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Nogueira RG, Pinheiro A, Brinjikji W, Abbasi M, Al-Bayati AR, Mohammaden MH, Souza Viana L, Ferreira F, Abdelhamid H, Bhatt NR, Kvamme P, Layton KF, Delgado Almandoz JE, Hanel RA, Mendes Pereira V, Almekhlafi MA, Yoo AJ, Jahromi BS, Gounis MJ, Patel B, Arturo Larco JL, Fitzgerald S, Mereuta OM, Doyle K, Savastano LE, Cloft HJ, Thacker IC, Kayan Y, Copelan A, Aghaebrahim A, Sauvageau E, Demchuk AM, Bhuva P, Soomro J, Nazari P, Cantrell DR, Puri AS, Entwistle J, Polley EC, Frankel MR, Kallmes DF, Haussen DC. Clot composition and recanalization outcomes in mechanical thrombectomy. J Neurointerv Surg 2024; 16:466-470. [PMID: 37419694 DOI: 10.1136/jnis-2023-020117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/24/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Mechanical thrombectomy (MT) has become standard for large vessel occlusions, but rates of complete recanalization are suboptimal. Previous reports correlated radiographic signs with clot composition and a better response to specific techniques. Therefore, understanding clot composition may allow improved outcomes. METHODS Clinical, imaging, and clot data from patients enrolled in the STRIP Registry from September 2016 to September 2020 were analyzed. Samples were fixed in 10% phosphate-buffered formalin and stained with hematoxylin-eosin and Martius Scarlett Blue. Percent composition, richness, and gross appearance were evaluated. Outcome measures included the rate of first-pass effect (FPE, modified Thrombolysis in Cerebral Infarction 2c/3) and the number of passes. RESULTS A total of 1430 patients of mean±SD age 68.4±13.5 years (median (IQR) baseline National Institutes of Health Stroke Scale score 17.2 (10.5-23), IV-tPA use 36%, stent-retrievers (SR) 27%, contact aspiration (CA) 27%, combined SR+CA 43%) were included. The median (IQR) number of passes was 1 (1-2). FPE was achieved in 39.3% of the cases. There was no association between percent histological composition or clot richness and FPE in the overall population. However, the combined technique resulted in lower FPE rates for red blood cell (RBC)-rich (P<0.0001), platelet-rich (P=0.003), and mixed (P<0.0001) clots. Fibrin-rich and platelet-rich clots required a higher number of passes than RBC-rich and mixed clots (median 2 and 1.5 vs 1, respectively; P=0.02). CA showed a trend towards a higher number of passes with fibrin-rich clots (2 vs 1; P=0.12). By gross appearance, mixed/heterogeneous clots had lower FPE rates than red and white clots. CONCLUSIONS Despite the lack of correlation between clot histology and FPE, our study adds to the growing evidence supporting the notion that clot composition influences recanalization treatment strategy outcomes.
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Affiliation(s)
| | | | | | - Mehdi Abbasi
- Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | | | | | - Nirav R Bhatt
- UPMC Stroke Institute, Pittsburgh, Pennsylvania, USA
| | - Peter Kvamme
- Radiology, University of Tennessee Medical Center, Knoxville, Tennessee, USA
| | - Kennith F Layton
- NeuroInterventional Radiology, Baylor University Medical Center, Dallas, Texas, USA
| | | | - Ricardo A Hanel
- Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA
| | - Vitor Mendes Pereira
- Division of Neuroradiology, Department of Medical Imaging and Division of Neurosurgery, Department of Surgery, University Health Network - Toronto Western Hospital, Toronto, Ontario, Canada
| | - Mohammed A Almekhlafi
- Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Albert J Yoo
- Neurointervention, Texas Stroke Institute, Plano, Texas, USA
| | - Babak S Jahromi
- Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Matthew J Gounis
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Biraj Patel
- Radiology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Radiology, Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA
| | | | | | - Oana Madalina Mereuta
- Radiology, Mayo Clinic, Rochester, Minnesota, USA
- CÚRAM-SFI Research Centre for Medical Devices and Physiology Department, National University of Ireland Galway, Galway, Ireland
| | - Karen Doyle
- Physiology, CURAM, National University of Ireland Galway, Galway, Ireland
| | | | | | - Ike C Thacker
- NeuroInterventional Radiology, Baylor University Medical Center, Dallas, Texas, USA
| | - Yasha Kayan
- Interventional Neuroradiology, Abbot Northwestern Hospital, 55435, Minnesota, USA
| | - Alexander Copelan
- NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Amin Aghaebrahim
- Lyerly Neurosurgery, Baptist Health System, Jacksonville, Florida, USA
| | - Eric Sauvageau
- Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA
| | - Andrew M Demchuk
- Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- University of Calgary, Calgary, Alberta, Canada
| | - Parita Bhuva
- Neuroendovascular Surgery, Texas Stroke Institute, Plano, Texas, USA
| | - Jazba Soomro
- Neurointervention, Texas Stroke Institute, Plano, Texas, USA
| | - Pouya Nazari
- Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Neurosurgery and Radiology, Northwestern University, Chicago, Illinois, USA
| | | | - Ajit S Puri
- Radiology, University of Massachusetts, Worcester, Massachusetts, USA
| | - John Entwistle
- Radiology, Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA
| | | | - Michael R Frankel
- Department of Neurology, Emory University Atlanta, Atlanta, Georgia, USA
- Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Atlanta, Georgia, USA
| | | | - Diogo C Haussen
- Neurology and Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
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Ball J, Neumann JT, Tonkin AM, Kirchhof P, Freedman B, Brodtmann A, Reid C, Nelson MR, Beilin LJ, Fitzgerald S, Stub D, Woods RL, McNeil JJ. Low-dose aspirin and incident atrial fibrillation in healthy older individuals: a post-hoc analysis of the ASPREE trial. Eur Heart J Cardiovasc Pharmacother 2024; 10:81-82. [PMID: 37951294 PMCID: PMC10766903 DOI: 10.1093/ehjcvp/pvad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/13/2023]
Affiliation(s)
- J Ball
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - J T Neumann
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg—Eppendorf, 20251 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), 10785 Berlin, Germany
| | - A M Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - P Kirchhof
- University Heart and Vascular Center Hamburg, University Medical Center Hamburg—Eppendorf, 20251 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), 10785 Berlin, Germany
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - B Freedman
- Heart Rhythm and Stroke Group, Heart Research Institute, Sydney 2042, Australia
- Charles Perkins Centre, The University of Sydney, Sydney 2050, Australia
| | - A Brodtmann
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne 3004, Australia
| | - C Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- School of Population Health, Curtin University, Perth, Western Australia 6102, Australia
| | - M R Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - L J Beilin
- UWA Medical School, University of Western Australia, Perth 6009, Australia
| | - S Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - D Stub
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
- Department of Cardiology, Alfred Health, Melbourne, Victoria 3004, Australia
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - J J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
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Gautam R, Ahmed R, Haugen E, Unal M, Fitzgerald S, Uppuganti S, Mahadevan-Jansen A, Nyman JS. Assessment of spatially offset Raman spectroscopy to detect differences in bone matrix quality. Spectrochim Acta A Mol Biomol Spectrosc 2023; 303:123240. [PMID: 37591015 PMCID: PMC10528408 DOI: 10.1016/j.saa.2023.123240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
Since spatially offset Raman spectroscopy (SORS) can acquire biochemical measurements of tissue quality through light scattering materials, we investigated the feasibility of this technique to acquire Raman bands related to the fracture resistance of bone. Designed to maximize signals at different offsets, a SORS probe was used to acquire spectra from cadaveric bone with and without skin-like tissue phantoms attenuating the light. Autoclaving the lateral side of femur mid-shafts from 5 female and 5 male donors at 100 °C and again at 120 °C reduced the yield stress of cortical beams subjected to three-point bending. It did not affect the volumetric bone mineral density or porosity. Without tissue phantoms, autoclaving affected more Raman characteristics of the organic matrix when determined by peak intensity ratios, but fewer matrix properties depended on the three offsets (5 mm, 6 mm, and 7 mm) when determined by band area ratios. The cut-off in the thickness of the tissue phantom layers was ∼4 mm for most properties, irrespective of offset. Matching trends when spectra were acquired without phantom layers between bone and the probe, ν1PO43-/Amide III and ν1PO43-/(proline + OH-proline) were higher and lower in the non-treated bone than in the autoclaved bone, respectively, when the thickness of tissue phantom layers was 4 mm. The layers, however, caused a loss of sensitivity to autoclaving-related changes in ν3CO3/ν1PO43- and crystallinity. Without advanced post-processing of Raman spectra, SORS acquisition through turbid layers can detect changes in Raman properties of bone that accompany a loss in bone strength.
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Affiliation(s)
- Rekha Gautam
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Biophotonics@Tyndall, IPIC, Tyndall National Institute, Cork, Ireland
| | - Rafay Ahmed
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA
| | - Ezekiel Haugen
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA
| | - Mustafa Unal
- Department of Bioengineering, Karamanoglu Mehmetbey University, Karaman, 70200, Turkey; Department of Biophysics, Faculty of Medicine, Karamanoglu Mehmetbey University, Karaman 70200, Turkey
| | - Sean Fitzgerald
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA
| | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA
| | - Anita Mahadevan-Jansen
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Vanderbilt Biophotonics Center, 410 24th Ave. S., Nashville, TN 37232, USA
| | - Jeffry S Nyman
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN 37232, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, 1310 24th Ave. S., Nashville, TN 37212, USA.
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Fitzgerald S, Wilson H, Brenan M, Rai H, Begossi N, Blake N, McCann H, Blake G, Colleran R, Hanratty CG, Byrne RA. Initial findings with the PATient experience in the CATH Lab (PATCATH) patient-reported experience metric. EUROINTERVENTION 2023; 19:e860-e862. [PMID: 37555643 PMCID: PMC10687643 DOI: 10.4244/eij-d-23-00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/28/2023] [Indexed: 08/10/2023]
Affiliation(s)
- Sean Fitzgerald
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Hannah Wilson
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Maureen Brenan
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Himanshu Rai
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Nicoletta Begossi
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Nial Blake
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
| | - Hugh McCann
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
| | - Gavin Blake
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
| | - Róisín Colleran
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm G Hanratty
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
| | - Robert A Byrne
- Cardiovascular Research Institute (CVRI) Dublin and Department of Cardiology, Mater Private Network, Dublin, Ireland
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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5
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Traynor BP, Fitzgerald S, Alfonso F, O'Kane P, Sabaté M, Tölg R, Trevelyan J, Hahn JY, Mylotte D, Wöhrle J, Rai H, Cortese B, Morice MC, Schuette D, Copt S, Oldroyd KG, Byrne RA. Design and rationale of a prospective, randomized, non-inferiority trial to determine the safety and efficacy of the Biolimus A9™ drug coated balloon for the treatment of in-stent restenosis: First-in-man trial (REFORM). Cardiovasc Revasc Med 2023; 56:75-81. [PMID: 37328392 DOI: 10.1016/j.carrev.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/29/2023] [Accepted: 06/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Drug-coated balloon (DCB) angioplasty with paclitaxel-eluting devices is an established treatment for coronary in-stent restenosis (ISR). Biolimus A9™ (BA9), a sirolimus analogue with enhanced lipophilicity, may facilitate enhanced local drug delivery into vascular tissue. A novel DCB coated with Biolimus A9™ represents an alternative to traditional paclitaxel- and sirolimus-coated devices. Hence, we sought to investigate the safety and efficacy of this novel DCB in the treatment of coronary ISR. METHODS AND DESIGN REFORM (NCT04079192) is a prospective, multicenter, single blind, randomized controlled trial comparing the BA9-DCB (Biosensors Europe SA, Morges, Switzerland) to the paclitaxel-coated SeQuent® Please DCB (Braun Melsungen AG, Germany) in the treatment of coronary ISR. A total of 201 patients with coronary artery disease and an indication for interventional treatment of ISR in a bare-metal stent (BMS) or drug-eluting stent (DES) have been randomized 2:1 to receive treatment with the BA9- or the paclitaxel-DCB comparator. Patients were enrolled across 24 investigational centers in Europe and Asia. The primary endpoint is percent diameter stenosis (%DS) of the target segment as assessed by quantitative coronary angiography (QCA) at 6 months. Key secondary endpoints are in-stent late lumen loss, binary restenosis, target lesion failure, target vessel failure, myocardial infarction and death at 6 months. Subjects will be followed for 24 months from enrolment. IMPLICATIONS The REFORM trial will seek to prove that the BA9-DCB is non-inferior to the standard paclitaxel-DCB comparator in the treatment of coronary ISR with respect to %DS at 6 months and has similar safety characteristics.
