1
|
Afreen A, Hameed H, Tariq M, Sharif MS, Ahmed R, Waheed A, Kousar MB, Akram Z. Shining insights: Deciphering the biogenic synthesis of Ajuga bracteosa-mediated gold nanoparticles with advanced microscopy techniques. Microsc Res Tech 2024. [PMID: 38619301 DOI: 10.1002/jemt.24571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/21/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
In this study, gold nanoparticles (AuNPs) were bioreduced from Ajuga bracteosa, a medicinal herb known for its therapeutic properties against various diseases. Different fractions of the plant extract were used, including the methanolic fraction (ABMF), the n-hexane fraction (ABHF), the chloroform fraction (ABCF), and the aqueous extract for AuNPs synthesis. The characterization of AuNPs was performed using UV-Vis spectrophotometry, FT-IR, XRD, EDX, and TEM. UV-Vis spectroscopy confirmed the formation of AuNPs, with peaks observed at 555 nm. FT-IR analysis indicated strong capping of phytochemicals on the surface of AuNPs, which was supported by higher total phenolic contents (TPC) and total flavonoid contents (TFC) in AuNPs. XRD results showed high crystallinity and a smaller size distribution of AuNPs. TEM analysis revealed the spherical shape of AuNPs, with an average size of 29 ± 10 nm. The biologically synthesized AuNPs exhibited superior antibacterial, antioxidant, and cytotoxic activities compared to the plant extract fractions. The presence of active biomolecules in A. bracteosa, such as neoclerodan flavonol glycosides, diterpenoids, phytoecdysone, and iridoid glycosides, contributed to the enhanced biological activities of AuNPs. Overall, this research highlights the potential of A. bracteosa-derived AuNPs for various biomedical applications due to their remarkable therapeutic properties and effective capping by phytochemicals. RESEARCH HIGHLIGHTS: This research underscores the growing significance of herbal medicine in contemporary healthcare by exploring the therapeutic potential of Ajuga bracteosa and gold nanoparticles (AuNPs). The study highlights the notable efficacy of A. bracteosa leaf extracts and AuNPs in treating bacterial infections, demonstrating their bactericidal effects on a range of strains. The anti-inflammatory properties of plant extracts and nanoparticles are evidenced through paw edema method suggesting their applicability in managing inflammatory conditions. These findings position A. bracteosa and AuNPs as potential candidates for alternative and effective approaches to modern medication.
Collapse
Affiliation(s)
- Afshan Afreen
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur, Pakistan
| | - Hajra Hameed
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Muhammad Tariq
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur, Pakistan
| | - Muhammad Shakeeb Sharif
- Department of Clinical and Translational Oncology, Scuola Superiore Meridionale Via Mezzocannone, Naples, Italy
| | - Rashid Ahmed
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur, Pakistan
| | - Abdul Waheed
- Shenzhen Branch, Guangdong Laboratory for Lingnan Modern Agriculture, Genome Analysis Laboratory of the Ministry of Agriculture, Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, China
| | - Momina Bint Kousar
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur, Pakistan
| | - Zeeshan Akram
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur, Pakistan
| |
Collapse
|
2
|
Müller A, Wouters EF, Koul P, Welte T, Harrabi I, Rashid A, Loh LC, Al Ghobain M, Elsony A, Ahmed R, Potts J, Mortimer K, Rodrigues F, Paraguas SN, Juvekar S, Agarwal D, Obaseki D, Gislason T, Seemungal T, Nafees AA, Jenkins C, Dias HB, Franssen FME, Studnicka M, Janson C, Cherkaski HH, El Biaze M, Mahesh PA, Cardoso J, Burney P, Hartl S, Janssen DJA, Amaral AFS. Association between lung function and dyspnoea and its variation in the multinational Burden of Obstructive Lung Disease (BOLD) study. Pulmonology 2024:S2531-0437(24)00044-8. [PMID: 38614859 DOI: 10.1016/j.pulmoe.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/14/2024] [Accepted: 03/31/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Dyspnoea is a common symptom of respiratory disease. However, data on its prevalence in general populations and its association with lung function are limited and are mainly from high-income countries. The aims of this study were to estimate the prevalence of dyspnoea across several world regions, and to investigate the association of dyspnoea with lung function. METHODS Dyspnoea was assessed, and lung function measured in 25,806 adult participants of the multinational Burden of Obstructive Lung Disease study. Dyspnoea was defined as ≥2 on the modified Medical Research Council (mMRC) dyspnoea scale. The prevalence of dyspnoea was estimated for each of the study sites and compared across countries and world regions. Multivariable logistic regression was used to assess the association of dyspnoea with lung function in each site. Results were then pooled using random-effects meta-analysis. RESULTS The prevalence of dyspnoea varied widely across sites without a clear geographical pattern. The mean prevalence of dyspnoea was 13.7 % (SD=8.2 %), ranging from 0 % in Mysore (India) to 28.8 % in Nampicuan-Talugtug (Philippines). Dyspnoea was strongly associated with both spirometry restriction (FVC CONCLUSION The prevalence of dyspnoea varies substantially across the world and is strongly associated with lung function impairment. Using the mMRC scale in epidemiological research should be discussed.
Collapse
Affiliation(s)
- A Müller
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - E F Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria; Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - P Koul
- Department of Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | - T Welte
- Department of Respiratory Medicine/Infectious Disease, Member of the German Centre for Lung Research, Hannover School of Medicine, Hannover, Germany
| | - I Harrabi
- Faculté de Médecine, Sousse, Tunisia
| | - A Rashid
- RCSI and UCD Malaysia Campus, Penang, Malaysia
| | | | - M Al Ghobain
- King Abdullah International Medical Research Center, King Saud ben Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - A Elsony
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | - J Potts
- National Heart and Lung Institute, Imperial College London, London, UK
| | - K Mortimer
- University of Cambridge, Cambridge, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - F Rodrigues
- Pulmonology Department, Lisbon North Hospital Centre, Lisbon, Portugal; Institute of Environmental Health, Associate Laboratory TERRA, Lisbon Medical School, Lisbon University, Lisbon, Portugal
| | - S N Paraguas
- Philippine College of Chest Physicians, Manila, Philippines
| | - S Juvekar
- KEM Hospital Research Centre, Pune, India
| | - D Agarwal
- KEM Hospital Research Centre, Pune, India
| | - D Obaseki
- Department of Medicine, Obafemi Awolowo University, Nigeria; Faculty of Medicine, University of British Columbia, Canada
| | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - T Seemungal
- Faculty of Medical Sciences, University of West Indies, St Augustine, Trinidad and Tobago
| | | | - C Jenkins
- Woolcock Institute of Medical Research, Sydney, Australia
| | - H B Dias
- Escola Superior de Tecnologia da Saúde de Lisboa, Politecnico de Lisboa, Lisbon, Portugal
| | - F M E Franssen
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Research and Development, Ciro, Horn, the Netherlands
| | - M Studnicka
- Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | - C Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - H H Cherkaski
- Faculty of Medicine, University Badji Mokhtar, Annaba, Algeria
| | - M El Biaze
- Department of Respiratory Medicine, Faculty of Medicine, Mohammed Ben Abdellah University, Fes, Morocco
| | - P A Mahesh
- Department of Respiratory Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - J Cardoso
- Pulmonology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal; NOVA Medical School, Nova University Lisbon, Lisboa, Portugal
| | - P Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - S Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - D J A Janssen
- Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Research and Development, Ciro, Horn, the Netherlands
| | - A F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, London, UK
| |
Collapse
|
3
|
Taj S, Ashfaq UA, Ahmad M, Noor H, Ikram A, Ahmed R, Tariq M, Masoud MS, Hasan A. The antihyperglycemic potential of pyrazolobenzothiazine 1, 1-dioxide novel derivative in mice using integrated molecular pharmacological approach. Sci Rep 2024; 14:7746. [PMID: 38565861 PMCID: PMC10987501 DOI: 10.1038/s41598-023-49932-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 04/04/2024] Open
Abstract
Diabetes Mellitus is a metabolic disease characterized by elevated blood sugar levels caused by inadequate insulin production, which subsequently leads to hyperglycemia. This study was aimed to investigate the antidiabetic potential of pyrazolobenzothiazine derivatives in silico, in vitro, and in vivo. Molecular docking of pyrazolobenzothiazine derivatives was performed against α-glucosidase and α-amylase and compounds were selected based on docking score, bonding interactions and low root mean square deviation (RMSD). Enzyme inhibition assay against α-glucosidase and α-amylase was performed in vitro using p-nitrophenyl-α-D-glucopyranoside (PNPG) and starch substrate. Synthetic compound pyrazolobenzothiazine (S1) exhibited minimal conformational changes during the 100 ns MD simulation run. S1 also revealed effective IC50 values for α-glucosidase (3.91 µM) and α-amylase (8.89 µM) and an enzyme kinetic study showed low ki (- 0.186 µM, - 1.267 µM) and ki' (- 0.691 µM, - 1.78 µM) values with the competitive type of inhibition for both enzymes α-glucosidase and α-amylase, respectively. Moreover, studies were conducted to check the effect of the synthetic compound in a mouse model. A low necrosis rate was observed in the liver, kidney, and pancreas through histology analysis performed on mice. Compound S1 also exhibited a good biochemical profile with lower sugar level (110-115 mg/dL), increased insulin level (25-30 μM/L), and low level of cholesterol (85 mg/dL) and creatinine (0.6 mg/dL) in blood. The treated mice group also exhibited a low % of glycated haemoglobin (3%). This study concludes that S1 is a new antidiabetic-agent that helps lower blood glucose levels and minimizes the complications associated with type-II diabetes.
Collapse
Affiliation(s)
- Saman Taj
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Matloob Ahmad
- Department of Chemistry, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Hasnat Noor
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Ayesha Ikram
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan
| | - Rashid Ahmed
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, New Mirpur City, 10250, Pakistan
| | - Muhammad Tariq
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, New Mirpur City, 10250, Pakistan
| | - Muhammad Shareef Masoud
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, 38000, Pakistan.
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, Qatar University, 2713, Doha, Qatar.
- Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
| |
Collapse
|
4
|
Premalatha P, Maha HMA, Shadia HA, Krishnaraju V, Prabahar K, Mathar Mohideen NT, Vinoth Prabhu V, Prema B, Mashat RM, Sampayan EL, Hala AE, Marwa AAZ, Kandasamy G, Ahmed R, Mervat MA. Effect of Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes among hyperglycemic mothers. Eur Rev Med Pharmacol Sci 2024; 28:2750-2759. [PMID: 38639514 DOI: 10.26355/eurrev_202404_35903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Hyperglycemic mothers and their offspring are at increased risk of various maternal and neonatal complications such as macrosomia, future type 2 diabetes, and metabolic abnormalities. Early diagnosis and individualized dietary management, exercise, and emotional well-being are expected to reduce these risks. The study aims to identify the effect of the Nutrition and Behavior Modification Program (NBMP) on maternal and neonatal outcomes of hyperglycemic mothers. PATIENTS AND METHODS A pre-experimental study was performed among 89 hyperglycemic mothers. Glycemic control at 28 and 36 weeks, weight gain during pregnancy, pre-eclampsia, pregnancy-induced hypertension (PIH), mode of delivery, duration of exercise, emotional well-being, neonates' birth weight, incidence of hypoglycemia, and NICU admission were compared among the study and control groups. The intervention group received an individualized NBMP from their diagnosis of hyperglycemia until delivery. RESULTS The results showed a significant difference in blood glucose between the study periods and groups at p<0.05 as per repeated ANOVA. Also, diet scores had a significant influence on BMI and glycemic control at p<0.05. Logistic regression models, adjusted for potential confounders including baseline blood glucose, age, economic status, previous GDM, family history of DM as well as baseline BMI, diet score, physical activity, and maternal well-being score, indicated that the NBMP reduced the blood glucose and BMI significantly at p<0.05 in the study group. NBMP also reduced the risk of SGA/LGA and preterm/post-mature birth, as well as increased the exercise duration and emotional well-being of mothers. CONCLUSIONS The study's conclusions draw attention to the possible roles that maternal wellness, physical activity, and diet may have in reducing risks for both hyperglycemic mothers and their newborns. The NBMP resulted in higher adherence to lifestyle changes. Further research on a larger sample of hyperglycemic mothers is recommended to expand the generalizability of the findings.
Collapse
Affiliation(s)
- P Premalatha
- College of Nursing, Mahalah Branch for Girls, King Khalid University, Abha, Asir, Saudi Arabia.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Suleiman M, Al Najjar A, Zakaria ZZ, Ahmed R, Yalcin HC, Korashy HM, Uddin S, Riaz S, Abdulrahman N, Mraiche F. The Role of p90 Ribosomal S6 Kinase (RSK) in Tyrosine Kinase Inhibitor (TKI)-Induced Cardiotoxicity. J Cardiovasc Transl Res 2024; 17:334-344. [PMID: 37725271 DOI: 10.1007/s12265-023-10431-4] [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] [Received: 03/29/2023] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
Targeted therapy, such as tyrosine kinase inhibitors (TKIs), has been approved to manage various cancer types. However, TKI-induced cardiotoxicity is a limiting factor for their use. This issue has raised the need for investigating potential cardioprotective techniques to be combined with TKIs. Ribosomal S6-kinases (RSKs) are a downstream effector of the mitogen-activated-protein-kinase (MAPK) pathway; specific RSK isoforms, such as RSK1 and RSK2, have been expressed in cancer cells, in which they increase tumour proliferation. Selective targeting of those isoforms would result in tumour suppression. Moreover, activation of RSKs expressed in the heart has resulted in cardiac hypertrophy and arrhythmia; thus, inhibiting RSKs would result in cardio-protection. This review article presents an overview of the usefulness of RSK inhibitors that can be novel agents to be assessed in future research for their effect in reducing cancer proliferation, as well as protecting the heart from cardiotoxicity induced by TKIs.
