have demonstrated that the characteristics and advantages of Raman spectroscopy could help to assess and understand the possible biogenicity and alteration processes of any geological sample to be found on Mars.
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Affiliation(s)
- E Lalla
- Centre for Research in Earth and Space Science, York University, Petrie Science Building, 4700 Keele St, Toronto, M3J 1P3, ON, Canada; Austrian Space Forum, Sillufer 3a, Innsbruck, 6020, Austria.
| | - A Sanz-Arranz
- Departamento de Física de la Materia Condensada, Cristalografía y Mineralogía. Universidad de Valladolid, P de Belén 7, 47011, Valladolid, Spain
| | - G Lopez-Reyes
- Departamento de Física de la Materia Condensada, Cristalografía y Mineralogía. Universidad de Valladolid, P de Belén 7, 47011, Valladolid, Spain
| | - K Cote
- Centre for Research in Earth and Space Science, York University, Petrie Science Building, 4700 Keele St, Toronto, M3J 1P3, ON, Canada
| | - M Daly
- Centre for Research in Earth and Space Science, York University, Petrie Science Building, 4700 Keele St, Toronto, M3J 1P3, ON, Canada
| | - M Konstantinidis
- Centre for Research in Earth and Space Science, York University, Petrie Science Building, 4700 Keele St, Toronto, M3J 1P3, ON, Canada
| | - J A Rodriguez-Losada
- Departamento de Biología Animal, Edafología y Geología, Universidad de La Laguna, Tenerife, C/ Astrofisco Sanchez s/n, 38211, La Laguna, Santa Cruz de Tenerife, Spain
| | - G Groemer
- Austrian Space Forum, Sillufer 3a, Innsbruck, 6020, Austria
| | - J Medina
- Departamento de Física de la Materia Condensada, Cristalografía y Mineralogía. Universidad de Valladolid, P de Belén 7, 47011, Valladolid, Spain
| | - J Martínez-Frías
- Dinámica Terrestre y Observación de la Tierra, Instituto de Geociencias, C/Severo Ochoa 7, Ed Entrepabellones 7 y 8, Ciudad Universitaria, 28040 Madrid, Spain
| | - F Rull-Pérez
- Austrian Space Forum, Sillufer 3a, Innsbruck, 6020, Austria
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Sachdev N, Maxwell S, Jordan A, Prates R, Konstantinidis M, Licciardi F. Determining the odds of pregnancy in brca positive women undergoing combined pre-implantation genetic diagnosis (PGD) and screening. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.796] [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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Doyle K, Prates R, Stimach C, Licciardi F, Dokras A, Chen S, McWilliams T, Benadiva C, Kitchen J, Konstantinidis M. Karyomapping: the gold standard for preimplantation genetic diagnosis. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.465] [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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Konstantinidis M, Milligan K, Berkeley A, Kennedy J, Maxson W, Racowsky C, Wells D, Munne S. Use of single nucleotide polymorphism (SNP) arrays and next generation sequencing (NGS) to study the incidence, type and origin of aneuploidy in the human preimplantation embryo. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cabey R, Goldberg-Strassler D, Konstantinidis M, Hershlag A, Cohen M, Rausch M, Guarnaccia M, Grifo J, Prates R, Munne S. The incidental finding of microdeletions and microduplications during preimplantation genetic diagnosis (PGD) - test implication and clinical correlation. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Wells D, Ravichandran K, Alper M, Jain J, Penzias A, Benadiva C, Colls P, Konstantinidis M, Munne S. Aneuploidy rates in embryos produced by fertile couples. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ravichandran K, Gunes Z, Bankowski B, Rosen A, Chen S, Hershlag A, Sandler B, Grifo J, Wells D, Konstantinidis M. Aneuploidy and recombination in in vitro fertilized embyros (blastocysts) undergoing preimplantation genetic diagnosis (PGD). Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Prates R, Jaroudi S, Jordan A, Goodall N, Chu B, Tecson V, Hershlag A, Garrisi M, Licciardi F, Witt B, Konstantinidis M. Advantages of triplet repeat expansion detection in blastocyst biopsy for preimplantation genetic diagnosis of fragile X syndrome. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.194] [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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Prates R, Jordan A, Rosen G, DiMattina M, Chen S, Tan SL, Hoffman D, Jaroudi S, Konstantinidis M. Usage of karyomapping for preimplantation genetic diagnosis (PGD) of complex single gene disorders (sgds). Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.595] [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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Konstantinidis M, Tortoriello D, Hill J, Kiltz R, Letterie G, Laskin C, Colls P, Wells D. Investigation of aneuploidy in human blastocysts through utilization of single nucleotide polymorphism (SNP) arrays and array comparative genomic hybridization (aCGH). Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Konstantinidis M, Goodall NN, Caswell W, Rosen G, Celia G, Meriano J, Yeboah E, Mills E, Munne S. A genome-wide study of recombination events in human preimplantation embryos. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.693] [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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Jaroudi S, Konstantinidis M, Alfarawati S, Fragouli E, Wells D. Investigation of telomere length as an indicator of aneuploidy risk and implantation potential in human oocytes and cleavage stage embryos. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jaroudi S, Konstantinidis M, Alfarawati S, Fragouli E, Wells D, Bianchi V, Jaroudi SJS, Baban DBD, Knight SKS, Borini ABA, Fragouli EFE, Wells DWD, Basile N, Bronet F, Nogales MC, Martinez E, Ariza M, Agudo D, Florensa M, Riqueros M, Meseguer M, Hyslop L, Prathalingam N, Clapham E, Nowak L, Dunkley E, Fenwick J, Byerley S, Murdoch A, Herbert M, Wong KM, Van Echten-Arends J, Korevaar JC, van der Veen F, Repping S, Mastenbroek S, Assou S, Haouzi D, Ferrieres A, Dechaud H, Hamamah S. Session 27: Genes and chromosomes in oocytes and embryos. Hum Reprod 2013. [DOI: 10.1093/humrep/det155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aizpurua J, Szlarb N, Moragues I, Ramos B, Rogel S, Li J, Yin XY, Tan K, Tan YQ, Chen F, Zhang LEI, Lin G, Jiang H, Wang W, Wells D, Kaur K, Grifo J, Anderson S, Taylor J, Fragouli E, Munne S, Levy B, Banjevic M, Hill M, Zimmermann B, Ryan A, Sigurjonsson S, Wayham N, Lacroute P, Dodd M, Hoang B, Tong J, Vu P, Hall MP, Demko Z, Rabinowitz M, Spath K, Fragouli E, Konstantinidis M, Poli M, Wells D. Session 16: Innovations in reproductive genetics. Hum Reprod 2013. [DOI: 10.1093/humrep/det143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Davies S, Christopikou D, Tsorva E, Karagianni A, Handyside AH, Mastrominas M, Alfarawati S, Poli M, Wells D, Fragouli E, Fragouli E, Alfarawati S, Konstantinidis M, Jaroudi S, Wells D, Van den Abbeel E, Balaban B, Ziebe S, Lundin K, Klein BM, Helmgaard L, Arce JC, Yokota Y, Yokota M, Yokota H, Sato S, Nakagawa M, Sato M, Anazawa I, Araki Y, Ledee N, Gridelet V, Ravet S, Jouan C, Gaspard O, Wenders F, Thonon F, Hincourt N, Dubois M, Foidart JM, Frankenne F, Munaut C, Perrier d'hauterive S, van Loendersloot LL, Van Wely M, van der Veen F, Bossuyt PMM, Repping S. SESSION 59: EMBRYOLOGY - DEVELOPMENT AND QUALITY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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ElInati E, Kuentz P, Redin C, Vanden Meerschaut F, Nasr-Esfahani M, Gurgan T, Louanjli N, Iqbal N, Carre Pigeon F, Gourabi H, Brugnon F, Gitlin S, De Sutter P, Muller J, Viville S, Dul EC, van Echten-Arends J, Groen H, Kastrop PMM, Amory-van Wissen LCP, Engelen JJM, Land JA, Coonen E, van de Werken C, van der Heijden GW, van Veen-Buurman CJH, Laven JSE, Peters AHFM, Baart EB, Rabinowitz M, Gemelos G, Banjevic M, Zimmermann B, Baner J, Levy B, Hill M, Mertzanidou A, Spits C, Van de Velde H, Sermon K, Wells D, Alfarawati S, Konstantinidis M, Jaroudi S, Fragouli E, Minasi MG, Ruberti A, Rubino P, Iammarrone E, Biricick A, Zavaglia D, Nuccitelli A, Colasante A, Fiorentino F, Greco E. SESSION 70: GENETICS: WHAT GENOMES GONE WRONG CAN TELL US. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.68] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fragouli E, Alfarawati S, Konstantinidis M, Jaroudi S, Wells D. The progress of chromosome abnormalities from meiosis to the blastocyst stage. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.236] [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]
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Alfarawati S, Fragouli E, Konstantinidis M, Wells D. Are patients undergoing PGD for chromosome rearrangements at increased risk of aneuploidy affecting chromosomes unrelated to their rearrangement (Interchromosomal effect)? Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fancsovits P, Murber A, Tothne Gilan Z, Rigo J, Urbancsek J, Balaban B, Yakin K, Ata B, Isiklar A, Urman B, Konstantinidis M, Alfarawati S, Hurd D, Wells D, Griffin DK, Gabriel AS, Ottolini CS, Thornhill AR, Gordon A, Brown APC, Taylor J, Bennett K, Handyside AH, Handyside AH, Geraedts JPM, Montag M, Magli MC, Repping S, Staessen C, Harper J, Schmutzler A, Collins J, Goossens V, van der Ven H, Vesela K, Gianaroli L. SELECTED ORAL COMMUNICATION SESSION, SESSION 17: EMBRYOLOGY AND GENETICS, Monday 4 July 2011 15:15 - 16:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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