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Affiliation(s)
- Bryan P Traynor
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Sean Fitzgerald
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fernando Alfonso
- Cardiology Department, Hospital Universitario de la Princesa, IIS-IP, CIBER-CV, Madrid, Spain
| | | | - Manel Sabaté
- Barcelona Hospital Clinic, Cardiology, Barcelona, Spain
| | - Ralph Tölg
- Heart Centre, Segeberger Kliniken, Bad Segeberg, Germany
| | | | - Joo-Yong Hahn
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Darren Mylotte
- Galway University Hospital, SAOLTA Health Care Group, and National University of Ireland, Galway, Ireland
| | - Jochen Wöhrle
- Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany
| | - Himanshu Rai
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Bernardo Cortese
- Interventional Cardiology, Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy
| | | | | | | | | | - Robert A Byrne
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
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6
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Rai H, Fitzgerald S, Coughlan JJ, Spence M, Colleran R, Joner M, Byrne RA. Glu298Asp variant of the endothelial nitric oxide synthase gene and acute coronary syndrome or premature coronary artery disease: A systematic review and meta-analysis. Nitric Oxide 2023; 138-139:85-95. [PMID: 37451608 DOI: 10.1016/j.niox.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/27/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Several published studies have reported an association between the Glu298Asp polymorphism (rs1799983), residing in the endothelial nitric oxide synthase (NOS3) gene, and lower levels of circulating nitric oxide, as well as an increased risk of coronary artery disease (CAD). However, association status of this genetic variant with acute coronary syndrome (ACS) or premature CAD (PCAD) is still unclear. Against this background, we conducted a systematic review and study level meta-analysis to assess the association of the NOS3 Glu298Asp polymorphism with ACS or PCAD. MATERIALS AND METHODS A comprehensive online search to identify relevant studies was performed on several databases including PubMed, EMBASE, MEDLINE, Scopus, Cochrane library and Web of Science. The identified studies were stratified into two ancestral subgroups: 'European ancestry' and 'All other ancestries combined'. Study level odds ratios (ORs) and their 95% confidence intervals (CI) were pooled using random/fixed effects employing a Z test. RESULTS Out of a total of 195 distinct records identified through online search, 37 articles with 39 different studies, with a total sample size of 27,441 (11,516 cases/15,925 controls) were included for quantitative synthesis. Pooled results suggested significant associations of the NOS3 Glu298Asp polymorphism with ACS or PCAD through dominant as well as allelic genetic models (p ≤ 0.002), primarily driven by the 'All other ancestries combined' subgroup. The 'All other ancestries combined' subgroup demonstrated an additional risk of 36% for ACS or PCAD, through both dominant and allelic genetic models (OR = 1.36, 95%CI = 1.13, 1.63, p = 0.001 and OR = 1.36, 95%CI = 1.14, 1.61, p = 0.0005 respectively). On the other hand, the 'European ancestry' subgroup did not show any significant associations. Sensitivity analysis and a sub-analysis for the myocardial infarction endpoint further supported these observed associations. CONCLUSIONS This meta-analysis indicates towards an association between the NOS3 Glu298Asp polymorphism and ACS or PCAD, predominantly driven by 'All other ancestries combined' subgroup. In contrast, the 'European ancestry' subgroup did not demonstrate any significant association. Further large-scale investigations are required to confirm our derived results.
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Affiliation(s)
- Himanshu Rai
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Sean Fitzgerald
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - J J Coughlan
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland
| | - Mark Spence
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Anatomy and Regenerative Medicine, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Roisin Colleran
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Robert A Byrne
- Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Fitzgerald S, Marple E, Mahadevan-Jansen A. Performance assessment of probe-based Raman spectroscopy systems for biomedical analysis. Biomed Opt Express 2023; 14:3597-3609. [PMID: 37497480 PMCID: PMC10368060 DOI: 10.1364/boe.494289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 07/28/2023]
Abstract
We present a methodology for evaluating the performance of probe-based Raman spectroscopy systems for biomedical analysis. This procedure uses a biological standard sample and data analysis approach to circumvent many of the issues related to accurately measuring and comparing the signal quality of Raman spectra between systems. Dairy milk is selected as the biological standard due to its similarity to tissue spectral properties and because its homogeneity eliminates the dependence of probe orientation on the measured spectrum. A spectral dataset is first collected from milk for each system configuration, followed by a model-based correction step to remove photobleaching artifacts and accurately calculate SNR. Results demonstrate that the proposed strategy, unlike current methods, produces an experimental SNR that agrees with the theoretical value. Four preconfigured imaging spectrographs that share similar manufacturer specifications were compared, showing that their capabilities to detect biological Raman spectra widely differ in terms of throughput and stray light rejection. While the methodology is used to compare spectrographs in this case, it can be adapted for other purposes, such as optimizing the design of a custom-built Raman spectrometer, evaluating inter-probe variability, or examining how altering system subcomponents affects signal quality.
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Affiliation(s)
- Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Eric Marple
- EmVision LCC, 1471 F Road, Loxahatchee, FL 33470, USA
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
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Fitzgerald S, Akhtar J, Schartner E, Ebendorff-Heidepriem H, Mahadevan-Jansen A, Li J. Multimodal Raman spectroscopy and optical coherence tomography for biomedical analysis. J Biophotonics 2023; 16:e202200231. [PMID: 36308009 PMCID: PMC10082563 DOI: 10.1002/jbio.202200231] [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] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Optical techniques hold great potential to detect and monitor disease states as they are a fast, non-invasive toolkit. Raman spectroscopy (RS) in particular is a powerful label-free method capable of quantifying the biomolecular content of tissues. Still, spontaneous Raman scattering lacks information about tissue morphology due to its inability to rapidly assess a large field of view. Optical Coherence Tomography (OCT) is an interferometric optical method capable of fast, depth-resolved imaging of tissue morphology, but lacks detailed molecular contrast. In many cases, pairing label-free techniques into multimodal systems allows for a more diverse field of applications. Integrating RS and OCT into a single instrument allows for both structural imaging and biochemical interrogation of tissues and therefore offers a more comprehensive means for clinical diagnosis. This review summarizes the efforts made to date toward combining spontaneous RS-OCT instrumentation for biomedical analysis, including insights into primary design considerations and data interpretation.
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Affiliation(s)
- Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jobaida Akhtar
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Erik Schartner
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Heike Ebendorff-Heidepriem
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jiawen Li
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, South Australia, Australia
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Nogueira RG, Pinheiro A, Brinjikji W, Abbasi M, Al-Bayati AR, Mohammaden M, Viana LS, Ferreira F, Abdelhamid HM, Bhatt N, Kvamme P, Layton K, Delgado Almandoz J, Hanel R, Mendes Pereira V, Almekhlafi M, Yoo AJ, Jahromi BS, Gounis MJ, Patel BM, Arturo Larco J, Fitzgerald S, Mereuta OM, Doyle K, Savastano L, Cloft HJ, Thacker I, Kayan Y, Copelan A, Aghaebrahim A, Sauvageau E, Demchuk AM, Bhuva P, Soomro J, Nazari P, Cantrell D, Puri AS, Entwistle J, Polley EC, Frankel MR, Kallmes DF, Haussen DC. Abstract 99: Clot Composition And Reperfusion Outcomes In 1430 Mechanical Thrombectomy Patients: Analysis Of The Stroke Thromboembolism Registry Of Imaging And Pathology. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.99] [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:
Understanding clot composition may allow for better technical planning and improved outcomes in mechanical thrombectomy (MT). We sought to correlate clot composition with reperfusion outcomes in MT.
Methods:
Clinical, imaging, and clot data from patients enrolled in the STRIP Registry from September 2016 to September 2020 were analyzed. Samples were fixed in 10% phosphate-buffered formalin and stained with hematoxylin and eosin and Martius Scarlett Blue. Percent composition, richness, and gross appearance were evaluated. Outcome measures included the rate of First-Pass Effect (mTICI2c/3, FPE) and the number of device passes.
Results:
A total of 1430 patients (mean age, 68.4±13.5years; median [IQR] baseline NIHSS,17.2 [10.5-23]; IV-tPA use, 36%; Stent-Retrievers [SR], 27%; Contact Aspiration [CA], 27%; Combined SR + CA, 43%) were included. The median [IQR] number of passes was 1 [1-2]. FPE was achieved in 39.3% of the cases. There was no association between percent histological composition or clot richness and FPE in the overall population. However, the combined technique resulted in lower FPE rates for RBC-rich (P<0.0001), platelet-rich (P=0.003), and mixed (P<0.0001) clots. Fibrin-rich and platelet-rich clots required a higher number of passes compared to RBC-rich and mixed clots (median, 2 and 1.5 vs.1, respectively, P=0.02). CA displayed a trend towards a higher number of passes with fibrin-rich clots (2 vs.1, P=0.12). By gross appearance, mixed/heterogeneous clots had lower FPE rates than red and white clots.