Collapse
Affiliation(s)
- Muna Suleiman
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Afnan Al Najjar
- National Center for Cancer Care and Research, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Zain Z Zakaria
- Medical and Health Sciences, Qatar University, PO Box 2713, Doha, Qatar
| | - Rashid Ahmed
- Department of Biotechnology, Faculty of Science, Mirpur University of Science and Technology, Mirpur, 10250, AJK, Pakistan
| | - Huseyin C Yalcin
- Biomedical Research Centre (BRC), Qatar University, PO Box 2713, Doha, Qatar
- College of Health Sciences, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Hesham M Korashy
- National Center for Cancer Care and Research, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Shahab Uddin
- Translational Research Institute and Dermatology Institute, Academic Health System, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Sadaf Riaz
- Pharmacy Department, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Nabeel Abdulrahman
- College of Health Sciences, QU-Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Fatima Mraiche
- National Center for Cancer Care and Research, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar.
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
6
|
Ul Haq B, Kim SH, Chaudhry AR, AlFaify S, Butt FK, Tahir SA, Ahmed R, Laref A. Effect of Surface Termination with Oxygen and Fluorine on the Electronic Structures and optical spectra of Mn2N Based MXenes. Chemphyschem 2024:e202300605. [PMID: 38517984 DOI: 10.1002/cphc.202300605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 03/24/2024]
Abstract
The extensive applications of MXenes, a novel type of layered materials known for their favorable characteristics, have sparked significant interest. This research focuses on investigating the impact of surface functionalization on the behavior of Mn2NX2 (X = O, F) MXenes monolayers using the "Density functional theory (DFT) based full-potential linearized augmented-plane-wave (FP-LAPW)" method. We observe and elucidate the variations in the physical properties of the Mn2NX2 by employing different surface terminations with F and O functional groups. We found that O-termination results in half-metallic behavior, whereas the N-termination evolves metallic characteristics within these MXene systems. Similarly, surface termination has effectively influenced their optical absorption efficiency. For instance, Mn2NO2 and Mn2NF2 effectively absorb UV light of magnitude 50.15×104 cm-1 and 37.71×104 cm-1, respectively. Additionally, they demonstrated prominent refraction and reflection characteristics, comprehensively discussed in the present work. Our predictions offer valuable perspectives into the optical and electronic characteristics of Mn2NX2-based MXenes, presenting the promising potential for implementing them in diverse optoelectronic devices.
Collapse
Affiliation(s)
- Bakhtiar Ul Haq
- Jeju National University, Physics Education, KOREA, REPUBLIC OF
| | - Se-Hun Kim
- Jeju National University, 102 Jejudaehakno, Jeju Physics Education, College of Education, Jeju National University, 63243, Jeju, KOREA, REPUBLIC OF
| | | | - S AlFaify
- King Khalid University, Physics, SAUDI ARABIA
| | | | - S A Tahir
- University of the Punjab, Physics, PAKISTAN
| | - R Ahmed
- University of Technology Malaysia, Physics, MALAYSIA
| | - A Laref
- King Saud University, Department of Physics and Astronomy, SAUDI ARABIA
| |
Collapse
|
7
|
Qaisrani ZN, Nuthammachot N, Techato K, Asadullah, Jatoi GH, Mahmood B, Ahmed R. Drought variability assessment using standardized precipitation index, reconnaissance drought index and precipitation deciles across Balochistan, Pakistan. BRAZ J BIOL 2024; 84:e261001. [DOI: 10.1590/1519-6984.261001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
Abstract Drought variability analysis is of utmost concern for planning and efficiently managing water resources and food security in any specific area. In the current study, drought spell occurrence has been investigated in the Balochistan province of Pakistan during the past four decades (1981-2020) using standardized precipitation index (SPI), reconnaissance drought index (RDI), and precipitation deciles (PD) at an annual timescale. Precipitation and temperature data collected from 13 synoptic meteorological stations located in Balochistan were used to calculate the SPI, the RDI, and the PD for calculation of drought severity and duration. Based on these indices, temporal analysis shows adverse impacts of drought spells in Nokkundi during 1991-1993, in Barkhan, Dalbandin, Quetta stations during 1999-2000, whereas Barkhan, Dalbandin, Lasbella, Sibi during 2002-2003, Zhob during 2010-2011, Kalat and Khuzdar during 2014-2015, and Panjgur during 2017-2018. Also, the aridity index for each station was calculated based on the UNEP method shows that major part of Balochistan lies in the arid zone, followed by the hyper-arid in the southwestern part and the semi-arid zones in the northeastern part of the province. SPI and RDI results were found more localized than PD, as PD shows extensive events. Furthermore, principal component analysis shows a significant contribution from all the indices. For SPI, RDI, and PD, the first three principal components have more than 70% share, contributing 73.63%, 74.15%, and 72.30% respectively. By integrating drought patterns, long-term planning, and preparedness to mitigate drought impacts are only possible. The RDI was found more suitable and recommended in case of temperature data availability.
Collapse
Affiliation(s)
- Z. N. Qaisrani
- Prince of Songkla University, Thailand; Balochistan University of Information Technology, Engineering & Management Sciences, Pakistan
| | | | | | - Asadullah
- Balochistan University of Information Technology, Engineering & Management Sciences, Pakistan
| | | | - B. Mahmood
- University of Poonch Rawalakot, Pakistan
| | - R. Ahmed
- University of Poonch Rawalakot, Pakistan
| |
Collapse
|
8
|
Donato K, Micheletti C, Medori MC, Maltese PE, Tanzi B, Tezzele S, Mareso C, Generali D, Donofrio CA, Cominetti M, Fioravanti A, Riccio L, Beccari T, Ceccarini MR, Iaconelli A, Aquilanti B, Matera G, Ahmed R, Stuppia L, Gatta V, Cecchin S, Marceddu G, Bertelli M. Omics sciences and precision medicine in pancreas cancer. Clin Ter 2023; 174:85-94. [PMID: 37994752 DOI: 10.7417/ct.2023.2475] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Abstract Pancreatic cancer is a leading cause of death worldwide, associated with poor prognosis outcomes and late treatment interventions. The pathological nature and extreme tissue heterogeneity of this disease has hampered all efforts to correctly diagnose and treat it. Omics sciences and precision medicine have revolutionized our understanding of pan-creatic cancer, providing a new hope for patients suffering from this devastating disease. By analyzing large-scale biological data sets and developing personalized treatment strategies, researchers and clinicians are working together to improve patient outcomes and ultimately find a cure for pancreatic cancer.
Collapse
Affiliation(s)
- K Donato
- MAGI EUREGIO, Bolzano, Italy
- MAGISNAT, Peachtree Corners (GA), USA
| | | | | | | | - B Tanzi
- MAGI'S LAB, Rovereto (TN), Italy
| | | | | | - D Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy; Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, Italy
| | - C A Donofrio
- Department of Neurosurgery, ASST Cremona, Italy
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - M Cominetti
- Department of Neurosurgery, ASST Cremona, Italy
| | | | - L Riccio
- Department of Neurosurgery, ASST Cremona, Italy
| | - T Beccari
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - M R Ceccarini
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - A Iaconelli
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - B Aquilanti
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - G Matera
- UOSD Medicina Bariatrica, Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - R Ahmed
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, Urbana, USA
- Department of Biotechnology, Mirpur University of Science and Technology, Pakistan
| | - L Stuppia
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - V Gatta
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Italy
| | | | | | - M Bertelli
- MAGI EUREGIO, Bolzano, Italy
- MAGISNAT, Peachtree Corners (GA), USA
- MAGI'S LAB, Rovereto (TN), Italy
| |
Collapse
|
9
|
Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
Collapse
|
10
|
Medori MC, Micheletti C, Madeo G, Maltese PE, Tanzi B, Tezzele S, Mareso C, Generali D, Donofrio CA, Donofrio CA, Cominetti M, Fioravanti A, Riccio L, Beccari T, Ceccarini MR, Stuppia L, Stuppia L, Gatta V, Cristoni S, Ahmed R, Ahmed R, Cecchin S, Marceddu G, Bertelli M. Omics sciences and precision medicine in Urothelial Carcinoma. Clin Ter 2023; 174:1-10. [PMID: 37994743 DOI: 10.7417/ct.2023.2466] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Abstract This comprehensive review explores the potential of omics sciences - such as genomics, transcriptomics, proteomics, and metabolomics - in advancing the diagnosis and therapy of urothelial carcinoma (UC), a prevalent and heterogeneous cancer affecting the urinary tract. The article emphasizes the significant advancements in understanding the molecular mechanisms underlying UC development and progression, obtained through the application of omics approa-ches. Genomic studies have identified recurrent genetic alterations in UC, while transcriptomic analyses have revealed distinct gene expression profiles associated with different UC subtypes. Proteomic investigations have recognized protein biomarkers with diagnostic and prognostic potential, and metabolomic profiling has found metabolic alterations that are specific to UC. The integration of multi-omics data holds promises in refining UC subtyping, identifying therapeutic targets, and predicting treatment response. However, challenges like the standardization of omics technologies, validation of biomarkers, and ethical considerations need to be addressed to successfully translate these findings into clinical practice. Omics sciences offer tremendous potential in revolutionizing the diagnosis and therapy of UC, enabling more precise diagnostic methods, prognostic evaluations, and personalized treatment selection for UC patients. Future research efforts should focus on overcoming these challenges and translating omics discoveries into meaningful clinical applications to improve outcomes for UC patients.
Collapse
Affiliation(s)
| | | | - G Madeo
- MAGI'S LAB, Rovereto (TN), Italy
| | | | - B Tanzi
- MAGI'S LAB, Rovereto (TN), Italy
| | | | | | - D Generali
- Department of Medicine, Surgery and Health Sciences, Uni-versity of Trieste, Italy; Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, Italy
| | | | - C A Donofrio
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - M Cominetti
- Department of Neurosurgery, ASST Cremona, Italy
| | | | - L Riccio
- Department of Neurosurgery, ASST Cremona, Italy
| | - T Beccari
- Department of Pharmaceutical Sciences, University of Perugia, Italy
| | - M R Ceccarini
- Department of Pharmaceutical Sciences, University of Perugia, Italy
| | - L Stuppia
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - L Stuppia
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - V Gatta
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University of Chieti-Pescara, Italy
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Italy
| | - S Cristoni
- ISB Ion Source & Biotechnologies srl, Bresso (MI), Italy
| | - R Ahmed
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, Urbana, USA
| | - R Ahmed
- Department of Biotechnology, Mirpur University of Science and Technology, Pakista
| | | | | | - M Bertelli
- MAGI'S LAB, Rovereto (TN), Italy
- MAGI EUREGIO, Bolzano, Italy
- MAGISNAT, Peachtree Corners (GA), USA
| |
Collapse
|
11
|
Khan MK, Nasti T, Kleber T, Qian JY, Switchenko J, Hess CB, Jonathan K, Nooka A, Lonial S, Ahmed R. Phase 2 Trial of Anti-PD1 and 8 Gy in 1 Fraction for Relapse/Refractory Myeloma. Int J Radiat Oncol Biol Phys 2023; 117:S108. [PMID: 37784285 DOI: 10.1016/j.ijrobp.2023.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Relapsed, refractory multiple myeloma is associated with poor outcome. Role of radiotherapy is mainly for palliation. Anti-PD1 inhibitors have failed to show efficacy in relapsed refractory myeloma patients. A phase 2 trial (NCT03267888) was conducted to see if radiotherapy (8 Gy in 1 fraction) and anti-PD1 (Pembrolizumab) could provide early signals of safety and response. MATERIALS/METHODS A prospective single-center phase 2 trial involving patients >18 years of age with ECOG 0-1 was conducted after obtaining IRB approval. Patients had to have ISS stage I-III multiple myeloma that was either relapsed or refractory, an osseous and/or extraosseous lesion that could be radiated, and who were candidates for pembrolizumab. Patients had to have either measurable disease per the International Myeloma Working Group Criteria (IMWG) and/or had to have progressive disease on imaging. Radiotherapy was given on day 0, cycle 1 followed by pembrolizumab (200 mg/kg iv on day 2 or 3, then every 3 weeks +/- 7 days) on day 2-3 for at least 2 years or until progression. Primary endpoint was toxicity. Secondary endpoints were IMWG response, abscopal response, overall survival, and immunological changes in patient's blood. Patients were assessed at 3 months, 6 months, and 12 months IMWG criteria as well as serial PET/CT based imaging. Patients with stable disease or better were continued on the trial. Patients that progressive were removed. Standard statistical analysis was performed, and included Kaplan-Meier to estimate OS and PFS. RESULTS From June, 2018 until October, 2021, 32 patients were screened and 25 were enrolled. Of the enrolled patients, 76% were Caucasian, 64% had ECOG 1, and the mean age was 60 years. Prior to enrollment, the mean number of prior lines of therapy that the patients had failed was 5.20 (range: 2 - 11), suggesting a cohort with poor expected outcome. These cohort also had limited alternative options. Toxicity, as its primary endpoint, was acceptable. There were no grade 2 or higher radiation related toxicity within the irradiated volume. Only one case of grade 3 or higher pembrolizumab-related toxicity was noted amongst the 25 patients. Abscopal response was noted in 5 of 25 patients (20% patients). Several patients showed robust reductions in the paraproteins and other myeloma labs, suggesting response to radiotherapy and anti-PD1 combination. These patients were also associated to have a robust CD 8 T cell activation and an abscopal response. The secondary outcomes were better than expected for this cohort. CONCLUSION Combination therapy of single-fraction, low-dose radiation therapy with pembrolizumab in patients with relapsed or refractory multiple myeloma is worth assessing in future trials.
Collapse
Affiliation(s)
| | - T Nasti
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | | | | | | | - C B Hess
- Grass Valley Radiation Oncology, Grass Valley, CA
| | | | - A Nooka
- Emory University, Atlanta, GA
| | | | - R Ahmed
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| |
Collapse
|
12
|
Hess CB, Eng TY, Nasti T, Dhere VR, Kleber T, Switchenko J, Weinberg BD, Rouphael N, Tian S, Rudra S, Olabode K, Samuel E, Ahmed R, Khan MK. Combined Analysis of a Phase III Randomized Trial and Phase II Prospective Trial with Blind Control Matching of Patients Receiving Whole-Lung, Low-Dose Radiation for COVID-19: Full Results and Immunologic Correlates of the RESCUE 1-19 Trial. Int J Radiat Oncol Biol Phys 2023; 117:e179. [PMID: 37784798 DOI: 10.1016/j.ijrobp.2023.06.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Whole-lung, low-dose radiation (LD-RT) for COVID-19 requires randomization and biologic correlates to determine causality and mechanism. MATERIALS/METHODS A phase III trial randomized COVID-19 patients to physician's choice of drug therapy with or without LD-RT. Primary endpoint was intubation-free survival (IFS). The trial was designed with 80% power (two-sided log rank, alpha 0.05) to detect a hazard ratio of 0.3 after 12 intubation events. Estimating a 25% event rate, the planned sample size was 84 patients plus 25 to account for declining intubation rates and screen failures. Due to hospitalization declines and other barriers, the trial closed prematurely. Available randomized data were analyzed by intention-to-treat and combined with phase II results and immunologic correlates, using one-sided significance and an alpha of 0.1 to inform future trial design. RESULTS From Jun 2020-Jun 2022, 14 patients were randomized on a phase III trial. From Apr 2020-Dec 2020, 42 patients were enrolled on a phase II trial and blindly matched to 40 controls from contemporaneous trials. 96 total patients and 193 blood samples were available for analysis. Mean hospital duration with LD-RT was 12.9 vs 15.4 days in controls (p = 0.12). Oxygen flow rate >15 L/min (26% vs 38%, p = .27), high-flow oxygen >30 L/min (24% vs 38%, p = 0.18), non-invasive positive-pressure >60 L/min (9% vs 27%, p = 0.03), and mechanical ventilation (9% vs 24%, p = 0.05) reduced with LD-RT. Mean supplemented oxygen volume was 171,759 vs 547,626 liters in controls, with daily means of 10 vs 23 L/min (p = 0.03). Radiographs worsened in 43% vs 71% of controls (p = 0.03). Arterial blood gas mean P/F ratios improved 22% after LD-RT vs declined 8% in controls (p = 0.12). Mean days febrile were 1.8 vs 2.9 in controls (p = 0.10). Rate of myocardial injury was 47% vs 40% in controls (p = 0.77). Flow cytometry revealed 4-fold and 30-fold larger expansions, respectively, in CD8- and CD4-positive CD3+PD1+Ki67-high proliferating cytotoxic T-cells (300% vs 75% expansion, p = 0.07) and helper T-cells (200% expansion vs 6% contraction, p = 0.03) at day 7. In the randomized cohort, mean oxygen volume fell 75% with LD-RT to 78,336 vs 316,786 liters in controls (p = 0.13), mean flow rates were 5.1 vs 18.4 L/min (p = 0.13), radiographs worsened in 50% vs 100% (p = .17), P/F ratios improved 31% vs declined 68% in controls (p = 0.03), hospital duration was 8.9 vs 11.5 days (p = 0.22), and zero LD-RT patients vs one control intubated. CONCLUSION Combined analysis of a phase II/III randomized trial suggests that LD-RT prevents ventilation, reduces supplemental oxygen need, improves clinical course, and enhances immune response. LD-RT may have both immediate direct effects and delayed enhanced immunity in COVID-19. Larger multi-institutional trials are justified.
Collapse
Affiliation(s)
- C B Hess
- Grass Valley Radiation Oncology, Grass Valley, CA
| | - T Y Eng
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - T Nasti
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | - V R Dhere
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | - J Switchenko
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | | | - S Tian
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - S Rudra
- Winship Cancer Institute of Emory University, Department of Radiation Oncology, Atlanta, GA
| | | | | | - R Ahmed
- Department of Microbiology/Immunology, Emory University, Atlanta, GA
| | | |
Collapse
|
13
|
Madden R, Ahmed R, Chambers H, Cloonan J, May E, Briggs R. Loneliness amongst Older Hospital Inpatients - Prevalence and Associated Factors. Ir Med J 2023; 116:838. [PMID: 37791718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
|
14
|
Parker A, Broadhurst AGB, Moolla MS, Amien L, Ahmed R, Taljaard JJ, Meintjes G, Nyasulu P, Koegelenberg CFN. A point-prevalence study of body mass indices in HIV-positive and HIV-negative patients admitted to hospital with COVID-19 in South Africa. Afr J Thorac Crit Care Med 2023; 29:10.7196/AJTCCM.2023.v29i3.660. [PMID: 37970574 PMCID: PMC10642405 DOI: 10.7196/ajtccm.2023.v29i3.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 08/22/2023] [Indexed: 11/17/2023] Open
Abstract
Background Obesity is now well recognised as a risk factor for severe COVID-19, but the true prevalence of obesity in hospitalised adults with COVID-19 remains unclear because formal body mass indices (BMIs) are not routinely measured on admission. Objectives To describe the true prevalence of obesity measured by the BMI, and associated comorbidities, in patients hospitalised with severe COVID-19, including people with HIV (PWH). Methods We conducted a point-prevalence study of measured BMI in consecutive patients with severe COVID-19 admitted to the medical COVID-19 wards in a tertiary academic hospital in Cape Town, South Africa (SA). Patients were enrolled over a 2-week period during the peak of the first COVID-19 wave in SA. Results We were able to measure the BMI in 122 of the 146 patients admitted during the study period. The prevalence of HIV was 20% (n=24/122). Most of the participants were overweight or obese (n=104; 85%), and 84 (68.9%) met criteria for obesity. The mean (standard deviation) BMI was 33 (7.5), and 34.5 (9.1) in PWH. Of PWH, 83% (n=20/24) were overweight or obese and 75% (n=18) met criteria for obesity. Multimorbidity was present in 22 (92%) of PWH. Conclusion We found that most patients, including PWH, met criteria for being overweight or obese. The high prevalence of obesity in PWH and severe COVID-19 reinforces the need for targeted management of non-communicable diseases, including obesity, in PWH. Study synopsis What the study adds. We found that the true prevalence of obesity, including in people with HIV (PWH), measured with the formal body mass index in hospitalised patients with severe COVID-19 was much higher than reported previously.Multimorbidity was present in over half of all patients, and in 92% of PWH. Implications of the findings. Urgent public health measures are required to tackle the rise in obesity, including in low- and middle-income countries.HIV care must integrate management of non-communicable diseases, including obesity.The pathogenic mechanism of the link between obesity and severe COVID-19 needs further research.
Collapse
Affiliation(s)
- A Parker
- Division of General Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - A G B Broadhurst
- Division of General Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - M S Moolla
- Division of General Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - L Amien
- Division of General Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - R Ahmed
- Division of General Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - J J Taljaard
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - G Meintjes
- Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
| | - P Nyasulu
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - C F N Koegelenberg
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| |
Collapse
|
15
|
Bangolo A, Fwelo P, Al-Qatish T, Bukasa-Kakamba J, Lee T, Cayago AG, Potiguara S, Nagesh VK, Kawall J, Ahmed R, Asjad Abbas M, Nursjamsi N, Lee SH, Meti S, Arana GV, Joseph CA, Mohamed A, Alencar A, Hassan HG, Aryal P, Javed A, Kalinin M, Lawal G, Khalaf IY, Mathew M, Karamthoti P, Gupta B, Weissman S. Outcomes of Patients with Gastrointestinal Stromal Tumors in the Past Decade. Med Sci (Basel) 2023; 11:54. [PMID: 37755158 PMCID: PMC10536810 DOI: 10.3390/medsci11030054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/10/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal tract (GIT) that represent approximately 1 to 2 percent of primary gastrointestinal (GI) cancers. Owing to their rarity, very little is known about their overall epidemiology, and the prognostic factors of their pathology. The current study aimed to evaluate the independent determinants of mortality in patients diagnosed with GISTs over the past decade. METHODS Our study comprised 2374 patients diagnosed with GISTs from 2000 to 2017 from the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed the baseline characteristics, and overall mortality (OM), as well as the cancer-specific mortality (CSM) of GISTs. Variables with a p value < 0.01 in the univariate Cox regression were incorporated into the multivariate Cox model, to determine the independent prognostic factors. RESULTS Multivariate Cox proportional hazard regression analyses of factors affecting the all-cause mortality and GIST-related mortality among US patients between 2010 and 2017 revealed a higher overall mortality in non-Hispanic Black patients (HR = 1.516, 95% CI 1.172-1.961, p = 0.002), patients aged 80+ (HR = 9.783, 95% CI 4.185-22.868, p = 0), followed by those aged 60-79 (HR = 3.408, 95% CI 1.488-7.807, p = 0.004); male patients (HR = 1.795, 95% CI 1.461-2.206, p < 0.001); patients with advanced disease with distant metastasis (HR = 3.865, 95% CI 2.977-5.019, p < 0.001), followed by cases with regional involvement via both direct extension and lymph node involvement (HR = 3.853, 95% CI 1.551-9.57, p = 0.004); and widowed patients (HR = 1.975, 95% CI 1.494-2.61, p < 0.001), followed by single patients (HR = 1.53, 95% CI 1.154-2.028, p = 0.003). The highest CSM was observed in the same groups, except widowed patients and patients aged 60-79. The highest CSM was also observed among patients that underwent chemotherapy (HR = 1.687, 95% CI 1.19-2.392, p = 0.003). CONCLUSION In this updated study on the outcomes of patients with GISTs, we found that non-Hispanic Black patients, male patients, and patients older than 60 years have a higher mortality with GISTs. Furthermore, patients who have received chemotherapy have a higher GIST-specific mortality, and married patients have a lower mortality. However, we do not know to what extent these independent prognostic factors interact with each other to influence mortality. This study paves the way for future studies addressing these interactions. The results of this study may help treating clinicians to identify patient populations associated with a dismal prognosis, as those may require closer follow-up and more intensive therapy; furthermore, with married patients having a better survival rate, we hope to encourage clinicians to involve family members of the affected patients early in the disease course, as the social support might impact the prognosis.
Collapse
Affiliation(s)
- Ayrton Bangolo
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, TX 77204, USA
| | - Tha’er Al-Qatish
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - John Bukasa-Kakamba
- Division of Endocrinology, Department of Medicine, Kinshasa University Clinics, Kinshasa 7948, Democratic Republic of the Congo;
| | - Tiffany Lee
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Akira G. Cayago
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Sarah Potiguara
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Vignesh K. Nagesh
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Jessica Kawall
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Rashid Ahmed
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Muhammad Asjad Abbas
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Narissa Nursjamsi
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Stacy H. Lee
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Shagi Meti
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Georgemar V. Arana
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Chrishanti A. Joseph
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Abdifitah Mohamed
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Arthur Alencar
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Huzaifa G. Hassan
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Pramanu Aryal
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Aleena Javed
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Maksim Kalinin
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Gbenga Lawal
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Ibtihal Y. Khalaf
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Midhun Mathew
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Praveena Karamthoti
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| | - Bhavna Gupta
- Division of Hematology and Oncology, Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA
| | - Simcha Weissman
- Department of Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, USA; (T.A.-Q.); (S.P.); (G.V.A.); (C.A.J.); (M.K.); (G.L.); (I.Y.K.)
| |
Collapse
|
16
|
Noreen K, Omer T, ul Hassan J, Kashif Rasheed H, Ahmed R. Some new constructions of minimal efficient circular nearly strongly balanced neighbor designs. Journal of King Saud University - Science 2023; 35:102748. [DOI: 10.1016/j.jksus.2023.102748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
17
|
Ahmed R, Osman R, Nightingale R, Nagem D, Thomson R, Malmborg R, Elmustafa M, Amaral AFS, Patel J, Burney P, El Sony A, Mortimer K. Prevalence and determinants of chronic respiratory diseases in adults in rural Sudan. Int J Tuberc Lung Dis 2023; 27:841-849. [PMID: 37880887 PMCID: PMC10599415 DOI: 10.5588/ijtld.22.0655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/19/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND: Chronic respiratory diseases (CRDs) greatly contribute to worldwide mortality. Despite new data emerging from Africa, prevalence estimates and determinants of CRDs in rural settings are limited. This study sought to extend the existing research conducted in urban Sudan by conducting a rural comparison.METHODS: Participants aged ≥18 years (n = 1,850), living in rural Gezira State completed pre-and post-bronchodilator spirometry and a questionnaire. Prevalence of respiratory symptoms and spirometric abnormalities were reported. Regression analyses were used to identify risk factors for CRDs.RESULTS: Prevalence of chronic airflow obstruction (CAO) was 4.1% overall and 5.5% in those aged ≥40 years. Reversibility was seen in 6.4%. Low forced vital capacity (FVC) was seen in 58.5%, and at least one respiratory symptom was present in 40.7% of the participants. CAO was more common among people aged 60-69 years (OR 2.07, 95% CI 1.13-3.82) and less common among highly educated participants (OR 0.50, 95% CI 0.27-0.93). Being underweight was associated with lower FVC (OR 3.07, 95% CI 2.24-4.20).CONCLUSIONS: A substantial burden of CRD exists among adults in rural Sudan. Investment in CRD prevention and management strategies is needed.