Conclusion:
Despite the lack of correlation between clot histology and FPE in the overall population, our study adds to the growing body of evidence supporting the notion that clot composition influences reperfusion treatment strategy outcomes. Additional studies are needed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ricardo Hanel
- Neurosurgery, Baptist Med Cntr Jacksonville, Jacksonville, FL
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jazba Soomro
- Neurointervention, Texas Stroke Institute, Dallas-Fort Worth, TX
| | | | | | | | | | - Eric C Polley
- Div of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN
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10
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Fitzgerald S, Gimenez MR, Allali A, Toelg R, Sulimov DS, Geist V, Kastrati A, Thiele H, Richardt G, Abdel-Wahab M. Sex-specific Inequalities in the Treatment of Severely Calcified Coronary Lesions: A Sub-analysis of the PREPARE-CALC Trial. Interv Cardiol 2023; 18:e02. [PMID: 36891034 PMCID: PMC9987508 DOI: 10.15420/icr.2022.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/06/2022] [Accepted: 06/09/2022] [Indexed: 01/21/2023] Open
Abstract
Background: Coronary vessels in women may have anatomical and histological particularities. The aim of this study was to investigate sex-specific characteristics and outcomes of patients with calcified coronary arteries in the Prepare-CALC (Comparison of Strategies to Prepare Severely Calcified Coronary Lesions) trial. Methods: The Prepare-CALC trial randomised patients with severe coronary calcification to coronary lesion preparation either using modified balloons (MB; cutting or scoring) or rotational atherectomy (RA). Results: Of 200 randomised patients, 24% were women. Strategy success in general was similar between women (93.8%) and men (88.2%; p=0.27). For men, strategy success was significantly more common with an RA-based strategy than an MB-based strategy (98.7% in the RA group versus 77.3% in the MB group, p<0.001), whereas for women there was no evidence of a significant difference in strategy success between RA and MB (95.7% in the RA group versus 92% in the MB group, p>0.99, p for interaction between sex and treatment strategy=0.03). Overall, significant complications such as death, MI, stent thrombosis, bypass operation and perforations were rare and did not differ significantly by gender or treatment strategy. Plaque rupture and disrupted calcified nodules were more common in women. Conclusion: In a well-defined patient population with severely calcified coronary arteries, lesion preparation with an RA-strategy was superior to an MB-strategy in men. For women, both RA and MB strategies appear to have a similar success rate, although definitive conclusions are limited due to the small number of women in the trial.
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Affiliation(s)
- Sean Fitzgerald
- Heart Center Leipzig Leipzig, Germany.,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences Dublin, Ireland
| | | | | | - Ralph Toelg
- Heart Center, Segeberger Kliniken Bad Segeberg, Germany
| | | | - Volker Geist
- Heart Center, Segeberger Kliniken Bad Segeberg, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technical University of Munich Germany
| | | | - Gert Richardt
- Heart Center, Segeberger Kliniken Bad Segeberg, Germany
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11
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Pinotsis DA, Fitzgerald S, See C, Sementsova A, Widge AS. Toward biophysical markers of depression vulnerability. Front Psychiatry 2022; 13:938694. [PMID: 36329919 PMCID: PMC9622949 DOI: 10.3389/fpsyt.2022.938694] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
A major difficulty with treating psychiatric disorders is their heterogeneity: different neural causes can lead to the same phenotype. To address this, we propose describing the underlying pathophysiology in terms of interpretable, biophysical parameters of a neural model derived from the electroencephalogram. We analyzed data from a small patient cohort of patients with depression and controls. Using DCM, we constructed biophysical models that describe neural dynamics in a cortical network activated during a task that is used to assess depression state. We show that biophysical model parameters are biomarkers, that is, variables that allow subtyping of depression at a biological level. They yield a low dimensional, interpretable feature space that allowed description of differences between individual patients with depressive symptoms. They could capture internal heterogeneity/variance of depression state and achieve significantly better classification than commonly used EEG features. Our work is a proof of concept that a combination of biophysical models and machine learning may outperform earlier approaches based on classical statistics and raw brain data.
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Affiliation(s)
- D. A. Pinotsis
- Centre for Mathematical Neuroscience and Psychology, Department of Psychology, City, University of London, London, United Kingdom
- The Picower Institute for Learning and Memory, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - S. Fitzgerald
- Centre for Mathematical Neuroscience and Psychology, Department of Psychology, City, University of London, London, United Kingdom
| | - C. See
- Department of Computer Science, City, University of London, London, United Kingdom
| | - A. Sementsova
- Department of Computer Science, City, University of London, London, United Kingdom
| | - A. S. Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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12
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Rheude T, Fitzgerald S, Allali A, Mashayekhi K, Gori T, Cuculi F, Kufner S, Hemetsberger R, Sulimov DS, Rai H, Ayoub M, Bossard M, Xhepa E, Fusaro M, Toelg R, Joner M, Byrne RA, Richardt G, Kastrati A, Cassese S, Abdel-Wahab M. Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely Calcified Coronary Lesions. JACC Cardiovasc Interv 2022; 15:1864-1874. [PMID: 36137691 DOI: 10.1016/j.jcin.2022.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND The comparative efficacy of percutaneous techniques for the preparation of calcified lesions before stenting remains poorly studied. OBJECTIVES This study sought to compare the performance of up-front rotational atherectomy (RA) or balloon-based techniques before drug-eluting stent implantation in severely calcified coronary lesions as assessed by angiography and optical coherence tomography (OCT). METHODS Patient-level data from the PREPARE-CALC (Comparison of Strategies to Prepare Severely Calcified Coronary Lesions) and ISAR-CALC (Comparison of Strategies to Prepare Severely Calcified Coronary Lesions) randomized trials were pooled. The primary endpoint was stent expansion as assessed by OCT imaging. The secondary endpoints included stent eccentricity, stent asymmetry, angiographic acute lumen gain, strategy success and in-hospital occurrence of cardiac death, target vessel myocardial infarction, and repeat revascularization. RESULTS Among 274 patients originally randomized, 200 participants with available OCT data after lesion preparation with RA (n = 63), a modified balloon (MB, n = 103), or a super high-pressure balloon (n = 34) before stenting were analyzed. The use of RA versus MB or a super high-pressure balloon led to comparable stent expansion (73.2% ± 11.6% vs 70.8% ± 13.6% vs 71.8% ± 12.2%, P = 0.49) and stent asymmetry (P = 0.83). Compared with RA or MB, a super high-pressure balloon was associated with less stent eccentricity (P = 0.03) with a numerically higher acute lumen gain, albeit not significantly different (P = 0.08). Strategy success was more frequent with RA versus MB (P = 0.002) and numerically more frequent with RA versus a super high-pressure balloon (P = 0.06). Clinical outcomes did not differ between groups. CONCLUSIONS In patients with severely calcified lesions undergoing drug-eluting stent implantation, lesion preparation with RA, MB, or a super high-pressure balloon was associated with comparable stent expansion. A super high-pressure balloon is associated with less stent eccentricity, whereas strategy success is more frequent with RA.
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Affiliation(s)
- Tobias Rheude
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany
| | - Sean Fitzgerald
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Kambis Mashayekhi
- Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Tommaso Gori
- Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Germany
| | - Florim Cuculi
- Department of Cardiology, Kantonspital Luzern, Switzerland
| | - Sebastian Kufner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany
| | - Rayyan Hemetsberger
- Klinik für Kardiologie und Angiologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum, Bochum, Germany
| | - Dmitriy S Sulimov
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | - Himanshu Rai
- Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mohamed Ayoub
- Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | - Erion Xhepa
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany
| | - Massimiliano Fusaro
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany; Klinik für Kardiologie und Angiologie, Zollernalb-Klinikum, Albstadt, Germany
| | - Ralph Toelg
- Heart Center, Segeberger Kliniken, Bad Segeberg, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
| | - Robert A Byrne
- Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, Ireland; School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Gert Richardt
- Heart Center, Segeberger Kliniken, Bad Segeberg, Germany
| | - Adnan Kastrati
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
| | - Salvatore Cassese
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Munich, Germany.
| | - Mohamed Abdel-Wahab
- Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
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13
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Granahan A, McCavana J, Lally A, Morgan I, Fitzgerald S, Moriarty B. A review of the selection process and decontamination methods with the use of face shields in UV phototherapy during the SARS‐CoV‐2 pandemic. Skin Health and Disease 2022; 2:e97. [PMID: 35941939 PMCID: PMC9348456 DOI: 10.1002/ski2.97] [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] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/08/2022]
Abstract
Targeted ultraviolet (UV) phototherapy has been used in the management of a wide variety of dermatological clinical conditions including moderate to severe psoriasis unresponsive to topical therapies, vitiligo, severe atopic dermatitis and lymphoproliferative disorders. To date there are no uniform, standardised guidelines for the selection and decontamination process for UV personal protective equipment (PPE) and facial shields used in phototherapy. In the current climate, Coronavirus 2019 (COVID‐19) pandemic, standards regarding all decontamination and disinfection processes are under significant scrutiny. In terms of the UV‐PPE and facial shields used in phototherapy, careful disinfection procedures need to be implemented to ensure that the decontamination practice is effective enough to neutralise the virulent virus whilst maintaining maximal protection to the user from UV‐rays and safeguard the equipment from damage during the cleaning process. The aim of this report is to provide an evidence based review of the current and international practice standards guiding the selection, use and decontamination processes of UV facial shields in phototherapy. The complications and concerns that the COVID‐19 pandemic has had on this practice is highlighted. As such, we performed a comprehensive evaluation of the literature to provide recommendations as to the most effective, time efficient and safest practices for disinfection and decontamination of UV facial shields used in phototherapy during these unprecedented times.
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Affiliation(s)
- A. Granahan
- Department of Dermatology St. Vincent’s University Hospital Dublin Ireland
| | - J. McCavana
- Department of Medical Physics St. Vincent’s University Hospital Dublin Ireland
| | - A. Lally
- Department of Dermatology St. Vincent’s University Hospital Dublin Ireland
| | - I. Morgan
- Department of Dermatology St. Vincent’s University Hospital Dublin Ireland
| | - S. Fitzgerald
- Medical Microbiology and Infection Control St. Vincent’s University Hospital Dublin Ireland
| | - B. Moriarty
- Department of Dermatology St. Vincent’s University Hospital Dublin Ireland
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14
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Park S, Perlin DS, Fitzgerald S, Petraitis V, Walsh TJ. Focused multivector ultraviolet (FMUV) technology rapidly eradicates SARS-CoV-2 in-vitro: Implications for hospital disinfection of COVID-19 environments. Am J Infect Control 2022; 50:828-830. [PMID: 35151772 PMCID: PMC8830925 DOI: 10.1016/j.ajic.2022.02.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/27/2022]
Abstract
Focused Multivector Ultraviolet technology rapidly killed the SARS-CoV-2 coronavirus in-vitro. Plates were inoculated with a mean of greater than 106 plaque forming units of USA-WA1 Washington index patient strain of SARS-CoV-2 and exposed to ultraviolet, resulting in mean reductions of 99.99% within 30 seconds, 99.999% within 60 seconds, and 99.9999% within 90 seconds. These results support the effectiveness of Focused Multivector Ultraviolet technology for SARS-CoV-2 disinfection.