Collapse
Affiliation(s)
- R Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Osman
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Nightingale
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - D Nagem
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Thomson
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - M Elmustafa
- University of Gezira, Wad Medani, Wad Medani College of Medical Sciences and Technology, Wad Medani, Sudan
| | - A F S Amaral
- National Heart and Lung Institute, Imperial College London, London
| | - J Patel
- National Heart and Lung Institute, Imperial College London, London
| | - P Burney
- National Heart and Lung Institute, Imperial College London, London
| | - A El Sony
- The Epidemiological Laboratory, Khartoum, Sudan
| | - K Mortimer
- Liverpool School of Tropical Medicine, Liverpool, UK, National Heart and Lung Institute, Imperial College London, London, Liverpool University Hospitals NHS Foundation Trust, Liverpool, University of Cambridge, Cambridge, UK, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
18
|
Javed R, Ijaz S, Hameed H, Nazish M, Sharif MS, Afreen A, Alarjani KM, Elshikh MS, Mehboob S, Abdul Razak S, Waheed A, Ahmed R, Tariq M. Phytochemical-Mediated Biosynthesis of Silver Nanoparticles from Strobilanthes glutinosus: Exploring Biological Applications. Micromachines 2023; 14:1372. [PMID: 37512683 PMCID: PMC10386440 DOI: 10.3390/mi14071372] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
The application of green synthesis for silver nanoparticles in nanomedicine has experienced significant growth. Strobilanthes glutinosus, a plant primarily located in the Himalayas, remains largely unexplored. Considering the biomedical value of S. glutinosus, phytochemicals from this plant were used for the biosynthesis of silver nanoparticles. Silver nanoparticles were synthesized from aqueous extract of root and leaves of Strobilanthes glutinosus. The synthesized silver nanoparticles were characterized using UV-Vis spectrophotometry, Fourier-transform infrared spectroscopy, transmission electron microscopy, and X-ray diffraction. Total phenolic and flavonoid contents of plants were determined and compared with nanoparticles. The biomedical efficacy of plant extracts and silver nanoparticles was assessed using antioxidant and antibacterial assays. The UV-Vis spectra of leaf- and root-extract-mediated AgNPs showed characteristic peaks at 428 nm and 429 nm, respectively. TEM images revealed the polycrystalline and spherical shapes of leaf- and root-extract-mediated AgNPs with size ranges of 15-60 nm and 20-52 nm, respectively. FTIR findings shown the involvement of phytochemicals of root and leaf extracts in the reduction of silver ions into silver nanoparticles. The crystalline face-centered cubic structure of nanoparticles is depicted by the XRD spectra of leaf and root AgNPs. The plant has an ample amount of total phenolic content (TPC) and total flavonoid content (TFC), which enhance the scavenging activity of plant samples and their respective AgNPs. Leaf and root AgNPs have also shown good antibacterial activity, which may enhance the medicinal value of AgNPs.
Collapse
Affiliation(s)
- Rabia Javed
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| | - Shumaila Ijaz
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Hajra Hameed
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| | - Moona Nazish
- Department of Botany, Rawalpindi Women University, Rawalpindi 46300, Pakistan
| | - Muhammad Shakeeb Sharif
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| | - Afshan Afreen
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| | - Khaloud Mohammed Alarjani
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohamed S Elshikh
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Saadia Mehboob
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| | - Sarah Abdul Razak
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Abdul Waheed
- Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen 518120, China
| | - Rashid Ahmed
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA
| | - Muhammad Tariq
- Department of Biotechnology, Mirpur University of Science and Technology, Mirpur 10250, Pakistan
| |
Collapse
|
19
|
Ahmed R, Osman N, Noory B, Osman R, ElHassan H, Eltigani H, Nightingale R, Amaral AFS, Patel J, Burney PG, Mortimer K, El Sony A. Prevalence and determinants of chronic respiratory diseases in adults in Sudan. Int J Tuberc Lung Dis 2023; 27:373-380. [PMID: 37143219 DOI: 10.5588/ijtld.22.0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND: Chronic respiratory diseases (CRDs) are considered a significant cause of morbidity and mortality worldwide, although data from Africa are limited. This study aimed to determine the prevalence and determinants of CRDs in Khartoum, Sudan.METHODS: Data were collected from 516 participants aged ≥40 years, who had completed a questionnaire and undertook pre- and post-bronchodilator spirometry testing. Trained field workers administered the questionnaires and conducted spirometry. Survey-weighted prevalence of respiratory symptoms and spirometric abnormalities were estimated. Regression analysis models were used to identify risk factors for chronic lung diseases.RESULTS: Using the Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III) reference equations, the prevalence of chronic airflow obstruction (CAO) was 10%. The main risk factor was older age, 60-69 years (OR 3.16, 95% CI 1.20-8.31). Lower education, high body mass index and a history of TB were also identified as significant risk factors. The prevalence of a low forced vital capacity (FVC) using NHANES III was 62.7% (SE 2.2) and 11.3% (SE 1.4) using locally derived values.CONCLUSION: The prevalence of spirometric abnormality, mainly low FVC, was high, suggesting that CRD is of substantial public health importance in urban Sudan. Strategies for the prevention and control of these problems are needed.
Collapse
Affiliation(s)
- R Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | - N Osman
- The Epidemiological Laboratory, Khartoum, Sudan, Federal Ministry of Health, Khartoum, Sudan
| | - B Noory
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Osman
- The Epidemiological Laboratory, Khartoum, Sudan
| | - H ElHassan
- The Epidemiological Laboratory, Khartoum, Sudan
| | - H Eltigani
- The Epidemiological Laboratory, Khartoum, Sudan
| | - R Nightingale
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - A F S Amaral
- National Heart and Lung Institute, Imperial College, London, UK
| | - J Patel
- National Heart and Lung Institute, Imperial College, London, UK
| | - P G Burney
- National Heart and Lung Institute, Imperial College, London, UK
| | - K Mortimer
- Liverpool University Hospitals NHS foundation Trust, Liverpool, UK, University of Cambridge, Cambridge, UK
| | - A El Sony
- The Epidemiological Laboratory, Khartoum, Sudan, Global Alliance for Respiratory Diseases, Africa
| |
Collapse
|
20
|
Al-Qaisi S, Mebed AM, Mushtaq M, Rai DP, Alrebdi TA, Sheikh RA, Rached H, Ahmed R, Faizan M, Bouzgarrou S, Javed MA. A theoretical investigation of the lead-free double perovskites halides Rb 2 XCl 6 (X = Se, Ti) for optoelectronic and thermoelectric applications. J Comput Chem 2023. [PMID: 37093704 DOI: 10.1002/jcc.27119] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
In this study, structural, electronic, optical, thermoelectric, and thermodynamics properties of vacancy-ordered double perovskites Rb2 XCl6 (X = Se, Ti) were explored theoretically. The results revealed that Rb2SeCl6 and Rb2 TiCl6 are indirect band gap (Eg ) semiconductors with Eg values of 2.95 eV, and 2.84 eV respectively. The calculated properties (phonons, elastic constant, Poisson's ratio, and Pugh's ratio) revealed that both materials are dynamically and chemically stable and can exhibit brittle (Rb2 SeCl6 ) and ductile (Rb2 TiCl6 ) nature. From the analysis of optical parameters, it was noticed that the refractive index of the materials has a value of 1.5-2.0 where light absorption was found from the visible to the ultraviolet region. The thermoelectric properties determined by using the BoltzTrap code demonstrated that at room temperature, the Figure of merit (ZT) was found to be 0.74 and 0.76 for Rb2 SeCl6 and Rb2 TiCl6 , respectively. Despite a moderate value of ZT in such materials, further studies might explore effective methods for tuning the electronic band gap and improving the thermoelectric response of the material for practical energy production applications.
Collapse
Affiliation(s)
- Samah Al-Qaisi
- Palestinian Ministry of Education and Higher Education, Nablus, Palestine
| | - Abdelazim M Mebed
- Department of Physics, College of Science, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
- Physics Department, Faculty of Science, Assuit University, Assuit, Egypt
| | - Muhammad Mushtaq
- Department of Physics, University of the Poonch, Rawalakot, Pakistan
| | - D P Rai
- Physical Sciences Research Center (PSRC), Department of Physics, Pachhunga University College, Mizoram University, Aizawl, India
| | - Tahani A Alrebdi
- Department of Physics, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rais Ahmad Sheikh
- Department of Electrical Engineering, College of Engineering, Jazan University, Jazan, Saudi Arabia
| | - Habib Rached
- Faculty of Exact Sciences and Informatics, Department of Physics, Hassiba Benbouali University of Chlef, Chlef, Algeria
- Magnetic Materials Laboratory, Department of Materials and Sustainable Development, Faculty of Exact Sciences, DjillaliLiabes University of SidiBel-Abbes, SidiBel-Abbes, Algeria
| | - R Ahmed
- Centre for High Energy Physics, University of the Punjab, Quaid-e-Azam Campus, Lahore, Pakistan
- Department of Physics, Faculty of Science, UniversitiTeknologi Malaysia, UTM, Skudai, Johor, Malaysia
| | - Muhammad Faizan
- Department of Physics, University of Peshawar, Peshawar, Pakistan
- State Key Laboratory of Superhard Materials and School of Materials Science and Engineering, Jilin University, Changchun, China
| | - S Bouzgarrou
- Department of Physics, College of Science, Qassim University, Buraidah, Saudi Arabia
- Laboratoire de Microélectronique et Instrumentation (UR 03/13-04), Faculté des Sciences de Monastir, Monastir, Tunisia
| | - Muhammad Anjum Javed
- Magnetic Materials Laboratory, Department of Materials and Sustainable Development, Faculty of Exact Sciences, DjillaliLiabes University of SidiBel-Abbes, SidiBel-Abbes, Algeria
| |
Collapse
|
21
|
Oumelaz F, Nemiri O, Boumaza A, Meradji H, Ghemid S, Khenata R, Bin-Omran S, Ahmed R, Tahir SA. First-principle investigations of structural, electronic, thermal, and mechanical properties of AlP 1-xBi x alloys. J Mol Model 2023; 29:124. [PMID: 37000284 DOI: 10.1007/s00894-023-05497-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 02/28/2023] [Indexed: 04/01/2023]
Abstract
CONTEXT In this work, a comprehensive study concerning the physical properties of ternary alloys system (AlP1-xBix) at different concentrations is presented. The obtained results from our first-principle calculations are compared with previously reported studies in the literature and discussed in detail. Our computed results are found in a nice agreement where available with earlier reported results. Electronic band structures at the above-mentioned concentrations are also determined. Likewise, the impact of the varying temperature and pressure on Debye temperature, heat capacity, and entropy is analyzed as well. Furthermore, elastic constants and related elastic moduli results are also computed. Our results show that alloys are stable and found to be in brittle nature. This is the first quantitative study related to ternary alloys (AlP1-xBix) at mentioned concentrations. We soon expect the experimental confirmation of our predictions. METHOD The calculations are performed, at concentrations x=0.0, 0.25, 0.5, 0.75, and 1.0 by using the "full potential (FP) linearized (L) augmented plane wave plus local orbital (APW+lo) method framed within density functional theory (DFT)" as recognized in the "WIEN2k computational code". The "quasi-harmonic Debye model" approach is employed to determine the thermal properties of the title alloys.
Collapse
Affiliation(s)
- F Oumelaz
- Laboratory of Physical Chemistry and Biology of Materials (LPCBM), Département of Physics, High School of Technological Teaching of Skikda, Skikda, Algeria
- Laboratoire LPR, Département de Physique, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria
| | - O Nemiri
- Laboratory of Physical Chemistry and Biology of Materials (LPCBM), Département of Physics, High School of Technological Teaching of Skikda, Skikda, Algeria
- Laboratoire LPR, Département de Physique, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria
| | - A Boumaza
- Laboratoire LPR, Département de Physique, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria
| | - H Meradji
- Laboratoire LPR, Département de Physique, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria.
| | - S Ghemid
- Laboratoire LPR, Département de Physique, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria
| | - R Khenata
- Laboratoire de Physique Quantique de la Matière et de la Modélisation Mathématique (LPQ3M), Université de Mascara, 29000, Mascara, Algeria
| | - S Bin-Omran
- Department of Physics and Astronomy, College of Science, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia
| | - R Ahmed
- Centre for High Energy Physics, Quaid-e-Azam Campus, University of the Punjab, Lahore, 54590, Pakistan
- Department of Physics, Faculty of Science, Universiti Teknologi Malaysia, UTM, 81310, Skudai, Johor, Malaysia
| | - S A Tahir
- Centre for High Energy Physics, Quaid-e-Azam Campus, University of the Punjab, Lahore, 54590, Pakistan
| |
Collapse
|
22
|
Ahmed R, Mhina C, Philip K, Patel SD, Aneni E, Osondu C, Lamikanra O, Akano EO, Anikpezie N, Albright KC, Latorre JG, Chaturvedi S, Otite FO. Age- and Sex-Specific Trends in Medical Complications After Acute Ischemic Stroke in the United States. Neurology 2023; 100:e1282-e1295. [PMID: 36599695 PMCID: PMC10033158 DOI: 10.1212/wnl.0000000000206749] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/15/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To test the hypothesis that the age and sex-specific prevalence of infectious (pneumonia, sepsis, and urinary tract infection [UTI]) and noninfectious (deep venous thrombosis [DVT], pulmonary embolism [PE], acute renal failure [ARF], acute myocardial infarction [AMI], and gastrointestinal bleeding [GIB]) complications increased after acute ischemic stroke (AIS) hospitalization in the United States from 2007 to 2019. METHODS We conducted a serial cross-sectional study using the 2007-2019 National Inpatient Sample. Primary AIS admissions in adults (aged 18 years or older) with and without complications were identified using International Classification of Diseases codes. We quantified the age/sex-specific prevalence of complications and used negative binomial regression models to evaluate trends over time. RESULTS Of 5,751,601 weighted admissions, 51.4% were women. 25.1% had at least 1 complication. UTI (11.8%), ARF (10.1%), pneumonia (3.2%), and AMI (2.5%) were the most common complications, while sepsis (1.7%), GIB (1.1%), DVT (1.2%), and PE (0.5%) were the least prevalent. Marked disparity in complication risk existed by age/sex (UTI: men 18-39 years 2.1%; women 80 years or older 22.5%). Prevalence of UTI (12.9%-9.7%) and pneumonia (3.8%-2.7%) declined, but that of ARF increased by ≈3-fold (4.8%-14%) over the period 2007-2019 (all p < 0.001). AMI (1.9%-3.1%), DVT (1.0%-1.4%), and PE (0.3%-0.8%) prevalence also increased (p < 0.001), but that of sepsis and GIB remained unchanged over time. After multivariable adjustment, risk of all complications increased with increasing NIH Stroke Scale (pneumonia: prevalence rate ratio [PRR] 1.03, 95% CI 1.03-1.04, for each unit increase), but IV thrombolysis was associated with a reduced risk of all complications (pneumonia: PRR 0.80, 85% CI 0.73-0.88; AMI: PRR 0.85, 95% CI 0.78-0.92; and DVT PRR 0.87, 95% CI 0.78-0.98). Mechanical thrombectomy was associated with a reduced risk of UTI, sepsis, and ARF, but DVT and PE were more prevalent in MT hospitalizations compared with those without. All complications except UTI were associated with an increased risk of in-hospital mortality (sepsis: PRR 1.97, 95% CI 1.78-2.19). DISCUSSION Infectious complications declined, but noninfectious complications increased after AIS admissions in the United States in the last decade. Utilization of IV thrombolysis is associated with a reduced risk of all complications.