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Affiliation(s)
- Steven Park
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, NJ
| | - David S Perlin
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, NJ
| | - Sean Fitzgerald
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, NJ
| | - Vidmantas Petraitis
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine of Cornell University, New York, NY.
| | - Thomas J Walsh
- Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine of Cornell University, New York, NY
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15
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Fitzgerald S, Thiele H. Primary and Rescue PCI in STEMI. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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16
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Fitzgerald S, Allali A, Toelg R, Sulimov DS, Geist V, Kastrati A, Thiele H, Neumann FJ, Richardt G, Abdel-Wahab M. Angiographic predictors of unplanned rotational atherectomy in complex calcified coronary artery disease: a pooled analysis from the randomised ROTAXUS and PREPARE-CALC trials. EUROINTERVENTION 2022; 17:1506-1513. [PMID: 34609284 PMCID: PMC9896390 DOI: 10.4244/eij-d-21-00612] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Calcified coronary lesions present therapeutic challenges for the interventional cardiologist, often requiring rotational atherectomy (RA). AIMS This study aimed to develop an angiographic scoring tool to predict the need for a priori RA. METHODS A pooled analysis of the randomised ROTAXUS and PREPARE-CALC studies was carried out, (N=220 patients, N=313 lesions), by virtue of the fact that both studies made provision for crossover to RA (from balloon dilatation or modified balloon dilatation, respectively). Logistical regression techniques were employed to assess for the presence of patient- or lesion-specific factors leading to a necessity for RA. External validation was performed though retrospective calculation of the score for 192 patients who underwent bail-out RA in a single centre. RESULTS Lesion length (odds ratio [OR] 1.02, 95% confidence interval [CI]: 1.00-1.04 per mm, p=0.04), bifurcation lesion (OR 2.60, 95% CI: 1.27-5.30, p=0.009), vessel tortuosity >45° (OR 3.49, 95% CI: 1.73-7.03, p<0.001) and severe vessel calcification (OR 11.60, 95% CI: 3.40-39.64, p<0.001) were predictive of the need for RA in multivariate analysis. Based on the regression coefficients, a scoring system was devised. The greater the score, the more likely a lesion required RA. The scoring system performed well in the external validation cohort, with 78% of patients crossing over having a score of greater than the proposed cut-off of 3. CONCLUSIONS We provide an angiographic scoring tool to support the expeditious use of time and resources, allowing assessment of the likelihood of success of a balloon-based strategy, or the necessity for RA.
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Affiliation(s)
- Sean Fitzgerald
- Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | | | - Ralph Toelg
- Heart Centre, Segeberger Kliniken, Bad Segeberg, Germany
| | | | - Volker Geist
- Heart Centre, Segeberger Kliniken, Bad Segeberg, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technical University of Munich, Munich, Germany
| | - Holger Thiele
- University Heart Centre Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | - Gert Richardt
- Heart Centre, Segeberger Kliniken, Bad Segeberg, Germany
| | - Mohamed Abdel-Wahab
- Heart Centre Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology, Strümpellstr. 39, 04289 Leipzig, Germany
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17
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Buckley AJ, O’Connor C, Fitzgerald S, Hennessy T, Kiernan T. Mechanical Chest Compressions and Intra-Aortic Balloon Pump Combination for Refractory Ventricular Fibrillation During Primary PCI. JACC Case Rep 2022; 4:364-369. [PMID: 35495556 PMCID: PMC9040123 DOI: 10.1016/j.jaccas.2022.01.018] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/18/2022] [Accepted: 01/28/2022] [Indexed: 01/01/2023]
Abstract
This case highlights the successful resuscitation of a 43-year-old man with ST-segment elevation myocardial infarction and refractory ventricular fibrillation by using a combination of mechanical chest compressions and intra-aortic balloon pump insertion. This bailout strategy facilitated primary multivessel percutaneous coronary intervention in a center without on-site extracorporeal membrane oxygenation. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Anthony J. Buckley
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
- Address for correspondence: Dr Anthony Buckley, University Hospital Limerick, St Nessan’s Road, Dooradoyle, Limerick V94 F858, Ireland. @AnthonyJBuckley
| | - Cormac O’Connor
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
| | - Sean Fitzgerald
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Terence Hennessy
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
| | - Thomas Kiernan
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
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18
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Donegan O, Hartigan I, Cowan K, Dunne N, Hally R, O'Connor CD, Fitzgerald S. 259 IDENTIFYING THE TOP 10 RESEARCH PRIORITIES FOR FAMILY CARERS: THE INTERFACE PROJECT. Age Ageing 2021. [PMCID: PMC8690100 DOI: 10.1093/ageing/afab219.259] [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: 11/30/2022] Open
Abstract
Background In assessing the global impact of the COVID-19 pandemic on society, it is important to understand the communities most affected and develop methods of support. Family carers provide a vital, yet often invisible role in our society and healthcare system. Identifying research priorities for carers helps establish overall gaps in the research agenda and increases awareness of the role of carers in the community. Methods A priority setting partnership methodology was engaged and through collaboration with carers, healthcare professionals and researchers, a participatory process was conducted to identify gaps in the current literature and prioritise research questions and uncertainties. Focus group discussions followed, the first consisted of family carers (n = 5). The second (n = 3) interviewed stakeholders namely healthcare professionals, researchers and policy makers. After collating the data, researchable questions were developed through an iterative process with a Multi Stakeholder Advisory Committee to identify the top 10 research priorities for Family Carers Ireland. Results The top 10 researchable questions were distilled from a list of 16 and fit into 7 broad categories. 1) economic impact and financial strain 2) Systemic issues, education, resources and policy 3) technology 4) support services and infrastructure 5) mental health and wellbeing of the carer 6) carers in society 7) Recognition and acknowledgment of the family carer. Conclusion The partnership focus of this project allowed the ‘ground-up’ development of research priorities for carers by carers. The COVID-19 pandemic served to magnify systemic issues already present in society, as well as highlight new burdens. As a result, the subsequent development of 10 researchable questions will guide further investigation to improve the support and wellbeing of family carers.
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Affiliation(s)
- O Donegan
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - I Hartigan
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - K Cowan
- Katherine Cowan Consultancy, Hastings, United Kingdom
| | - N Dunne
- Family Carers Ireland, Dublin, Ireland
| | - R Hally
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - C D O'Connor
- College of Medicine and Health, University College Cork, Cork, Ireland
| | - S Fitzgerald
- College of Medicine and Health, University College Cork, Cork, Ireland
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19
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Ho NX, Clarke L, Collins PM, Fitzgerald S, Sheehan S, Paul T, Treacy G, McNicholas S. 1080 An Audit on Compliance with Recommended Duration of Surgical Antimicrobial Prophylaxis in St. Vincent’s University Hospital, Dublin, Ireland. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.120] [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]
Abstract
Abstract
Aim
Surgical site infection (SSI) is a common healthcare-associated infection, and a frequent cause of post-operative morbidity. SSI comprises any infection of the operative incision, cavity or involved organ, that occurs within the 30-day post-operative period. Antimicrobial prophylaxis is critical in reducing SSIs. Our aim was to assess adherence to the recommended surgical antimicrobial prophylaxis guidelines in St. Vincent’s University Hospital (SVUH), as part of the hospital antimicrobial stewardship programme. Compliance of surgical services was measured against the recommended regimens described in the SVUH Antimicrobial Guidelines.
Method
Data on duration and choice of prophylaxis were prospectively gathered on inpatients undergoing elective surgery during a three-week period between August-September 2020. Patients undergoing transplant procedures, inpatients in the intensive care unit, and patients who moved off-site postoperatively were excluded.
Results
Eighty-one patients were included. Sixty-four (79%) were compliant with prophylaxis duration, while seventeen (21%) were not. Reasons for extended prophylaxis included three (18%) cases where there were intra-operative complications and five (29%) cases of routine prescribing of an additional 24-hour coverage. Nine (53%) did not document the reason for extended cover.
Conclusions
Compliance with recommended duration of prophylaxis improved in comparison to prior audits. Among patients receiving extended prophylaxis, documentation of the indication was poor. Patients with evidence of post-operative infection may be better served with targeted antimicrobial therapy rather than extended prophylaxis. One reason for extended prophylaxis may be due to difficulty accessing guidelines on recommended prophylaxis duration, hence a targeted smartphone application was introduced to improve accessibility.
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Affiliation(s)
- N X Ho
- St Vincent's University Hospital, Dublin, Ireland
| | - L Clarke
- St Vincent's University Hospital, Dublin, Ireland
| | - P M Collins
- St Vincent's University Hospital, Dublin, Ireland
| | - S Fitzgerald
- St Vincent's University Hospital, Dublin, Ireland
| | - S Sheehan
- St Vincent's University Hospital, Dublin, Ireland
| | - T Paul
- St Vincent's University Hospital, Dublin, Ireland
| | - G Treacy
- St Vincent's University Hospital, Dublin, Ireland
| | - S McNicholas
- St Vincent's University Hospital, Dublin, Ireland
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20
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Wilson J, Carson G, Fitzgerald S, Llewelyn MJ, Jenkins D, Parker S, Boies A, Thomas J, Sutcliffe K, Sowden AJ, O'Mara-Eves A, Stansfield C, Harriss E, Reilly J. Are medical procedures that induce coughing or involve respiratory suctioning associated with increased generation of aerosols and risk of SARS-CoV-2 infection? A rapid systematic review. J Hosp Infect 2021; 116:37-46. [PMID: 34245806 PMCID: PMC8264274 DOI: 10.1016/j.jhin.2021.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The risk of transmission of SARS-CoV-2 from aerosols generated by medical procedures is a cause for concern. AIM To evaluate the evidence for aerosol production and transmission of respiratory infection associated with procedures that involve airway suctioning or induce coughing/sneezing. METHODS The review was informed by PRISMA guidelines. Searches were conducted in PubMed for studies published between January 1st, 2003 and October 6th, 2020. Included studies examined whether nasogastric tube insertion, lung function tests, nasendoscopy, dysphagia assessment, or suctioning for airway clearance result in aerosol generation or transmission of SARS-CoV-2, SARS-CoV, MERS, or influenza. Risk of bias assessment focused on robustness of measurement, control for confounding, and applicability to clinical practice. FINDINGS Eighteen primary studies and two systematic reviews were included. Three epidemiological studies found no association between nasogastric tube insertion and acquisition of respiratory infections. One simulation study found low/very low production of aerosols associated with pulmonary lung function tests. Seven simulation studies of endoscopic sinus surgery suggested significant increases in aerosols but findings were inconsistent; two clinical studies found airborne particles associated with the use of microdebriders/drills. Some simulation studies did not use robust measures to detect particles and are difficult to equate to clinical conditions. CONCLUSION There was an absence of evidence to suggest that the procedures included in the review were associated with an increased risk of transmission of respiratory infection. In order to better target precautions to mitigate risk, more research is required to determine the characteristics of medical procedures and patients that increase the risk of transmission of SARS-CoV-2.
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Affiliation(s)
- J Wilson
- Richard Wells Research Centre, University of West London, London, UK.
| | - G Carson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - S Fitzgerald
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - M J Llewelyn
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - D Jenkins
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - S Parker
- Defence Science and Technology Laboratory, Porton Down, Salisbury, UK
| | - A Boies
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - J Thomas
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - K Sutcliffe
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - A J Sowden
- Centre for Reviews and Dissemination, University of York, York, UK
| | - A O'Mara-Eves
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - C Stansfield
- EPPI-Centre, Social Research Institute, UCL Institute of Education, University College London, London, UK
| | - E Harriss
- Bodleian Health Care Libraries, John Radcliffe Hospital, Oxford, UK
| | - J Reilly
- Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK
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21
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Abstract
Despite the rapidly evolving evidence base in modern cardiology, progress in the area of cardiogenic shock remains slow, with short-term mortality still reaching 40-50%, relatively unchanged in recent years. Despite advances with an increase in the number of clinical trials taking place in this admittedly difficult-to-study area, the evidence base on which we make day-to-day decisions in clinical practice remains relatively sparse. With only definitive evidence for early revascularisation and the relative ineffectiveness of intra-aortic balloon pumping, most aspects of patient management are based on expert consensus, rather than randomised controlled trials. This updated 2020 review will outline the management of CS mainly after acute myocardial infarction with major focus on state-of-the-art treatment based on randomised clinical trials or matched comparisons if available.