Collapse
Affiliation(s)
- Rashid Ahmed
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Carl Mhina
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Karan Philip
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Smit D Patel
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Ehimen Aneni
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Chukwuemeka Osondu
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Oluwatomi Lamikanra
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Emmanuel Oladele Akano
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Nnabuchi Anikpezie
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Karen C Albright
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Julius G Latorre
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Seemant Chaturvedi
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore
| | - Fadar Oliver Otite
- From the Department of Neurology (R.A.), Massachusetts General Hospital/Harvard Medical School, Boston; Department of Population Health Sciences (C.M.), Duke University, Raleigh, NC; Department of Neurology (K.P., K.C.A., J.G.L., F.O.O.), SUNY Upstate Medical University, Syracuse; Department of Neurology (S.D.P.), University of California Los Angeles; Department of Cardiology (E.A.), Yale University, New Haven, CT; Baptist Health South Florida (C.O.), Miami; Department of Critical Care (O.L.), Springfield Clinic, Springfield, IL; Molecular Neuropharmacology Unit (E.O.A.), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Department of Population Health Science (N.A.), University of Mississippi Medical Center, Jackson; and Department of Neurology (S.C.), University of Maryland, Baltimore.
| |
Collapse
|
23
|
Ahmed R, Tahir MH, Jabeen R, Rasheed HMK, Khan A. Minimal circular efficient generalized strongly balanced repeated measurements designs. COMMUN STAT-THEOR M 2023. [DOI: 10.1080/03610926.2023.2179885] [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: 03/02/2023]
Affiliation(s)
- Rashid Ahmed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - M. H. Tahir
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Rida Jabeen
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - H. M. Kashif Rasheed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Abid Khan
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
24
|
Roy AT, Ahmed R, Marquez Loza A, Crowe J, Montes D, Hamam O, Romero JM, Silverman S. Abstract WP134: Long-Term Spontaneous Recanalization Rates Of Symptomatic Cervical Carotid Artery Occlusions. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.wp134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background:
Long-term rates of spontaneous recanalization of a previously acutely symptomatic cervical internal carotid artery occlusion (ICAO) have not been well characterized. The purpose of this study was to determine the rate of ICAO recanalization after index transient ischemic attack (TIA)/stroke in patients with serial vessel imaging, and the clinical factors associated with recanalization.
Methods:
This was a single-center, retrospective analysis from 2012-2020 of patients presenting with TIA/stroke due to an acute cervical ICAO. Patients were included if follow-up neck vessel imaging (CTA, MRA or ultrasound) was performed after index TIA/stroke. Recanalization was classified as the presence of continuous flow within the cervical carotid artery on repeat imaging. Patients were excluded if they received catheterization of the occluded artery during index admission or if the occlusion was previously documented (i.e., chronic).
Results:
Fifty-five patients were included in this study (mean age 61 ± 12 years, 27% female). The most common etiology for cervical ICAO was atherosclerosis (71%), followed by dissection (22%). Twelve patients (22%) demonstrated recanalization on follow-up imaging at a median of 125 days from index TIA/stroke (range 2-1072 days). Three patients with recanalization underwent carotid revascularization with endarterectomy or stenting. The administration of intravenous alteplase during index stroke admission was associated with recanalization (p=0.008). However, discharge antithrombotic regimen (antiplatelet or anticoagulation) or the etiology of the occlusion were not associated with recanalization (p=0.48 and p=0.73, respectively). There was no difference in 6-month recurrent TIA/stroke rates between those with recanalization (1 patient, 8.3%) and those without recanalization (4 patients, 9.3%), p=1.0.
Conclusion:
Cervical ICAO recanalization occurred in 12 (22%) patients in our cohort at follow-up and allowed for carotid revascularization procedures in 3 (25%) of these patients. Outpatient follow-up cervical vessel imaging should be considered after symptomatic cervical ICAO, as identifying spontaneous recanalization can alter management.
Collapse
|
25
|
Ul Haq B, Alsardia M, Khadka I, Ahmed R, AlFaify S, Butt FK, Ali Shah Z, Kim SH. First-principles study of the physical properties of Ti2SnX (X: C, N) based 211-MAX phases. Chem Phys 2023. [DOI: 10.1016/j.chemphys.2023.111850] [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: 02/13/2023]
|
26
|
Mariniello A, Nasti T, Chang D, Malik S, McManus D, McGuire D, Buchwald Z, Novello S, Sangiolo D, Scagliotti G, Ramalingam S, Ahmed R. 222P Platinum-based chemotherapy attenuates the CD8 T cell proliferative response to concomitant PD-1 blockade. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
27
|
Andleeb A, Mehmood A, Tariq M, Butt H, Ahmed R, Andleeb A, Ghufran H, Ramzan A, Ejaz A, Malik K, Riazuddin S. Hydrogel patch with pretreated stem cells accelerates wound closure in diabetic rats. Biomater Adv 2022; 142:213150. [PMID: 36306556 DOI: 10.1016/j.bioadv.2022.213150] [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: 05/17/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Delay in wound healing is a diabetes mellites resulting disorder causing persistent microbial infections, pain, and poor quality of life. This disorder is treated by several strategies using natural biomaterials, growth factors and stem cells molded into various scaffolds which possess the potential to accelerate the closure of impaired diabetic wounds. In this study, we developed a hydrogel patch using chitosan (CS) and polyethylene glycol (PEG) with laden bone marrow-derived mesenchymal stem cells (BMSCs) that were pretreated with fibroblast growth factor 21 (FGF21). The developed hydrogel patches were characterized by scanning electron microscopy and fourier transform infrared (FTIR) spectroscopy. After studying the swelling behavior, growth factor (FGF21) was used to modulate BMSC in the hyperglycemic environment. Later, FGF21 treated BMSC were embedded in CS/PEG hydrogel patch and their wound closure effect was assessed in diabetic rats. The results showed that CS/PEG hydrogel patches have good biocompatibility and possess efficient BMSC recruiting properties. The application of CS/PEG hydrogel patches accelerated wound closure in diabetic rats as compared to the control groups. However, the use of FGF21 pretreated BMSCs laded CS/PEG hydrogel patches further increased the therapeutic efficacy of wound closure in diabetic rats. This study demonstrated that the application of a hydrogel patch of CS/PEG with FGF21 pretreated BMSCs improves diabetic wound healing, but further studies are needed on larger animals before the use of these dressings in clinical trials.
Collapse
Affiliation(s)
- Anisa Andleeb
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan; Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250, AJK, Pakistan
| | - Azra Mehmood
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan
| | - Muhammad Tariq
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250, AJK, Pakistan
| | - Hira Butt
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan
| | - Rashid Ahmed
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250, AJK, Pakistan; Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, IL, USA
| | - Aneeta Andleeb
- School of Biochemistry & Biotechnology, University of the Punjab, Lahore 54590, Pakistan
| | - Hafiz Ghufran
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan
| | - Amna Ramzan
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan
| | - Asim Ejaz
- Adipose Stem Cells Center, Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, USA
| | - Kausar Malik
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan
| | - Sheikh Riazuddin
- National Centre of Excellence in Molecular Biology, University of the Punjab, 87-West Canal Bank Road, Lahore, Pakistan; Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan.
| |
Collapse
|
28
|
Madden R, Ahmed R, Cloonan J, May E, Chambers H, Briggs R. 347 LONELINESS AMONGST OLDER INPATIENTS IN THE CONTEXT OF COVID-RELATED VISITING RESTRICTIONS. Age Ageing 2022. [PMCID: PMC9620284 DOI: 10.1093/ageing/afac218.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Loneliness can affect people at all stages of life, but appears to be more closely linked to adverse health outcomes such as quality of life and healthcare use amongst older people. There are concerns that restrictions on hospital visits due to infection control policies related to the COVID-19 pandemic may exacerbate loneliness amongst older inpatients. The aim of this study is to quantify the burden of loneliness amongst older inpatients on a specialist geriatric medicine unit. Methods The study site is a large urban university teaching hospital with a 150-bed specialist geriatric medicine unit, comprising acute medical, rehabilitation and long-stay wards. The University of California, Los Angeles (UCLA) Scale was used to measure symptoms of loneliness with scores≥43 indicating high levels of loneliness. Results Over 84% of patients were lonely at some time while in hospital, with over one-third (24/76) reporting high levels of loneliness. The mean number of days since last visit from a relative or friend for patients reporting high degrees of loneliness was 11.4 (1.2 – 21.6) days, compared to 5.2 (3.2 – 7.1) days for those with reporting lower levels or no loneliness, though confidence intervals overlapped (p = 0.108). Similarly, patients with higher levels of loneliness had a longer length of stay (68.2 (49.4 – 87.1) compared to 47.9 (33.1 – 62.6) but again findings did not reach significance (p = 0.098). Linear regression models, controlling for competing covariates, found that depressive symptoms, were independently associated with burden of loneliness with a β-Coefficient = 10.69 (5.00 – 16.39). Conclusion Loneliness is particularly prevalent amongst older inpatients, with a trend towards higher levels of loneliness in those with less frequent visits. Interventions to help older people stay in touch with family and friends, and maintain social connectedness while in hospital, allowing for COVID-related restrictions, would be welcome, particularly for those with longer lengths of stay.
Collapse
Affiliation(s)
- R Madden
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - R Ahmed
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - J Cloonan
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - E May
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - H Chambers
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - R Briggs
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| |
Collapse
|
29
|
Chambers H, Ahmed R, Cloonan J, May E, Madden R, Briggs R. 345 HOW PREVALENT ARE UNDETECTED DEPRESSIVE SYMPTOMS AMONGST OLDER HOSPITAL INPATIENTS? Age Ageing 2022. [DOI: 10.1093/ageing/afac218.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Depression in later life can have a profound effect on quality of life, functional independence, healthcare use and early mortality. For multiple reasons however, depression in later life may often go undetected. The aim of this study is to ascertain the point prevalence of depressive symptoms on a specialist geriatric medicine unit, examining the rate of detection of clinically significant symptoms.
Methods
The study site is a large urban university teaching hospital with a 150-bed specialist geriatric medicine unit, comprising acute medical, rehabilitation and long-stay wards. Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale (CES-D) with a score ≥16 indicating significant symptoms. Medical notes were examined for documentation of screening for/assessment of depression since admission. Patients were included if they were aged ≥70 years, a current inpatient and able to give informed consent.
Results
Almost 62% (47/76) of the study sample (Mean age 83 years, 66% female) met criteria for significant depressive symptoms. Almost-half (23/47, 49%) of patients with significant depressive symptoms were screened for depression (either with a structured screening tool, a documented mood assessment or review by psychiatry) while in hospital. The mean length of stay for patients with depressive symptoms who had not yet been screened for depression was 42.7 (23.2 – 62.2) days and over 70% had been in hospital for at least 10 days, with almost two-thirds (15/24, 65%) currently residing on an acute geriatric medicine ward (rather than a rehabilitation or long stay ward).
Conclusion
Our study demonstrates a high burden of depressive symptoms amongst older inpatients, with almost 2 in 3 meeting criteria for clinically significant symptoms. Less than half of those with clinically significant symptoms were screened for depression however, representing an important missed opportunity to identify, and possibly treat, depression.
Collapse
Affiliation(s)
- H Chambers
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - R Ahmed
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - J Cloonan
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - E May
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - R Madden
- Trinity College Dublin School of Medicine, , Dublin, Ireland
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| | - R Briggs
- Trinity College Dublin Discipline of Medical Gerontology, , Dublin, Ireland
| |
Collapse
|
30
|
Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
Collapse
Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abhilash Jain
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
| | | |
Collapse
|
31
|
Ahmed R, Shi R, Pan J, Okafor J, Azzu A, Qadeer A, Khattar R, Baksi J, Wechalekar K, Wells A, Kouranos V, Sharma R. Impact of cardiac resynchronisation therapy in patients with cardiac sarcoidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Implantation of a device is usually required in cardiac sarcoidosis (CS) patients presenting with advanced conduction abnormalities or ventricular arrhythmias. A cardiac resynchronisation therapy (CRT) device is often chosen in patients with concomitant left ventricular systolic impairment. The role of CRT in CS is not well established.
Purpose
To describe the cohort of CS patients with CRT device in situ in our hospital focusing on the short-term effect in serial echocardiography and long-term outcomes on morbidity and mortality.
Methods
All consecutive CS patients with a CRT device in situ were identified in our CS database (2005–2022). A confident CS diagnosis was provided after review of all relevant clinical and imaging baseline data in our CS multi-disciplinary meeting and a consensus decision for CRT-D implantation was made based on international guidelines. All patients were followed up for at least 6 months with serial echocardiography. Serial data regarding symptoms, rhythm disturbance and echocardiographic parameters were obtained and comparisons were performed using Wilcoxon signed rank test.
Results
A total of 51 CS patients with CRT-D were identified (mean age: 57±10 years old). Patients were male predominant (64.7%) and Caucasian in origin (86.2%). Extra-cardiac sarcoidosis was confirmed histologically in 33 (64.7%) patients. The prevalence of smoking, diabetes, hypertension and ischaemic heart disease was 27.5%, 21.6%, 49.0% and 7.8% respectively. At the time of device implantation or during follow-up, 43 (84.3%) patients were found to have active cardiac sarcoidosis on cardiac PET.