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Affiliation(s)
- Holger Thiele
- Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology, Strümpellstr. 39, 04289 Leipzig, Germany
| | | | - Anne Freund
- Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Leipzig Heart Institute, Leipzig, Germany
| | - Uwe Zeymer
- Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Steffen Desch
- Heart Center Leipzig at University of Leipzig, Leipzig, Germany,Leipzig Heart Institute, Leipzig, Germany
| | - Sean Fitzgerald
- Heart Center Leipzig at University of Leipzig, Leipzig, Germany
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22
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Abbasi M, Dai D, Liu Y, Fitzgerald S, Kadirvel R, Savastano LE, Cloft H, Kallmes DF, Brinjikji W. Iatrogenic Foreign Materials Associated with Retrieved Clot Tissue via Mechanical Thrombectomy. AJNR Am J Neuroradiol 2021; 42:1239-1249. [PMID: 34255735 DOI: 10.3174/ajnr.a7106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Hydrophilic polymers and polytetrafluoroethylene liners, commonly used in the construction of endovascular devices, occasionally separate from devices with subsequent embolization. We determined the frequency of such materials in thrombus specimens retrieved by mechanical thrombectomy in patients with stroke. MATERIALS AND METHODS We retrospectively reviewed H&E-stained thrombus sections for presence and types of foreign materials. We identified 4 types of foreign materials-Type I: material was light green with refraction and had a homogeneous texture; type II: material was light gray and/or dark gray, thin, and loose or attenuated in texture; type III: material was light green with refraction, solitary in texture, irregular in shape, and was often associated with round or oval bubblelike particles and/or diffuse black particles; and type IV: material had homogeneous texture and was light pink or red. In addition, polymer materials from different layers of used mechanical thrombectomy catheters were compared with the foreign materials found in thrombus specimens. RESULTS A total of 101 thrombi were evaluated. Foreign materials were found in 53 (52.5%) thrombus samples. The most common type was type I (92%), followed by type II (30%). The histopathologic features of the polymer materials from mechanical thrombectomy catheters were similar to the foreign materials found in thrombus specimens. The inner polytetrafluoroethylene liner and coating layer of catheters resembled type I and type II of the foreign materials, respectively. CONCLUSIONS Foreign polymer materials are present in approximately half of retrieved thrombi, most commonly polytetrafluoroethylene from catheter liners and less from hydrophilic coatings.
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Affiliation(s)
- M Abbasi
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - D Dai
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - Y Liu
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - S Fitzgerald
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - R Kadirvel
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - L E Savastano
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
- Neurosurgery (L.E.S.), Mayo Clinic, Rochester, Minnesota
| | - H Cloft
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - D F Kallmes
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
| | - W Brinjikji
- Departments of Radiology (M.A., D.D., Y.L., S.F., R.K., L.E.S., H.C., D.F.K. W.B.)
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23
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Mitchell MI, Ben‐Dov IZ, Liu C, Ye K, Chow K, Kramer Y, Gangadharan A, Park S, Fitzgerald S, Ramnauth A, Perlin DS, Donato M, Bhoy E, Manouchehri Doulabi E, Poulos M, Kamali‐Moghaddam M, Loudig O. Extracellular Vesicle Capture by AnTibody of CHoice and Enzymatic Release (EV-CATCHER): A customizable purification assay designed for small-RNA biomarker identification and evaluation of circulating small-EVs. J Extracell Vesicles 2021; 10:e12110. [PMID: 34122779 PMCID: PMC8173589 DOI: 10.1002/jev2.12110] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
Circulating nucleic acids, encapsulated within small extracellular vesicles (EVs), provide a remote cellular snapshot of biomarkers derived from diseased tissues, however selective isolation is critical. Current laboratory-based purification techniques rely on the physical properties of small-EVs rather than their inherited cellular fingerprints. We established a highly-selective purification assay, termed EV-CATCHER, initially designed for high-throughput analysis of low-abundance small-RNA cargos by next-generation sequencing. We demonstrated its selectivity by specifically isolating and sequencing small-RNAs from mouse small-EVs spiked into human plasma. Western blotting, nanoparticle tracking, and transmission electron microscopy were used to validate and quantify the capture and release of intact small-EVs. As proof-of-principle for sensitive detection of circulating miRNAs, we compared small-RNA sequencing data from a subset of small-EVs serum-purified with EV-CATCHER to data from whole serum, using samples from a small cohort of recently hospitalized Covid-19 patients. We identified and validated, only in small-EVs, hsa-miR-146a and hsa-miR-126-3p to be significantly downregulated with disease severity. Separately, using convalescent sera from recovered Covid-19 patients with high anti-spike IgG titers, we confirmed the neutralizing properties, against SARS-CoV-2 in vitro, of a subset of small-EVs serum-purified by EV-CATCHER, as initially observed with ultracentrifuged small-EVs. Altogether our data highlight the sensitivity and versatility of EV-CATCHER.
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Affiliation(s)
- Megan I. Mitchell
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Iddo Z. Ben‐Dov
- Laboratory of Medical TranscriptomicsHadassah‐Hebrew University Medical CenterJerusalemIsrael
| | - Christina Liu
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Kenny Ye
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Kar Chow
- BiorepositoryHackensack University Medical CenterHackensackNew JerseyUSA
| | - Yael Kramer
- BiorepositoryHackensack University Medical CenterHackensackNew JerseyUSA
| | - Anju Gangadharan
- BiorepositoryHackensack University Medical CenterHackensackNew JerseyUSA
| | - Steven Park
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Sean Fitzgerald
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Andrew Ramnauth
- Department of Pathology and Laboratory MedicineWeill Cornell MedicineNew YorkUSA
| | - David S. Perlin
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Michele Donato
- BiorepositoryHackensack University Medical CenterHackensackNew JerseyUSA
| | - Emily Bhoy
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Ehsan Manouchehri Doulabi
- Department of Immunology, Genetics and PathologyScience for Life LaboratoryUppsala UniversityUppsalaSweden
| | - Michael Poulos
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
| | - Masood Kamali‐Moghaddam
- Department of Immunology, Genetics and PathologyScience for Life LaboratoryUppsala UniversityUppsalaSweden
| | - Olivier Loudig
- Center for Discovery and InnovationHackensack Meridian HealthNutleyNew JerseyUSA
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24
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Connolly NP, Simpkin A, Mylotte D, Crowley J, O'Connor S, AlHarbi K, Kiernan T, Arockiam S, Owens P, John A, Blake GJ, Fitzgerald S, Cadogan D, Rosseel L. Impact on percutaneous coronary intervention for acute coronary syndromes during the COVID-19 outbreak in a non-overwhelmed European healthcare system: COVID-19 ACS-PCI experience in Ireland. BMJ Open 2021; 11:e045590. [PMID: 33811055 PMCID: PMC8023726 DOI: 10.1136/bmjopen-2020-045590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
AIMS To evaluate temporal trends of acute coronary syndromes (ACS) treated via percutaneous coronary intervention (PCI) throughout the COVID-19 outbreak in a European healthcare system affected but not overwhelmed by COVID-19-related pathology. METHODS AND RESULTS We performed a retrospective multicentre analysis of the rates of PCI for the treatment of ACS within the period 2 months pre and post the first confirmed COVID-19 case in Ireland, as well as comparing PCI for ST-elevation myocardial infarction (STEMI) with the corresponding period in 2019. During the 2020 COVID-19 period (29 February-30 April 2020), there was a 24% decline in PCI for overall ACS (incidence rate ratio (IRR) 0.76; 95% CI 0.65 to 0.88; p<0.001), including a 29% reduction in PCI for non-ST-elevation ACS (IRR 0.71; 95% CI 0.57 to 0.88; p=0.002) and an 18% reduction in PCI for STEMI (IRR 0.82; 95% CI 0.67 to 1.01; p=0.061), as compared with the 2020 pre-COVID-19 period (1 January-28 February 2020). A 22% (IRR 0.78; 95% CI 0.65 to 0.93; p=0.005) reduction of PCI for STEMI was seen as compared with the 2019 reference period. CONCLUSION This study demonstrates a significant reduction in PCI procedures for the treatment of ACS since the COVID-19 outbreak in Ireland. The reasons for this decline are still unclear but patients need to be encouraged to seek medical attention when cardiac symptoms appear, in order to avoid incremental cardiac morbidity and mortality due to a reduction in coronary revascularisation for the treatment of ACS.
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Affiliation(s)
| | - Andrew Simpkin
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Darren Mylotte
- Department of Cardiology, Galway University Hospitals, Galway, Ireland
| | - James Crowley
- Department of Cardiology, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | | | - Khalid AlHarbi
- Department of Cardiology, St. James's Hospital, Dublin, Ireland
| | - Thomas Kiernan
- Department of Cardiology, University of Limerick, Limerick, Ireland
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
| | - Sacchin Arockiam
- Department of Cardiology, University Hospital Limerick, Limerick, Ireland
| | - Patrick Owens
- Department of Cardiology, University Hospital Waterford, Waterford, Ireland
| | - Amal John
- Department of Cardiology, University Hospital Waterford, Waterford, Ireland
| | - Gavin J Blake
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sean Fitzgerald
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Diarmaid Cadogan
- Department of Cardiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Liesbeth Rosseel
- Department of Cardiology, Galway University Hospitals, Galway, Ireland
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25
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Zhao Y, Cunningham MH, Mediavilla JR, Park S, Fitzgerald S, Ahn HS, Li X, Zhan C, Hong T, Munk G, Chow KF, Perlin DS. Diagnosis, clinical characteristics, and outcomes of COVID-19 patients from a large healthcare system in northern New Jersey. Sci Rep 2021; 11:4389. [PMID: 33623090 PMCID: PMC7902820 DOI: 10.1038/s41598-021-83959-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022] Open
Abstract
New Jersey was an early epicenter for the COVID-19 pandemic in the United States, yet information on hospitalized COVID-19 patients from this area is scarce. This study aimed to provide data on demographics and clinical features of a hospitalized patient population who were confirmed with infection by our in-house (CDI) real-time reverse-transcription polymerase chain reaction (RT-PCR) test. We included consecutive patients who were admitted to Hackensack Meridian Health system hospitals with laboratory-confirmed diagnoses of COVID-19 at Hackensack University Medical Center by the CDI virus test between March 12, 2020, and April 8, 2020. Clinical data and viral testing results were collected and analyzed for characteristics associated with outcomes, as well as the correlation with viral load. A total of 722 patients were included in the study, with a median age of 63 (interquartile range (IQR), 51–75) and 272 (37.7%) females. Mortality of this case series was 25.8%, with a statistically significant linear increase observed from age 40 to ≥ 80 by 10-year intervals. Viral load, as indicated by the cycle of threshold (Ct) values from the RT-PCR test, was significantly higher in the oldest patient group (≥ 80), and inversely correlated with survival. This is the first report to describe the clinical characteristics and outcomes in a large hospitalized COVID-19 patient series from New Jersey. Findings from this study are valuable to the ongoing response of both nationwide healthcare networks and the medical research community.
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Affiliation(s)
- Yanan Zhao
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA. .,Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
| | - Marcus H Cunningham
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Jose R Mediavilla
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Steven Park
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Sean Fitzgerald
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
| | - Hee Sang Ahn
- Molecular Diagnostic Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Xiangyang Li
- Molecular Diagnostic Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Caixin Zhan
- Molecular Diagnostic Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Tao Hong
- Molecular Diagnostic Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA.,Microbiology Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA.,Department of Pathology, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Gary Munk
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA.,Department of Pathology, Hackensack Meridian School of Medicine, Nutley, NJ, USA.,Clinical Virology Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Kar Fai Chow
- Molecular Diagnostic Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA.,Core Laboratory, Department of Pathology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - David S Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA.
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26
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Abbasi M, Fitzgerald S, Ayers-Ringler J, Espina V, Mueller C, Rucker S, Kadirvel R, Kallmes D, Brinjikji W. Proteomic Analysis of Cardioembolic and Large Artery Atherosclerotic Clots Using Reverse Phase Protein Array Technology Reveals Key Cellular Interactions Within Clot Microenvironments. Cureus 2021; 13:e13499. [PMID: 33777584 PMCID: PMC7990677 DOI: 10.7759/cureus.13499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 01/29/2023] Open
Abstract
Thrombus characteristics are dependent on clot composition, but identification of the etiology based on histological analysis has proved inconclusive. Identification of proteomic signatures may help to differentiate between clots of different etiologies such as cardioembolic, large artery atherosclerotic, and other known etiologies, information that could enhance an individualized medicine approach to secondary stroke prevention. In this study, total protein extracts from cardioembolic (n=25) and large artery atherosclerotic (n=23) thrombus specimens were arrayed in quadruplicate on nitrocellulose slides and immunostained for 31 proteins using a Dako Autostainer (Agilent Technologies, Inc., Santa Clara, USA). We quantified 31 proteins involved in platelet and/or endothelial function, inflammation, oxidative stress, and metabolism. Pathway analysis showed more heterogeneity and protein network interactions in the cardioembolic clots but no specific correlations with clot etiology. Reverse-phase protein arrays are a powerful tool for assessing cellular interactions within the clot microenvironment and may enhance understanding of clot formation and origination. This tool could be further explored to help in identifying stroke etiology in large vessel occlusion patients with embolic stroke of an undetermined source.
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Affiliation(s)
| | - Sean Fitzgerald
- Physiology, National University of Ireland Galway, Galway, IRL
| | | | - Virginia Espina
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, USA
| | - Claudius Mueller
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, USA
| | - Sally Rucker
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, USA
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27
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Stoiber T, Fitzgerald S, Leiba NS. Asbestos Contamination in Talc-Based Cosmetics: An Invisible Cancer Risk. Environ Health Insights 2020; 14:1178630220976558. [PMID: 33281454 PMCID: PMC7691901 DOI: 10.1177/1178630220976558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
The lack of regulation and adequate testing of talc-containing personal care products in the U.S. has resulted in the contamination of cosmetics with asbestos. As such, the true exposure of consumers to asbestos is poorly characterized and likely underestimated. In this study, transmission electron microscopy analysis revealed that 3 of 21 powder-based cosmetic products tested were contaminated with amphibole asbestos. One of these contaminated products is expressly marketed for use by children. The presence of asbestos found in products demonstrates the urgency to revise cosmetics policy. Further, talc-based cosmetics may be an overlooked and difficult to characterize source of exposure to asbestos, a known carcinogen.
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28
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Locke A, Fitzgerald S, Mahadevan-Jansen A. Advances in Optical Detection of Human-Associated Pathogenic Bacteria. Molecules 2020; 25:E5256. [PMID: 33187331 PMCID: PMC7696695 DOI: 10.3390/molecules25225256] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023] Open
Abstract
Bacterial infection is a global burden that results in numerous hospital visits and deaths annually. The rise of multi-drug resistant bacteria has dramatically increased this burden. Therefore, there is a clinical need to detect and identify bacteria rapidly and accurately in their native state or a culture-free environment. Current diagnostic techniques lack speed and effectiveness in detecting bacteria that are culture-negative, as well as options for in vivo detection. The optical detection of bacteria offers the potential to overcome these obstacles by providing various platforms that can detect bacteria rapidly, with minimum sample preparation, and, in some cases, culture-free directly from patient fluids or even in vivo. These modalities include infrared, Raman, and fluorescence spectroscopy, along with optical coherence tomography, interference, polarization, and laser speckle. However, these techniques are not without their own set of limitations. This review summarizes the strengths and weaknesses of utilizing each of these optical tools for rapid bacteria detection and identification.
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Affiliation(s)
- Andrea Locke
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
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29
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Santorelli A, Fitzgerald S, Douglas A, Doyle K, O'Halloran M. Dielectric profile of blood clots to inform ischemic stroke treatments. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3723-3726. [PMID: 33018810 DOI: 10.1109/embc44109.2020.9175387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Platelet and fibrin-rich blood clots can respond differently to red blood cell rich clots during ischemic stroke treatment, which includes thrombolysis and mechanical thrombectomy. Currently, there is no accurate way to identify the type of clot in advance of treatment. If the type of blood clot can be identified, the optimum clot removal process can be chosen and patient outcomes can be improved. In this paper we fabricate physiologically relevant blood clot analogues from human blood, that cover a range of red blood cell, fibrin, and platelet concentrations. We characterize the dielectric profile of these formed clots using an open-ended coaxial probe method across a wide frequency range. After the dielectric measurements are completed, histology on each blood clot is performed to determine the concentration of red blood cells present. In total, 32 unique blood clots were measured.With this completed analysis, we investigate the correlation between the dielectric properties across this frequency range and the red blood cell count of the formed blood clots. Furthermore, we develop a model to predict whether an unknown blood clot can be categorized as red blood cell rich or platelet and fibrin-rich based solely on the measured dielectric properties.Clinical Relevance-Using the dielectric profile of a clot we can predict whether a clot is platelet and fibrin-rich or red blood cell rich allowing clinicians to more easily determine treatment methods during an intervention for ischemic stroke.
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30
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Petersen S, Srisutiva S, Jewell A, Spoozak L, Chapman J, Fitzgerald S, Khabele D. Geographic distance greater than 50 miles is associated with better overall survival for ovarian cancer patients treated at a frontier state NCI-designated cancer center. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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31
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Brinjikji W, Fitzgerald S, Kallmes DF, Layton K, Hanel R, Pereira VM, Kvamme P, Delgado J, Yoo A, Jahromi B, Almekhlafi M, Gounis M, Nogueira RG. Abstract 147: Outcomes of the Stroke Thromboembolism Registry of Imaging and Pathology: A Multicenter International Study. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
We performed a multicenter prospective clinical registry across 11 centers to study the association between histopathological characteristics of retrieved clots and imaging, stroke etiology and clinical outcomes.
Materials and Methods:
Following IRB approval at the 11 centers, patients were enrolled in the STRIP registry. All retrieved emboli were sent for histopathological analysis with H&E and MSB staining. Demographic variables, comorbidities, stroke etiology, imaging findings and procedural details were collected for each case. We studied the association between clot histopathology and imaging findings, stroke etiology and and revascularization outcomes. Student’s t-test was used for continuous variables and chi-squared testing for categorical variables.
Results:
To date, 1022 patients have been included. There was a significant correlation between platelet rich clots and the absence of hyperdensity on non-contrast CT [p=0.321, p=0.003) and a significant inverse correlation between the percentage of platelets and mean HU on NCCT (p=-0.243, p=0.025). The proportion of platelet-rich clots (55.0% versus 21.2%, p=0.005) and the percentage of platelet content (22.1% versus 13.9%, p=0.03) was significantly higher in patient with large artery atherosclerosis compared to those with a cardioembolic etiology. There was no correlation between RBC density, WBC density, fibrin density or platelet density and revascularization outcomes with stent-retrievers. However, we have found that with aspiration alone, patients with platelet rich clots are less likely to be fully revascularized (i.e. TICI 2c/3) than non-platelet rich clots (OR=0.36, 95%CI=0.12-0.81, P<.0001). Meanwhile, patients with RBC rich clots are more likely to be completely revascularized with aspiration alone than those with RBC poor clots (OR=2.71, 95%CI=1.25-3.24, P=0.02).
Conclusions:
Interim analysis of the STRIP registry suggests that the platelet content of a clot may be the most revealing factor in determining a clot’s etiology, imaging features and revascularization outcome. Platelet rich clots are less dense on NCCT, are associated with a large artery atherosclerosis source and are less likely to be completely revascularized with aspiration alone.
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Affiliation(s)
| | | | | | | | - Ricardo Hanel
- Lyerly Neurosurgery/Baptist Neurological Institute, Jacksonville, FL
| | | | | | | | - Albert Yoo
- Texas Stroke Institute, Dallas Fort Worth, TX
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Mereuta OM, Fitzgerald S, Abbasi M, Dai D, Kadirvel R, Kallmes DF, Doyle KM, Brinjikji W. Abstract WP268: Von Willebrand Factor Expression in Various Subtypes of Acute Ischemic Stroke. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Von Willebrand factor (VWF) is a key component of acute ischemic stroke (AIS) thrombi. The aim of our prospective study was to investigate the immunohistochemical expression of VWF in clots and to evaluate whether VWF is associated with certain subtypes of AIS.
Methods:
VWF immunostaining was performed on 79 thrombi collected as part of the multi-center Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) registry. The cases were classified according to TOAST criteria. The VWF expression was quantified using Orbit Image Analysis (www.Orbit.bio) machine learning software. IBM SPSS statistics 25 was used to assess the relationship between the VWF levels and different etiology subtypes.
Results:
A cardioembolic stroke was defined in 39 cases (49.4%) whereas an atherosclerotic origin was identified in 13 patients (16.5%). Other causes accounted for 12 cases (15.1%). Unknown etiology was reported in 15 cases (19%). The mean VWF content in the clots was 12.8%. According to the Mann-Whitney U-test, the level of VWF was significantly higher in the cases with unknown etiology compared to cardioembolic origin (p=0.044). We found also that patients with unknown etiology of stroke had higher VWF expression as compared to the other two subtypes, although this difference was not statistically significant.
Conclusions:
Among the patients with ischemic stroke included in this study, the VWF expression was significantly increased in those with unknown etiology compared to the group with cardioembolic stroke. Our finding provides new insights into clot composition in cryptogenic stroke and may influence the treatment and secondary prevention in these cases.