Post CRT implantation there was a significant difference in LV ejection fraction (35.9±15.0% vs 42.2±14.1%, p<0.001), LV end-systolic diameter (4.90±1.46 cm vs 4.62±1.32 cm, p=0.012) and LV end-diastolic diameter (5.99±1.18 cm vs 5.66±1.06 cm, p<0.001). No significant changes were observed in the right ventricular function (p=0.09) and severity of mitral regurgitation (p=0.40). There was one patient who experienced acute heart failure decompensation admission within six months of CRT-D implantation. The New York Heart Association (NYHA) class improved in 26 patients (51.0%), worsened in 4 (7.8%) patients and remained the same in 21 (41.2%) patients at 6 months post CRT-implantation. During the mean follow up of 47.6 months, the composite end-point of death and cardiac transplantation was reached in 9 (17.6%) patients (8 deaths and 1 cardiac transplantation). 5 patients had major complications including a large haematoma, a small atrio-septal defect, haemothorax, device associated endocarditis and lead fracture. Minor wound infections were seen in 3 patients and 4 patients received inappropriate shock or anti-tachycardia pacing.
Conclusions
CRT in cardiac sarcoidosis patients is associated with short-term improvement in LV remodelling and functional status but over a four year follow up, morbidity and mortality are common.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- R Ahmed
- Royal Brompton Hospital , London , United Kingdom
| | - R Shi
- Royal Brompton Hospital , London , United Kingdom
| | - J Pan
- Royal Brompton Hospital , London , United Kingdom
| | - J Okafor
- Royal Brompton Hospital , London , United Kingdom
| | - A Azzu
- Royal Brompton Hospital , London , United Kingdom
| | - A Qadeer
- Royal Brompton Hospital , London , United Kingdom
| | - R Khattar
- Royal Brompton Hospital , London , United Kingdom
| | - J Baksi
- Royal Brompton Hospital , London , United Kingdom
| | - K Wechalekar
- Royal Brompton Hospital , London , United Kingdom
| | - A Wells
- Royal Brompton Hospital , London , United Kingdom
| | - V Kouranos
- Royal Brompton Hospital , London , United Kingdom
| | - R Sharma
- Royal Brompton Hospital , London , United Kingdom
| |
Collapse
|
32
|
Bashir Z, Ahmed R, Gondaliya J, Rasheed K. Some classes of circular balanced RMDs and their conversion into circular strongly and nearly strongly balanced RMDs. COMMUN STAT-THEOR M 2022. [DOI: 10.1080/03610926.2020.1863989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Zahid Bashir
- Department of Statistics, The Islamia University of Bahawalpur, Pakistan
| | - Rashid Ahmed
- Department of Statistics, The Islamia University of Bahawalpur, Pakistan
| | | | - Kashif Rasheed
- Department of Statistics, The Islamia University of Bahawalpur, Pakistan
| |
Collapse
|
33
|
Dommaraju SR, Rivera SG, Rocha EG, Bicknell S, Loizzo D, Mohammad A, Rajan P, Seballos A, Datta A, Ahmed R, Krishnan JA, Keehn MT. Health professional students at the University of Illinois Chicago (HOLISTIC) Cohort Study: A protocol. PLoS One 2022; 17:e0269964. [PMID: 36040905 PMCID: PMC9426903 DOI: 10.1371/journal.pone.0269964] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/14/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The objectives of the HOLISTIC Cohort Study are to establish a prospective cohort study covering a period of three years that characterizes the health of students within and across health professional education programs at the University of Illinois Chicago (UIC) during the coronavirus disease 2019 (COVID-19) pandemic, implement an interprofessional student research team, and generate a meaningful dataset that is used to inform initiatives that improve student health. This report describes the protocol of the HOLISTIC Cohort Study, including survey development, recruitment strategy, and data management and analysis. METHODS An interprofessional student research team has been organized with the goal of providing continuous assessment of study design and implementation across the seven health science colleges (applied health sciences, dentistry, medicine, nursing, pharmacy, public health, and social work) at the University of Illinois Chicago in Chicago, IL. To be eligible to participate in the HOLISTIC Cohort Study, students are required to be 1) age 18 years or older; 2) enrolled full- or part-time in one or more of UIC's seven health science colleges; and 3) enrolled in a program that prepares its graduates to enter a healthcare profession. The study protocol includes a series of three recruitment waves (Spring 2021 [April 14, 2021, to May 5, 2021; completed], Spring 2022, Spring 2023). In the first recruitment wave, eligible students were sent an invitation via electronic mail (e-mail) to complete an online survey. The online survey was based on the U.S. Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System 2019 survey and the 2014 World Health Organization Report of the Strategic Advisory Group of Experts Working Group Vaccine Hesitancy Scale. Electronic informed consent and study data are collected and managed using Research Electronic Data Capture (REDCap) tools. This study utilizes convenience sampling from all seven health science colleges at UIC with a target recruitment total of 2,000 participants. DISCUSSION AND FUTURE DIRECTIONS A total of 555 students across all seven health science colleges (10.8% of 5,118 students who were invited; 27.6% of target sample size) enrolled in the cohort during the first recruitment wave. The pilot data establishes the feasibility of the study during the COVID-19 pandemic. Adaptations to overcome barriers to study implementation, including the use of remote, rather than in-person, study meetings, staff training, and participant recruitment are discussed. For the second and third waves of recruitment, the student research team will seek institutional review board (IRB) approval to implement additional enrollment strategies that are tailored to each health science college, such as online newsletters, virtual townhalls, flyers on bulletin boards near classrooms tailored to each health science college.
Collapse
Affiliation(s)
- Sunil R. Dommaraju
- College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Stephanie Gordon Rivera
- School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Ethan G. Rocha
- College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Scott Bicknell
- College of Dentistry, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Daniel Loizzo
- College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Ayesha Mohammad
- College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Priya Rajan
- College of Nursing, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Alexandria Seballos
- College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Avisek Datta
- School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Rashid Ahmed
- School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Jerry A. Krishnan
- College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States of America
- Population Health Sciences Program, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Mary T. Keehn
- College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, United States of America
- Interprofessional Practice and Education, Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois, United States of America
| |
Collapse
|
34
|
Ghauri AU, Ijaz O, Sabir N, Chaudhery MI, Saleem MM, Ahmed R. 429 Clinical Audit Ankle Fractures. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Aim
Ankle fractures are common among adult age group with an incidence of 174 per 100000 per year and they pose serious problems in management of geriatric age group because of osteoporotic bone. Our aim of current clinical audit was to introduce changes in current clinical practice by recommendations according to Standard BOAST guidelines of management of Ankle Fractures.
Method
Clinical Audit was carried out in Department of Orthopedics Benazir Bhutto Hospital in Outdoor and Emergency in March 2021 in patients of age group 20–70 years taking 50 patients for pre- and post-audit assessment. Emergency, Outdoor Slips were evaluated according to Standards of Practice formulated. Then a presentation was given to medical staff on Guidelines of Ankle fractures management, and they were informed about the deficiencies in their documentation and management. Panaflexes of Guidelines were displayed in ER, ward and then re-evaluation was done after 4 weeks in April 2021 using proformas in which clinical notes, discharge certificates and emergency slips were used for data analysis and observing improvement.
Results
The results of asymmetric data were calculated by Fischer Exact Test and with a p-value of <0.05 considered as significant. Results were very pleasing as they showed great improvements in documentation as well as management of patients in accordance with the set guidelines and protocols.
Conclusion
Clinical Audits should be carried out on regular basis in hospital settings as they help to improve the standards of care as well as proper documentation which has medico-legal importance.
Collapse
Affiliation(s)
- AU Ghauri
- Orthopedics BBH , Rawalpindi , Pakistan
| | - O Ijaz
- Orthopedics BBH , Rawalpindi , Pakistan
| | - N Sabir
- Orthopedics BBH , Rawalpindi , Pakistan
| | | | - MM Saleem
- Orthopedics BBH , Rawalpindi , Pakistan
| | - R Ahmed
- Orthopedics BBH , Rawalpindi , Pakistan
| |
Collapse
|
35
|
Ijaz O, Waqar Bhatti H, Ahmed R. 431 Writing the Right Way! Improvement of Operation Notes in an Orthopaedic Ward – a Closed Loop Audit. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Introduction
Operation notes are recognized as standard for documentation of details of operation but still it's often neglected. Proper documentation is necessary as it is correlated with good patient care, quality assurance, future decisions, and medico-legal issues.
Aim
The objective of this study is twofold: one to compare the documentation of notes against standard RCS (Royal College of Surgeons) guidelines and secondly making sure that surgeons follow these by educating them through presentations, brochures, aide memoires and introduction of proformas.
Method
We prospectively studied 50 post-op notes against standard RCS guidelines consecutively both pre and post intervention. Asymmetric data was analyzed after 4 weeks using the Fischer-Exact Test and statistical significance was set as <0.05.
Results
A total of 18 guidelines were audited. First loop showed deficiencies in fields of elective/emergency, operative diagnosis, operative findings, complications, extra procedure performed, tissue removed/added, details of closure, blood loss and antibiotic prophylaxis. After intervention documentation improved and percentages rose and reached almost 100%.
Conclusion
Proper documentation is of great importance as it carries both medical and legal implications. Three step intervention showed remarkable improvement in documenting of these operation notes according to standard RCS guidelines.
Collapse
Affiliation(s)
- O Ijaz
- Orthopedics , BBH, Rawalpindi , Pakistan
| | - H Waqar Bhatti
- Orthopedics , BBH, Rawalpindi , Pakistan
- Agha Khan University , Karachi , Pakistan
| | - R Ahmed
- Dean Orthopedics , BBH, Rawalpindi , Pakistan
| |
Collapse
|
36
|
Mann A, Safa N, Martell E, Luo W, Paul P, Abbasian P, Ahmed R, Sitar D, Sharif T, Lakowski T, Miller D, Pitz M. BSCI-07 ACETYL-AMANTADINE AS A DIAGNOSTIC BIOMARKER IN PATIENTS WITH GLIOBLASTOMA. Neurooncol Adv 2022. [PMCID: PMC9354153 DOI: 10.1093/noajnl/vdac078.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AIM Glioblastoma (GB) is the most common malignant primary brain tumor in adults, with a prognosis as poor as 12-15 months with standard treatment. Spermidine/spermine N1-acetyltransferase (SAT1) is a rate limiting enzyme in polyamine metabolism and has been reported to be upregulated in various cancers, including GB. Amantadine is a Health Canada approved drug that is acetylated by SAT1. We established a clinical trial in GB patients to determine if plasma and urine acetyl amantadine (Ac-Am) can be used to measure SAT1 activity and whether levels correlate with their tumor burden. METHODS A clinical trial was established that is currently active and recruiting patients with GB who receive care at CancerCare Manitoba. A total of n=8 participants have been recruited thus far. Participants’ blood and urine were collected two hours after ingesting amantadine (200 mg). Levels of serum and urine Ac-Am were measured using liquid chromatography-tandem mass spectrometry. Acetyl-amantadine levels were correlated with tumour bidimensional diameter and volume measured on MRI. In addition, expression of SAT1 was examined in various cultured GB cells (both cell lines and patient-derived cells) and correlated with Ac-Am. RESULTS Preliminary results indicate that the levels of plasma Ac-Am in study participants positively correlate with their initial tumor burden (r = 0.41). While transient increases in plasma and urine Ac-Am above baseline levels were observed, the clinical significance of these findings is undergoing further analysis. SAT1 was detected in all the GB tumor cells examined. The production of Ac-Am in cultured GB cells varied as a function of SAT1 expression. SIGNIFICANCE A diagnostic biomarker, such as Ac-Am, that could effectively and reliably detect tumor progression and recurrence would be an invaluable adjunct to MRI imaging and could significantly impact the timing of appropriate treatment and reduce patients’ morbidity and mortality.
Collapse
Affiliation(s)
- Anmol Mann
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB , Canada
| | - Nur Safa
- Kleysen Institute of Advanced Medicine, Health Sciences Center , Winnipeg, MB , Canada
| | - Emma Martell
- Department of Pathology and Human Anatomy and Cell Sciences, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB , Canada
| | - Wenxia Luo
- College of Pharmacy, Pharmaceutical Analysis Laboratory, University of Manitoba , Winnipeg, MB , Canada
| | - Prasanta Paul
- College of Pharmacy, Pharmaceutical Analysis Laboratory, University of Manitoba , Winnipeg, MB , Canada
| | - Parandoush Abbasian
- Medical Physics, Physics and Astronomy, University of Manitoba , Winnipeg, MB , Canada
| | - Rashid Ahmed
- BioMark Diagnostics Inc. , Richmond, BC , Canada
| | - Daniel Sitar
- Department of Pharmacology and Therapeutics, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB , Canada
| | - Tanveer Sharif
- Department of Pathology and Human Anatomy and Cell Science, University of Manitoba , Winnipeg, MB , Canada
| | - Ted Lakowski
- Pharmaceutical Analysis Laboratory, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB , Canada
| | - Donald Miller
- Kleysen Institute of Advanced Medicine, Health Sciences Center , Winnipeg, MB , Canada
| | - Marshall Pitz
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba , Winnipeg, MB , Canada
- Research Institute of Oncology and Hematology, CancerCare Manitoba , Winnipeg, MB , Canada
| |
Collapse
|
37
|
Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
Collapse
|
38
|
Jabeen R, Bashir Z, Rasheed HMK, Gondaliya J, Ahmed R. Minimal circular generalized strongly balanced and their conversion into circular balanced and strongly balanced repeated measurements designs. COMMUN STAT-THEOR M 2022. [DOI: 10.1080/03610926.2022.2101664] [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: 11/03/2022]
Affiliation(s)
- Rida Jabeen
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Zahid Bashir
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - H. M. Kashif Rasheed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | | | - Rashid Ahmed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
39
|
Noreen K, Rashid MS, Shehzad F, Ul Hassan M, Noreen Z, Omer T, Ahmed R. Algorithms to obtain generalized neighbor designs in minimal circular blocks. COMMUN STAT-SIMUL C 2022. [DOI: 10.1080/03610918.2022.2098330] [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: 11/03/2022]
Affiliation(s)
- Khadija Noreen
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Muhammad Sajid Rashid
- Department of Computer Science, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Farrukh Shehzad
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | | | - Zahra Noreen
- Division of Science and Technology, University of Education, Lahore, Pakistan
| | - Talha Omer
- Department of Economics, Finance and Statistics, JIBS, Jönköping University, Jönköping, Sweden
| | - Rashid Ahmed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
40
|
Abir FF, Alyafei K, Chowdhury MEH, Khandakar A, Ahmed R, Hossain MM, Mahmud S, Rahman A, Abbas TO, Zughaier SM, Naji KK. PCovNet: A presymptomatic COVID-19 detection framework using deep learning model using wearables data. Comput Biol Med 2022; 147:105682. [PMID: 35714504 PMCID: PMC9170596 DOI: 10.1016/j.compbiomed.2022.105682] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
While the advanced diagnostic tools and healthcare management protocols have been struggling to contain the COVID-19 pandemic, the spread of the contagious viral pathogen before the symptom onset acted as the Achilles' heel. Although reverse transcription-polymerase chain reaction (RT-PCR) has been widely used for COVID-19 diagnosis, they are hardly administered before any visible symptom, which provokes rapid transmission. This study proposes PCovNet, a Long Short-term Memory Variational Autoencoder (LSTM-VAE)-based anomaly detection framework, to detect COVID-19 infection in the presymptomatic stage from the Resting Heart Rate (RHR) derived from the wearable devices, i.e., smartwatch or fitness tracker. The framework was trained and evaluated in two configurations on a publicly available wearable device dataset consisting of 25 COVID-positive individuals in the span of four months including their COVID-19 infection phase. The first configuration of the framework detected RHR abnormality with average Precision, Recall, and F-beta scores of 0.946, 0.234, and 0.918, respectively. However, the second configuration detected aberrant RHR in 100% of the subjects (25 out of 25) during the infectious period. Moreover, 80% of the subjects (20 out of 25) were detected during the presymptomatic stage. These findings prove the feasibility of using wearable devices with such a deep learning framework as a secondary diagnosis tool to circumvent the presymptomatic COVID-19 detection problem.