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Affiliation(s)
| | | | | | | | | | | | - Karen M Doyle
- Physiology, National Univ of Ireland Galway, Galway, Ireland
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Etemadifar M, Nikanpour Y, Neshatfar A, Mansourian M, Fitzgerald S. Incidence and prevalence of multiple sclerosis in persian gulf area: A systematic review and meta-analysis. Mult Scler Relat Disord 2020; 40:101959. [PMID: 31991397 DOI: 10.1016/j.msard.2020.101959] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 05/20/2019] [Revised: 01/08/2020] [Accepted: 01/18/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND There is an unapprehended diversity in the epidemiology of multiple sclerosis (MS) in different geographical regions. In this study, for the first time, we systematically review the studies estimating the incidence and/or prevalence of MS in the Persian Gulf area. The goal is to obtain the overall incidence and prevalence of MS and elucidate the reasons for the geographical variation. METHODS A comprehensive literature search was carried out using MEDLINE and EMBASE through articles published between January 1985 and December 2018 on MS epidemiology in Persian Gulf countries including Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Search terms included 'Multiple sclerosis', 'Incidence', 'Prevalence', 'Epidemiology', 'Persian Gulf', 'Arabian Gulf' and name of each country. Only full-text articles published in English were included. All abstracts were considered and two trained reviewers evaluated the study quality using an assessment tool specifically designed for this study. RESULTS 39 studies met the inclusion criteria. The mean age at disease onset varied in each country and the pooled mean age of onset was 23.11. The overall pooled MS incidence was 5.03/100,000 person-years (95% CI: 0.04 - 10.02). Prevalence was 39.31/100,000 (95% CI: 29.12 - 49.50) and the result of the meta-regression method showed that prevalence increased by 2.3% per year between 1985-2018 (p = 0.04). Quality scores ranged from 4/7 to 8/8. CONCLUSION The prevalence and incidence of MS in the Persian Gulf region has gone through significant changes during the past decades. This study highlights the need for future studies of MS prevalence and incidence, which will further elucidate the possible etiologies leading to periodical and geographical variations in MS incidence.
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Affiliation(s)
- Masoud Etemadifar
- Department of Functional Neurosurgery Medical School, Isfahan University of Medical Science, Isfahan, Iran
| | - Yalda Nikanpour
- Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Amir Neshatfar
- Department of Neurology, Louisiana State University Health Science Center, Shreveport, USA
| | - Marjan Mansourian
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sean Fitzgerald
- Department of Physiology, National University of Ireland Galway, Galway, Ireland
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Feldsine PT, Lienau AH, Forgey RL, Calhoon RD, Al-Hasani S, Arling V, Bandiera T, Barnes M, Beatty S, Beaudoin A, Beyer D, Bryant J, Burzynski M, Carey B, Copeland F, Culver D, Danisavich T, Destro C, Diaz B, Fitzgerald S, Gallagher D, Franke W, Freshly J, Gary J, Harper M, Hermann C, Isakson T, Jenkins P, Johnson S, Ke J, Krause C, Lange K, Maki G, McDonagh S, McKee B, McLenaghan J, Miller L, Phebus R, Raghubeer E, Redding R, Retzlaff D, Richter D, Ritger C, Robinson J, Saunders L, Schwants D, Trottier Y, Tuncan E, Vanderbilt K, Ward D, West D, Woo L, Zebchek A. Visual Immunoprecipitate Assay (VIP) for Listeria monocytogenes and Related Listeria Species Detection in Selected Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.791] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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]
Abstract
Abstract
Six foods representing a variety of food products were analyzed by the Assurance Listeria polyclonal enzyme immunoassay (EIA) and by either the Bacteriological Analytical Manual or the U.S. Department of Agriculture culture method for detecting Listeria monocytogenes and related Listeria species. Samples of each food type, at each inoculation level, were analyzed simultaneously by both methods. A total of 19 laboratories representing federal government agencies and private industry in the United States and Canada participated. Food types were inoculated with Listeria species including L. monocytogenes, with the exception of 3 lots of green beans, which were naturally contaminated. During this study, 1764 samples and controls were analyzed and confirmed, of which 492 were positive and 947 were negative by both methods. There were 159 samples that were positive by culture method but negative by the EIA and 188 that were negative by culture method but positive by EIA. Twenty-two samples were negative by EIA and by culture method but confirmed positive when Assurance selective enrichment broths were subcultured to selective agar. The Assurance polyclonal EIA for detecting L. monocytogenes and related Listeria species in foods has been adopted first action by AOAC INTERNATIONAL.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Robin L Forgey
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
| | - Roger D Calhoon
- BioControl Systems, Inc., 19805 N. Creek Parkway, Bothell, WA 98011
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Feldsine PT, Jucker MT, Kaur M, Lienau AH, Kerr DE, Adamson A, Beaupre L, Bishop J, Casasola E, Cote C, Desilets S, D’lima C, Elahimanesh P, Fitzgerald S, Forgey R, Fortin J, Gohil V, Griffin J, Hardin M, Kaur D, Ketrenos J, King A, Kupski B, Luce S, Lucia L, Maeda S, Markun D, Marquez-Gonzalez M, McClendon J, McKessock J, Nelson C, Nguyen T, O’Brien C, Ramos M, Reilly S, Roa N, Schiffelbein Z, Shaffer K, Shepherd D, Sowell S, Trujillo E, Wang S, Williams K. Evaluation of the Assurance GDS® for Salmonella Method in Foods and Environmental Surfaces: Multilaboratory Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/93.1.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A multilaboratory collaborative study was conducted to compare the detection of Salmonella by the Assurance GDS® for Salmonella method and the Reference culture methods. Six foods, representing a variety of low microbial and high microbial load foods were analyzed. Seventeen laboratories in the United States and Canada participated in this study. No statistical differences (P < 0.05) were observed between the Assurance GDS for Salmonella and the Reference culture methods for any inoculation level of any food type or naturally contaminated food, except for pasta, for which the Assurance GDS method had a higher number of confirmed test portions for Salmonella compared to the Reference method.
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Affiliation(s)
| | - Markus T Jucker
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Mandeep Kaur
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - David E Kerr
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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36
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aharchi J, Aldridge I, Arling V, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Rucker C, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 996.14 Assurance® Polyclonal Enzyme Immunoassay for Detection of Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Assurance®Listeria Polyclonal Enzyme Immunoassay (EIA) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 23 collaborators, representing government agencies, as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 550 test portions and controls was analyzed and confirmed, of which 207 were positive and 336 were negative by both methods. Six test portions were positive by culture, but negative by the EIA. Three test portions were negative by culture, but positive by the EIA. Two test portions were negative by EIA and by culture, but confirmed positive when EIA enrichment broths were subcultured to selective agars. The data reported here indicate that the Assurance®Listeria EIA method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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37
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Feldsine PT, Lienau AH, Leung SC, Mui LA, Aguilar G, Aharchi J, Aldridge I, Arling V, Bitner B, Bullard C, Carlson P, Cox C, Deiss K, Dillon J, Dombroski P, Ellingson J, Fitzgerald S, Forgey R, Gailbreath K, Gallagher D, Geftman V, Herbst K, Hillis P, Johnson M, Koch S, Lewis D, Luepke J, Martensen D, McDonagh S, McGovern B, Moon B, Moreland L, Murray L, Richter D, Robertson M, Rogers P, Rucker C, Sacca J, Siu MC, Smith C, Smith J, Stoltzfus E, Summers C, Taylor B, Toth J, Vess R, White S, Witt JL, Young S. Method Extension Study to Validate Applicability of AOAC Official Method 997.03 Visual Immunoprecipitate Assay (VIP®) for Listeria monocytogenes and Related Listeria spp. from Environmental Surfaces: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Test portions from 3 environmental surface types, representative of typical surfaces found in a food production facility, were analyzed by the Visual Immunoprecipitate assay (VIP®) and the U.S. Department of Agriculture/Food Safety and Inspection Service (USDA/FSIS) culture method for Listeria monocytogenes and related Listeria species. In all cases, naturally contaminated environmental test samples were collected from an actual food production facility by sponge or swab. Test samples from concrete surfaces were collected by both swab and sponge; sponge test samples were collected from rubber surfaces, and swabs were used to sample steel surfaces. Test portions from each surface type were simultaneously analyzed by both methods. A total of 27 laboratories, representing government agencies as well as private industry in both the United States and Canada, participated in the study. During this study, a total of 615 test portions and controls was analyzed and confirmed, of which 227 were positive and 378 were negative by both methods. Nine test portions were positive by culture, but negative by the VIP. Five test portions were negative by culture, but positive by the VIP. Four test portions were negative by VIP and by culture, but confirmed positive when VIP enrichment broths were subcultured to selective agars. The data reported here indicate that the VIP method and the USDA/FSIS culture method are statistically equivalent for detection of L. monocytogenes and related Listeria species from environmental surfaces taken by sponges or swabs.
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Affiliation(s)
| | - Andrew H Lienau
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | | | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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38
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Feldsine PT, Mui LA, Forgey RL, Kerr DE, Al-Hasani S, Arling V, Beatty S, Bohannon J, Brannan J, Brown N, Bryant J, Burford M, Chavez C, Chinault K, Cooan N, Copeland F, Dixon L, Fitzgerald S, Franke W, Frissora R, Gailbreath K, Godon S, Good M, Ha T, Hagen H, Hanson S, Johnson K, Koch S, Leung S, Lienau A, Lin J, Lin S, Marolla B, Maycock L, McDonagh S, Miller L, Otten N, Post R, Resutek J, Rice B, Richter D, Ritger C, Schwantes D, Simon J, Smith J, Smith S, Stokes R, Thibideau J, Tuncan E, Uber D, Van Landingham V, Vrana D, West D. Equivalence of Assurance® Gold Enzyme Immunoassay for Visual or Instrumental Detection of Motile and Nonmotile Salmonella in All Foods to AOAC Culture Method: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/83.4.871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Six foods representative of a wide variety of processed, dried powder processed, and raw food types were analyzed by the Assurance® Gold Salmonella Enzyme Immunoassay (EIA) and AOAC INTERNATIONAL culture method. Paired samples of each food type were simultaneously analyzed; one sample by the Assurance method and one by the AOAC culture method. The results for Assurance method were read visually and instrumentally with a microplate reader. A total of 24 laboratories representing federal government agencies and private industry, in the United States and Canada, participated in this collaborative study. Food types were inoculated with species of Salmonella with the exception of raw ground chicken, which was naturally contaminated. No statistical differences (p < 0.05) were observed between Assurance Gold Salmonella EIA with either visual or instrumental interpretation and the AOAC culture method for any inoculation level of any food type or naturally contaminated food. The Assurance visual and instrumental options of reading sample reactions produced the same results for 1277 of the 1296 sample and controls analyzed.
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Affiliation(s)
| | - Linda A Mui
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - Robin L Forgey
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
| | - David E Kerr
- BioControl Systems, Inc., 12822 SE 32nd St, Bellevue, WA 98005
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39
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Staessens S, Fitzgerald S, Andersson T, Clarençon F, Denorme F, Gounis MJ, Hacke W, Liebeskind DS, Szikora I, van Es ACGM, Brinjikji W, Doyle KM, De Meyer SF. Histological stroke clot analysis after thrombectomy: Technical aspects and recommendations. Int J Stroke 2019; 15:467-476. [DOI: 10.1177/1747493019884527] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The recent advent of endovascular procedures has created the unique opportunity to collect and analyze thrombi removed from cerebral arteries, instigating a novel subfield in stroke research. Insights into thrombus characteristics and composition could play an important role in ongoing efforts to improve acute ischemic stroke therapy. An increasing number of centers are collecting stroke thrombi. This paper aims at providing guiding information on thrombus handling, procedures, and analysis in order to facilitate and standardize this emerging research field.
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Affiliation(s)
- S Staessens
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - S Fitzgerald
- CÚRAM-Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - T Andersson
- Department of Medical Imaging, AZ Groeninge, Kortrijk, Belgium
- Department of Neuroradiology, Karolinska University Hospital and Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - F Clarençon
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - F Denorme
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - MJ Gounis
- Division of Neuroimaging and Intervention and New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - W Hacke
- Department of Neurology, University Hospital Heidelberg, Ruprecht-Karls University, Heidelberg, Germany
| | - DS Liebeskind
- Neurovascular Imaging Research Core and UCLA Stroke Center, University of California, Los Angeles, CA, USA
| | - I Szikora
- Department of Neuroradiology, National Institute of Neurosciences, Budapest, Hungary
| | - ACGM van Es
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center (EMC), Rotterdam, The Netherlands
| | - W Brinjikji
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - KM Doyle
- CÚRAM-Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - SF De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Sttot H, Leime C, Ratcliffe P, Curry J, Mcconnell R, Fitzgerald S. Development of a new biochip based immunoassay for the determination of the bone formation biomarker N-terminal propeptide of Type 1 collagen (P1NP). Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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41
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Mcgivern P, Donnelly E, Sheehy N, Rodríguez M, Lenehan E, Fitzgerald S. Analytical performance evaluation of an assay for the direct measurement of HbA1c in whole blood on RX series analysers of different throughput. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Anderson V, Cahir D, Mckinstry E, Norney G, Robinson P, Darragh J, Rodríguez M, Mcconnell R, Fitzgerald S. Rapid simultaneous screening (<23 minutes) of twenty drug classes from a single whole blood sample on the biochip analyzer evidence multistat. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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43
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Martin K, Dunne P, Connolly A, Richardson C, Mcconnell R, Lamont J, Fitzgerald S. Biomarker glycosylation evaluation in pancreatic cancer utilising biochip array technology. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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44
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Summers M, Mcclafferty L, Donnellan G, Richardson C, Mcconnell R, Lamont J, Fitzgerald S. Development of a biochip array for the simultaneous detection of twelve cytokines on the new random access fully automated evidence evolution analyzer. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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45
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Abstract
Background Easily available commercial Indian talc products widely used in Southeast Asia were examined for the presence of asbestos. Asbestos in talc products carry all risks of asbestos‐related disease. Methods Using polarizing light microscopy, transmission electron microscopy (TEM), electron diffraction, and X‐ray analysis, multiple over‐the‐counter Indian talc products were examined for the presence of asbestos. Results Results In an initial group of five Indian talc products, one was found to contain tremolite asbestos. The second group of eight products was tested and six of eight contained tremolite asbestos as well. No other regulated amphibole was found. Conclusion Large quantities of body talc products containing asbestos are used throughout Southeast Asia and are likely to pose a public health risk for asbestos‐related diseases, especially for the cancers related to asbestos exposure. The country of origin in which the talc examined was sourced for production is unknown to the authors, and further investigation to measure associated public health risk is needed.
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Affiliation(s)
| | | | - Tushar Kant Joshi
- Ministry of Environment, Forests, and Climate Change, Government of IndiaNew Delhi India
| | - Arthur L. Frank
- Drexel University Dornsife School of Public HealthPhiladelphia Pennsylvania
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46
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Villaseñor-Derbez JC, Fitzgerald S. Spatial variation in allometric growth of invasive lionfish has management implications. PeerJ 2019; 7:e6667. [PMID: 30972253 PMCID: PMC6450370 DOI: 10.7717/peerj.6667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/09/2018] [Accepted: 02/21/2019] [Indexed: 11/20/2022] Open
Abstract
Lionfish (Pterois volitans/miles) are an invasive species in the Western Atlantic and the Caribbean. Improving management of invasive lionfish populations requires accurate total biomass estimates, which depend on accurate estimates of allometric growth; sedentary species like lionfish often exhibit high levels of spatial variation in life history characteristics. We reviewed 17 published length-weight relationships for lionfish taken throughout their invasive range and found regional differences that led to significant misestimates when calculating weight from length observations. The spatial pattern we observed is consistent with findings from other studies focused on genetics or length-at-age. Here, the use of ex situ parameter values resulted in total biomass estimates between 76.2% and 140% of true observed biomass, and up to a threefold under- or overestimation of total weight for an individual organism. These findings can have implications for management in terms of predicting effects on local ecosystems, evaluating the effectiveness of removal programs, or estimating biomass available for harvest.
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Affiliation(s)
- Juan Carlos Villaseñor-Derbez
- Bren School of Environmental Science and Management, University of California, Santa Barbara, Santa Barbara, CA, United States of America
| | - Sean Fitzgerald
- Bren School of Environmental Science and Management, University of California, Santa Barbara, Santa Barbara, CA, United States of America
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47
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Muster M, Luthman AS, Fitzgerald S, Doyle K, Lovblad KO. Abstract WP95: Microct Data Can Distinguish Between
in vitro
Clot Types of Different Composition. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.wp95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Several clinical studies have demonstrated that thrombectomy leads to improved clinical outcome and extends the treatment window for patients with acute ischemic stroke. This has motivated an expansion of the arsenal of available thrombectomy devices and an increased interest in image-guided patient selection and treatment.
In vitro
and
in vivo
studies have shown that the choice of thrombectomy device may be optimized according to the composition of the occluding clot. Baseline imaging may, therefore, guide the thrombectomy device choice, provided that the composition of the clot can be determined by imaging. Due to the low soft tissue contrast of CT images, the extraction of image parameters may, however, be confounded by pooling of blood around the occlusion.
Hypothesis:
MicroCT images can be used to verify the x-ray density of the extracted clots in an unambiguous manner. These images may eventually be correlated to clinical baseline imaging to determine whether the x-ray density extracted from clinical images is representative of the clot or confounded by the pooling of blood around the occlusion.
Methods:
In this pilot study, we investigated whether the x-ray density, as measured with a microCT (Qunatum GX; Perkin Elmer), could be used to distinguish between clot analogs made from whole blood (n=1) and clots of blood constituents mixed to produce ratios of 95% : 5% (n=1) and 5% : 95% red blood cells : fibrin (n=1). After imaging, the compositions of the clots were histologically verified by H&E staining.
Results:
MicroCT data could be used to distinguish between red blood cell rich, whole blood and fibrinous clots with area-under-curve of receiver operating curves ranging between 0.64 and 0.82. The compositions of the red blood cell rich, the whole blood and the fibrinous clot were verified to contain 94% red blood cells and 6% fibrin, 70% red blood cells and 30 % fibrin, and 97% fibrin and 3% white blood cells respectively.
Conclusions:
X-ray density—as measured on a microCT— can be used to infer the composition of blood clots. Further studies will be performed to determine whether the x-ray density of patient-derived clots, as measured with the microCT, is representative of the appearance of the clots on clinical baseline imaging.
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Affiliation(s)
- Michel Muster
- Hopital Universitaire De Geneve, Geneva, Switzerland
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Robb T, Blenkiron C, Tsai P, Parker K, Drummond A, Black M, Gavryushkin A, Woodhouse B, Houseman P, Coats E, Shields P, Fitzgerald S, Wright D, Tse R, Kramer N, Barker C, Triggs Y, Stables S, Lawrence B, Print C. Investigating tumour evolution in a single patient with disseminated cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy425.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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49
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Wilson JR, Lomonico S, Bradley D, Sievanen L, Dempsey T, Bell M, McAfee S, Costello C, Szuwalski C, McGonigal H, Fitzgerald S, Gleason M. Adaptive comanagement to achieve climate‐ready fisheries. Conserv Lett 2018. [DOI: 10.1111/conl.12452] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jono R. Wilson
- The Nature Conservancy San Francisco CA 94105 USA
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | - Serena Lomonico
- The Nature Conservancy San Francisco CA 94105 USA
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | - Darcy Bradley
- The Nature Conservancy San Francisco CA 94105 USA
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | | | - Tom Dempsey
- The Nature Conservancy San Francisco CA 94105 USA
| | - Michael Bell
- The Nature Conservancy San Francisco CA 94105 USA
| | - Skyli McAfee
- The Nature Conservancy San Francisco CA 94105 USA
| | - Christopher Costello
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | - Cody Szuwalski
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | | | - Sean Fitzgerald
- Bren School of Environmental Science & ManagementUniversity of California Santa Barbara CA 93106 USA
| | - Mary Gleason
- The Nature Conservancy San Francisco CA 94105 USA
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50
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Villaseñor-Derbez JC, Faro C, Wright M, Martínez J, Fitzgerald S, Fulton S, Mancha-Cisneros MDM, McDonald G, Micheli F, Suárez A, Torre J, Costello C. A user-friendly tool to evaluate the effectiveness of no-take marine reserves. PLoS One 2018; 13:e0191821. [PMID: 29381762 PMCID: PMC5790253 DOI: 10.1371/journal.pone.0191821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/11/2018] [Indexed: 11/19/2022] Open
Abstract
Marine reserves are implemented to achieve a variety of objectives, but are seldom rigorously evaluated to determine whether those objectives are met. In the rare cases when evaluations do take place, they typically focus on ecological indicators and ignore other relevant objectives such as socioeconomics and governance. And regardless of the objectives, the diversity of locations, monitoring protocols, and analysis approaches hinder the ability to compare results across case studies. Moreover, analysis and evaluation of reserves is generally conducted by outside researchers, not the reserve managers or users, plausibly thereby hindering effective local management and rapid response to change. We present a framework and tool, called "MAREA", to overcome these challenges. Its purpose is to evaluate the extent to which any given reserve has achieved its stated objectives. MAREA provides specific guidance on data collection and formatting, and then conducts rigorous causal inference analysis based on data input by the user, providing real-time outputs about the effectiveness of the reserve. MAREA's ease of use, standardization of state-of-the-art inference methods, and ability to analyze marine reserve effectiveness across ecological, socioeconomic, and governance objectives could dramatically further our understanding and support of effective marine reserve management.
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Affiliation(s)
- Juan Carlos Villaseñor-Derbez
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Caio Faro
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Melaina Wright
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Jael Martínez
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Sean Fitzgerald
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Stuart Fulton
- Comunidad y Biodiversidad A.C., Calle Isla del Peruano, Guaymas, Sonora, México
| | | | - Gavin McDonald
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
- Sustainable Fisheries Group, University of California Santa Barbara, Santa Barbara, California, United States of America
- Marine Science Institute, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Fiorenza Micheli
- Hopkins Marine Station and Center for Ocean Solutions, Stanford University, Pacific Grove, CA, 93950, United States of America
| | - Alvin Suárez
- Comunidad y Biodiversidad A.C., Calle Isla del Peruano, Guaymas, Sonora, México
| | - Jorge Torre
- Comunidad y Biodiversidad A.C., Calle Isla del Peruano, Guaymas, Sonora, México
| | - Christopher Costello
- Bren School of Environmental Science and Management, University of California Santa Barbara, Santa Barbara, California, United States of America
- Sustainable Fisheries Group, University of California Santa Barbara, Santa Barbara, California, United States of America
- Marine Science Institute, University of California Santa Barbara, Santa Barbara, California, United States of America
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