Collapse
Affiliation(s)
- Farhan Fuad Abir
- Department of Electrical and Electronic Engineering, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Khalid Alyafei
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha, 2713, Qatar
| | | | - Amith Khandakar
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Rashid Ahmed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha, 2713, Qatar; Biomedical Research Centre, Qatar University, Doha, 2713, Qatar
| | | | - Sakib Mahmud
- Department of Electrical Engineering, Qatar University, Doha, 2713, Qatar
| | - Ashiqur Rahman
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Japan
| | - Tareq O Abbas
- Urology Division, Surgery Department, Sidra Medicine, Doha, Qatar, 26999
| | - Susu M Zughaier
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
| | | |
Collapse
|
41
|
Doos D, Barach P, Alves NJ, Falvo L, Bona A, Moore M, Cooper DD, Lefort R, Ahmed R. The Dangers of Reused Personal Protective Equipment: Healthcare Workers and Workstation Contamination. J Hosp Infect 2022; 127:59-68. [PMID: 35688273 PMCID: PMC9172254 DOI: 10.1016/j.jhin.2022.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022]
Abstract
Background Personal protective equipment (PPE) is essential to protect healthcare workers (HCWs). The practice of reusing PPE poses high levels of risk for accidental contamination by HCWs. Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients. Methods In this study, observations were made of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of patients with coronavirus disease 2019. Participants' N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing. Participants were evaluated using blacklight after each doffing encounter to evaluate new contamination sites, and were assessed for the cumulative surface area that occurred due to PPE doffing. Additionally, participants' workstations were evaluated for contamination. Results All participants experienced some contamination on their upper extremities, neck and face. The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods, and the least contamination occurred with the tabletop storage method. Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current recommendation of the US Centers for Disease Control and Prevention to use a paper bag for storage. All participants donning and doffing PPE were contaminated. Conclusion PPE reusage practices pose an unacceptably high level of risk of accidental cross-infection contamination to healthcare workers. The current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers.
Collapse
Affiliation(s)
- D Doos
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - P Barach
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA; University of Queensland, Brisbane, Queensland, Australia
| | - N J Alves
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - L Falvo
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Bona
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M Moore
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - D D Cooper
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - R Lefort
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - R Ahmed
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
42
|
Nabi H, Hetland ML, Loft AG, Hendricks O, Jensen D, Pedersen JK, Just SA, Danebod K, Munk HL, Kristensen S, Manilo N, Colic A, Linauskas A, Thygesen PH, Christensen LB, Høgberget Kalisz M, Lomborg N, Grydehøj J, Raun J, Ahmed R, Mehnert F, Steen Krogh N, Glintborg B. OP0065 INFLIXIMAB BIOSIMILAR-TO-BIOSIMILAR SWITCHING IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASES: CLINICAL OUTCOMES IN REAL-WORLD PATIENTS FROM THE DANBIO REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIn routine care, biosimilar-to-biosimilar infliximab switching may occur to save costs (=non-medical switching). Previous studies have investigated the efficacy and safety of switches from originator infliximab to a corresponding biosimilar in patients with inflammatory rheumatic diseases (1). However, the outcomes after switching from one infliximab biosimilar to a second infliximab biosimilar remain scarcely investigated.Denmark has recently conducted a nationwide mandatory infliximab biosimilar-to-biosimilar switch.ObjectivesTo investigate the effectiveness of infliximab biosimilar-to-biosimilar switch (CTP-13 to GP1111) among patients with RA, PsA and AxSpA, including patients who had previously switched from originator (originator-experienced) to CT-P13 as well as patients who were originator-naïve.MethodsObservational cohort study based on DANBIO registry (for clinical data upon switch =baseline) linked with national patient registries (to identify prior comorbidities). Patients with RA, PsA or AxSpA who performed a biosimilar-to-biosimilar switch from CT-P13 to GP1111 between April 1st 2019 and February 1st 2020 were included. Patient were divided into two groups: originator-naïve and originator-experienced. Main outcomes in the two groups were one-year GP1111 treatment retention (Kaplan Meier “drug survival curves”) and changes in disease activity 4 months before versus 4 months after switch in individual patients. Also, factors associated with GP1111 treatment retention for both groups combined were explored with Cox proportional hazard regression analyses, stratified by diagnosis (univariate-, age-and gender adjusted and fully adjusted). Analyses were adjusted for relevant clinical factors (for details: see Table 1)Table 1.Baseline variables associated with GP1111 withdrawal (RA shown below, similar findings for PsA and AxSpA)UnivariateAge- and gender adjustedMultivariateHR (95% CI)p-valueHR (95% CI)p-valueHR (95%CI)p-valueRAFemale gender0.9 (0.6-1.3)0.4-0.7 (0.5-1.2)0.2Age, years1.0 (0.9-1.0)0.9-1.0 (0.9-1.1)0.6Originator-experienced versus originator naïve to infliximab0.5 (0.3-0.8)0.0020.5 (0.3-0.8)0.0020.4 (0.2-0.9)0.01Methotrexate use, yes0.5 (0.3-0.7)<0.0010.5 (0.3-0.7)<0.0010.6 (0.4-0.9)0.01Comorbidities ≥11.1 (0.7-1.5)0.81.1 (0.7-1.5)0.80.9 (0.6-1.4)0.7In remission (yes)0.4 (0.3-0.6)<0.0010.4 (0.2-0.6)<0.0010.5 (0.3-0.7)<0.001DAS281.7 (1.4-1.9)<0.0011.7 (1.5-1.9)<0.001--Patient global VAS, mm1.0 (1.0-1.1)<0.0011.0 (1.0-1.1)<0.001--ResultsIn total, 1,605 patients underwent an infliximab biosimilar-to-biosimilar switch and were included; 1,171 were originator-naïve and 434 were originator-experienced, 685 RA/314 PsA/606 AxSpA, median disease duration was 9 years, 42% were in DAS28/ASDAS remission at the time of switch.At one year, 83% (95% CI 81-85) of the originator-naive and 92% (95% CI 90-95) of the originator-experienced switchers maintained GP1111 treatment (Figure 1). Changes in disease activity 4 months pre- and post-switch were close to zero for all disease activity measures (e.g. DAS28, ASDAS, VAS pain, not shown).The risk of GP1111 withdrawal was lower in originator-experienced compared to originator-naïve patients in patients with RA and PsA: HR 0.4 (95% CI 0.2-0.9, p-value 0.01) and HR 0.1 (0.1-0.6, p=0.01), but not significantly for AxSpA 0.56 (0.27-1.13, p=0.1). Across all indications, lower disease activity at baseline (DAS28/ASDAS remission) was associated with higher retention (Table 1).ConclusionBiosimilar-to-biosimilar infliximab switch was effective and well-tolerated in >1,500 real-world patients. Retention was higher in originator-experienced switchers and patients, who were in remission at the time of the switch, suggesting retention to be more affected by patient-related than drug-related factors.References[1]Glintborg et al, ARD, 2017; 76: 1426–1431AcknowledgementsWe thank departments reporting to the DANBIO registry.Disclosure of InterestsHafsah Nabi Grant/research support from: Research grant from Sandoz, who had no influence on the analysis, interpretation and presentation of data., Merete L. Hetland Speakers bureau: Biogen, Celltrion, Janssen Biologics B.V, MSD, Pfizer, Samsung Biopis, Consultant of: Biogen, Celltrion, Janssen Biologics B.V, MSD, Pfizer,Samsung Biopis, Grant/research support from: AbbVie, Biogen, BMS, Eli Lilly Denmark A/S,Lundbeck Fond, Pfizer, Roche, Sandoz, Novartis, Anne Gitte Loft Paid instructor for: AbbVie, Eli Lilly Denmark A/S, Janssen- Cilag A/S, MSD, Novartis, Pfizer, UCB, Consultant of: AbbVie, Eli Lilly Denmark A/S, Janssen-CilagA/S, MSD, Novartis, Pfizer, UCB, Grant/research support from: Novartis, Oliver Hendricks Speakers bureau: AbbVie, Pfizer, Novartis, Dorte Jensen: None declared, Jens Kristian Pedersen: None declared, Søren Andreas Just: None declared, Kamilla Danebod: None declared, Heidi Lausten Munk: None declared, Salome Kristensen: None declared, Natalia Manilo: None declared, Ada Colic: None declared, Asta Linauskas: None declared, Pia Høger Thygesen: None declared, Louise Brot Christensen: None declared, Maren Høgberget Kalisz: None declared, Niels Lomborg: None declared, Jolanta Grydehøj: None declared, Johnny Raun: None declared, Rabiah Ahmed: None declared, Frank Mehnert: None declared, Niels Steen Krogh: None declared, Bente Glintborg Grant/research support from: BMS, Pfizer, Sandoz.
Collapse
|
43
|
Signore AK, Jung ME, Semenchuk B, Kullman SM, Tefft O, Webber S, Ferguson LJ, Kowalski K, Fortier M, McGavock J, Ahmed R, Orr M, Strachan S. A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes. Pilot Feasibility Stud 2022; 8:111. [PMID: 35624519 PMCID: PMC9135984 DOI: 10.1186/s40814-022-01072-6] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.
Collapse
Affiliation(s)
- Alana K Signore
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada.
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Brittany Semenchuk
- Applied Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Sasha M Kullman
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Olivia Tefft
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Kent Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, S7N 5B2, Canada
| | - Michelle Fortier
- School of Human Kinetics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jon McGavock
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 3P5, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Marion Orr
- Inner Compass Counselling, Winnipeg, MB, R3G 2X6, Canada
| | - Shaelyn Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| |
Collapse
|
44
|
Jabeen R, Khan A, Rasheed HMK, Ul Hassan M, Ahmed R. General construction of efficient circular partially strongly-balanced repeated measurements designs. COMMUN STAT-SIMUL C 2022. [DOI: 10.1080/03610918.2022.2076871] [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: 11/03/2022]
Affiliation(s)
- Rida Jabeen
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Abid Khan
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - H. M. Kashif Rasheed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | | | - Rashid Ahmed
- Department of Statistics, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| |
Collapse
|
45
|
Ahmed R, Augustine R, Chaudhry M, Akhtar UA, Zahid AA, Tariq M, Falahati M, Ahmad IS, Hasan A. Nitric oxide-releasing biomaterials for promoting wound healing in impaired diabetic wounds: State of the art and recent trends. Pharmacotherapy 2022; 149:112707. [PMID: 35303565 DOI: 10.1016/j.biopha.2022.112707] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022]
Abstract
Impaired diabetic wounds are serious pathophysiological complications associated with persistent microbial infections including failure in the closure of wounds, and the cause of a high frequency of lower limb amputations. The healing of diabetic wounds is attenuated due to the lack of secretion of growth factors, prolonged inflammation, and/or inhibition of angiogenic activity. Diabetic wound healing can be enhanced by supplying nitric oxide (NO) endogenously or exogenously. NO produced inside the cells by endothelial nitric oxide synthase (eNOS) naturally aids wound healing through its beneficial vasculogenic effects. However, during hyperglycemia, the activity of eNOS is affected, and thus there becomes an utmost need for the topical supply of NO from exogenous sources. Thus, NO-donors that can release NO are loaded into wound healing patches or wound coverage matrices to treat diabetic wounds. The burst release of NO from its donors is prevented by encapsulating them in polymeric hydrogels or nanoparticles for supplying NO for an extended duration of time to the diabetic wounds. In this article, we review the etiology of diabetic wounds, wound healing strategies, and the role of NO in the wound healing process. We further discuss the challenges faced in translating NO-donors as a clinically viable nanomedicine strategy for the treatment of diabetic wounds with a focus on the use of biomaterials for the encapsulation and in vivo controlled delivery of NO-donors.
Collapse
Affiliation(s)
- Rashid Ahmed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar; Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250, AJK, Pakistan; Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, IL, USA
| | - Robin Augustine
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar
| | - Maryam Chaudhry
- Department of Continuing Education, University of Oxford, OX1 2JD Oxford, United Kingdom
| | - Usman A Akhtar
- Department of Chemical Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
| | - Alap Ali Zahid
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar
| | - Muhammad Tariq
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250, AJK, Pakistan
| | - Mojtaba Falahati
- Nanomedicine Innovation Center Erasmus (NICE), Erasmus Medical Center, 3015GE Rotterdam, The Netherlands
| | - Irfan S Ahmad
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, IL, USA; Department of Agricultural and Biological Engineering, University of Illinois at Urbana Champaign, IL, USA; Carle Illinois College of Medicine, University of Illinois at Urbana Champaign, IL, USA
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar; Biomedical Research Center (BRC), Qatar University, PO Box 2713, Doha, Qatar.
| |
Collapse
|
46
|
Ahmed R, Khan S, Quddus N, Saher T, Fatima N. Physical performance among post-COVID and non-COVID individuals: a comparative study. Comparative Exercise Physiology 2022. [DOI: 10.3920/cep220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this comparative cross-sectional study, we compare the physical performance among post-COVID and non-COVID subjects. A sample of 64 subjects recovered from COVID-19 and 64 subjects who were not infected with COVID-19 were recruited for the study. Both groups were tested for physical performance by 30-s sit-to-stand test, 6-min walk test, and HUMAC balance system. The findings of the present study reveal that there was a significant difference in physical performance between both the groups. In conclusion, this study demonstrated that physical performance is impaired in the post-COVID subjects as compared to the matched non-COVID subjects. Therefore, physical therapy exercise program/regimen should be a part of recovery from COVID-19.
Collapse
Affiliation(s)
- R. Ahmed
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - S.A. Khan
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - N. Quddus
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - T. Saher
- Department of Rehabilitation Sciences, Jamia Hamdard University, 110025 New Delhi, India
| | - N. Fatima
- Department of Molecular Medicine, Jamia Hamdard University, 110062 New Delhi, India
| |
Collapse
|
47
|
Ahmad J, Khan OS, Russell SS, Ahmed R, Hoque R. Effect of Cardiopulmonary Bypass on Blood and Coagulation Profile in Patients Undergoing Cardiac Surgery. Mymensingh Med J 2022; 31:477-483. [PMID: 35383769] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study was carried out in the department of cardiac surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2014 to April 2016. This study aims to evaluate the inadvertent effect of cardiopulmonary bypass on complete blood count and coagulation profile. This study was also compared the hemostatic parameters between patients undergoing elective cardiac surgery with CPB and without CPB. A total of 55 patients were included in this study. Among them 20 patients (Group A) were selected for elective cardiac surgery without cardiopulmonary bypass (CPB), 20 patients (Group B) with cardiopulmonary bypass time less than 90 minutes and 15 patients (Group C) were included with cardiopulmonary bypass time either 90 minutes or more. The mean age were 51.5±4.7 years ranging from 40-57 years in Group A, 33.2±10.2 years ranging from 18-50 years in Group B and 34.2±11.4 years ranging from 18-57 years in Group C. The difference of age was statistically significant (p<0.05) among three groups. The difference of post-operative mean hemoglobin and RBC value, WBC and Platelet count on arrival at the intensive care unit, at 48 hours and at 7 days after surgery were statistically significant (p<0.05) in the three groups. However, on arrival at Intensive Care Unit, after 48 hours and at 7 days after surgery, the change of coagulation profile like mean fibrinogen level, bleeding time, clotting time and prothrombin time were statistically significant (p<0.05) among the groups. Patient with long cardiopulmonary bypass time had shown blood and coagulation profile abnormality and it can be minimized if we can curtail the bypass time.
Collapse
Affiliation(s)
- J Ahmad
- Dr Jubayer Ahmad, Assistant Professor, Department of Vascular Surgery, Ibrahim Cardiac Hospital and Research Institute (ICHRI), Dhaka, Bangladesh: E-mail:
| | | | | | | | | |
Collapse
|
48
|
Abdulrahman N, Ibrahim M, Joseph JM, Elkoubatry HM, Al-Shamasi AA, Rayan M, Gadeau AP, Ahmed R, Eldassouki H, Hasan A, Mraiche F. Empagliflozin inhibits angiotensin II-induced hypertrophy in H9c2 cardiomyoblasts through inhibition of NHE1 expression. Mol Cell Biochem 2022; 477:1865-1872. [PMID: 35334035 PMCID: PMC9068664 DOI: 10.1007/s11010-022-04411-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus (DM)-induced cardiac morbidities have been the leading cause of death among diabetic patients. Recently, sodium-glucose cotransporter-2 (SGLT-2) inhibitors including empagliflozin (EMPA), which have been approved for the treatment of DM, have gained attention for their cardioprotective effect. The mechanism by which SGLT-2 inhibitors exert their cardioprotective effect remains unclear. Recent studies have suggested that EMPA exerts its cardioprotective effect by inhibiting the Na+/H+ exchanger (NHE), a group of membrane proteins that regulate intracellular pH and cell volume. Increased activity and expression of NHE isoform 1 (NHE1), the predominant isoform expressed in the heart, leads to cardiac hypertrophy. p90 ribosomal s6 kinase (p90 RSK) has been demonstrated to stimulate NHE1 activity. In our study, H9c2 cardiomyoblasts were treated with angiotensin II (ANG) to activate NHE1 and generate a hypertrophic model. We aimed to understand whether EMPA reverses the ANG-induced hypertrophic response and to elucidate the molecular pathway contributing to the cardioprotective effect of EMPA. Our study demonstrated that ANG-induced hypertrophy of H9c2 cardiomyoblasts is accompanied with increased SGLT-1 and NHE1 protein expression, an effect which is prevented in the presence of EMPA. EMPA reduces ANG-induced hypertrophy through the inhibition of SGLT-1 and NHE1 expression.
Collapse
Affiliation(s)
- Nabeel Abdulrahman
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar.,Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
| | - Meram Ibrahim
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar
| | - Jensa Mariam Joseph
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar
| | - Hanan Mahmoud Elkoubatry
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar
| | - Al-Anood Al-Shamasi
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar
| | - Menatallah Rayan
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar
| | | | - Rashid Ahmed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
| | - Hussein Eldassouki
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
| | - Fatima Mraiche
- College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar. .,Biomedical and Pharmaceutical Research Unit, Qatar University, Doha, Qatar.
| |
Collapse
|
49
|
Linschoten M, Uijl A, Schut A, Jakob CEM, Romão LR, Bell RM, McFarlane E, Stecher M, Zondag AGM, van Iperen EPA, Hermans-van Ast W, Lea NC, Schaap J, Jewbali LS, Smits PC, Patel RS, Aujayeb A, van der Harst P, Siebelink HJ, van Smeden M, Williams S, Pilgram L, van Gilst WH, Tieleman RG, Williams B, Asselbergs FW, Al-Ali AK, Al-Muhanna FA, Al-Rubaish AM, Al-Windy NYY, Alkhalil M, Almubarak YA, Alnafie AN, Alshahrani M, Alshehri AM, Anning C, Anthonio RL, Badings EA, Ball C, van Beek EA, ten Berg JM, von Bergwelt-Baildon M, Bianco M, Blagova OV, Bleijendaal H, Bor WL, Borgmann S, van Boxem AJM, van den Brink FS, Bucciarelli-Ducci C, van Bussel BCT, Byrom-Goulthorp R, Captur G, Caputo M, Charlotte N, vom Dahl J, Dark P, De Sutter J, Degenhardt C, Delsing CE, Dolff S, Dorman HGR, Drost JT, Eberwein L, Emans ME, Er AG, Ferreira JB, Forner MJ, Friedrichs A, Gabriel L, Groenemeijer BE, Groenendijk AL, Grüner B, Guggemos W, Haerkens-Arends HE, Hanses F, Hedayat B, Heigener D, van der Heijden DJ, Hellou E, Hellwig K, Henkens MTHM, Hermanides RS, Hermans WRM, van Hessen MWJ, Heymans SRB, Hilt AD, van der Horst ICC, Hower M, van Ierssel SH, Isberner N, Jensen B, Kearney MT, van Kesteren HAM, Kielstein JT, Kietselaer BLJH, Kochanek M, Kolk MZH, Koning AMH, Kopylov PY, Kuijper AFM, Kwakkel-van Erp JM, Lanznaster J, van der Linden MMJM, van der Lingen ACJ, Linssen GCM, Lomas D, Maarse M, Macías Ruiz R, Magdelijns FJH, Magro M, Markart P, Martens FMAC, Mazzilli SG, McCann GP, van der Meer P, Meijs MFL, Merle U, Messiaen P, Milovanovic M, Monraats PS, Montagna L, Moriarty A, Moss AJ, Mosterd A, Nadalin S, Nattermann J, Neufang M, Nierop PR, Offerhaus JA, van Ofwegen-Hanekamp CEE, Parker E, Persoon AM, Piepel C, Pinto YM, Poorhosseini H, Prasad S, Raafs AG, Raichle C, Rauschning D, Redón J, Reidinga AC, Ribeiro MIA, Riedel C, Rieg S, Ripley DP, Römmele C, Rothfuss K, Rüddel J, Rüthrich MM, Salah R, Saneei E, Saxena M, Schellings DAAM, Scholte NTB, Schubert J, Seelig J, Shafiee A, Shore AC, Spinner C, Stieglitz S, Strauss R, Sturkenboom NH, Tessitore E, Thomson RJ, Timmermans P, Tio RA, Tjong FVY, Tometten L, Trauth J, den Uil CA, Van Craenenbroeck EM, van Veen HPAA, Vehreschild MJGT, Veldhuis LI, Veneman T, Verschure DO, Voigt I, de Vries JK, van de Wal RMA, Walter L, van de Watering DJ, Westendorp ICD, Westendorp PHM, Westhoff T, Weytjens C, Wierda E, Wille K, de With K, Worm M, Woudstra P, Wu KW, Zaal R, Zaman AG, van der Zee PM, Zijlstra LE, Alling TE, Ahmed R, van Aken K, Bayraktar-Verver ECE, Bermúdez Jiménes FJ, Biolé CA, den Boer-Penning P, Bontje M, Bos M, Bosch L, Broekman M, Broeyer FJF, de Bruijn EAW, Bruinsma S, Cardoso NM, Cosyns B, van Dalen DH, Dekimpe E, Domange J, van Doorn JL, van Doorn P, Dormal F, Drost IMJ, Dunnink A, van Eck JWM, Elshinawy K, Gevers RMM, Gognieva DG, van der Graaf M, Grangeon S, Guclu A, Habib A, Haenen NA, Hamilton K, Handgraaf S, Heidbuchel H, Hendriks-van Woerden M, Hessels-Linnemeijer BM, Hosseini K, Huisman J, Jacobs TC, Jansen SE, Janssen A, Jourdan K, ten Kate GL, van Kempen MJ, Kievit CM, Kleikers P, Knufman N, van der Kooi SE, Koole BAS, Koole MAC, Kui KK, Kuipers-Elferink L, Lemoine I, Lensink E, van Marrewijk V, van Meerbeeck JP, Meijer EJ, Melein AJ, Mesitskaya DF, van Nes CPM, Paris FMA, Perrelli MG, Pieterse-Rots A, Pisters R, Pölkerman BC, van Poppel A, Reinders S, Reitsma MJ, Ruiter AH, Selder JL, van der Sluis A, Sousa AIC, Tajdini M, Tercedor Sánchez L, Van De Heyning CM, Vial H, Vlieghe E, Vonkeman HE, Vreugdenhil P, de Vries TAC, Willems AM, Wils AM, Zoet-Nugteren SK. Clinical presentation, disease course, and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease: a cohort study across 18 countries. Eur Heart J 2022; 43:1104-1120. [PMID: 34734634 DOI: 10.1093/eurheartj/ehab656] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. METHODS AND RESULTS We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66-75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02-1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10-1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20-1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. CONCLUSION Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
Collapse
|
50
|
Ahmed R, Zaman T, Chowdhury F, Mraiche F, Tariq M, Ahmad IS, Hasan A. Single-Cell RNA Sequencing with Spatial Transcriptomics of Cancer Tissues. Int J Mol Sci 2022; 23:3042. [PMID: 35328458 PMCID: PMC8955933 DOI: 10.3390/ijms23063042] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/02/2022] [Accepted: 03/07/2022] [Indexed: 01/27/2023] Open
Abstract
Single-cell RNA sequencing (RNA-seq) techniques can perform analysis of transcriptome at the single-cell level and possess an unprecedented potential for exploring signatures involved in tumor development and progression. These techniques can perform sequence analysis of transcripts with a better resolution that could increase understanding of the cellular diversity found in the tumor microenvironment and how the cells interact with each other in complex heterogeneous cancerous tissues. Identifying the changes occurring in the genome and transcriptome in the spatial context is considered to increase knowledge of molecular factors fueling cancers. It may help develop better monitoring strategies and innovative approaches for cancer treatment. Recently, there has been a growing trend in the integration of RNA-seq techniques with contemporary omics technologies to study the tumor microenvironment. There has been a realization that this area of research has a huge scope of application in translational research. This review article presents an overview of various types of single-cell RNA-seq techniques used currently for analysis of cancer tissues, their pros and cons in bulk profiling of transcriptome, and recent advances in the techniques in exploring heterogeneity of various types of cancer tissues. Furthermore, we have highlighted the integration of single-cell RNA-seq techniques with other omics technologies for analysis of transcriptome in their spatial context, which is considered to revolutionize the understanding of tumor microenvironment.
Collapse
Affiliation(s)
- Rashid Ahmed
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Centre, Qatar University, Doha 2713, Qatar
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250 AJK, Pakistan;
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA;
| | - Tariq Zaman
- College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA;
| | - Farhan Chowdhury
- Department of Mechanical Engineering and Energy Processes, Southern Illinois University Carbondale, Carbondale, IL 62901, USA;
| | - Fatima Mraiche
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha 2713, Qatar;
| | - Muhammad Tariq
- Department of Biotechnology, Faculty of Natural and Applied Sciences, Mirpur University of Science and Technology, Mirpur 10250 AJK, Pakistan;
| | - Irfan S. Ahmad
- Nick Holonyak Jr. Micro and Nanotechnology Laboratory, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA;
- Department of Agricultural and Biological Engineering, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA
- Carle Illinois College of Medicine, University of Illinois at Urbana Champaign, Urbana, IL 61801, USA
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha 2713, Qatar
- Biomedical Research Centre, Qatar University, Doha 2713, Qatar
| |
Collapse
|