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Ahmadi Z, Björk J, Gilljam H, Gogineni M, Gustafsson T, Runold M, Ringbæk T, Wahlberg J, Wendel L, Ekström M. Smoking and home oxygen therapy: a review and consensus statement from a multidisciplinary Swedish taskforce. Eur Respir Rev 2024; 33:230194. [PMID: 38296345 PMCID: PMC10828833 DOI: 10.1183/16000617.0194-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/02/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations. METHODS The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population-intervention-comparator-outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology. RESULTS General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research. CONCLUSIONS Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.
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Affiliation(s)
- Zainab Ahmadi
- Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden
| | - Joar Björk
- Centre for Research Ethics and Bioethics (CRB), Uppsala University, Uppsala, Sweden
- Stockholm Centre for Healthcare Ethics (CHE), LIME, Karolinska Institute, Stockholm, Sweden
| | - Hans Gilljam
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Madhuri Gogineni
- Stockholms Sjukhem, Palliative Home Care and Hospice Wards, Stockholm, Sweden
| | - Torbjörn Gustafsson
- Department of Respiratory Medicine and Allergy, University Hospital of Umeå, Umeå, Sweden
| | - Michael Runold
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Respiratory Medicine Unit, Karolinska Institute, Stockholm, Sweden
| | | | | | - Lotta Wendel
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Magnus Ekström
- Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden
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Sakhi R, Jalalzai S, Ahmadi Z, Almaszada R, Zarghoon FN, Mohammadi R, Ahmad H, Mazhar S, Faqirzada M, Hamidi M. Knowledge, Beliefs, and Practices Related to Menstruation Among Female Students in Afghanistan. Int J Womens Health 2023; 15:1139-1149. [PMID: 37492375 PMCID: PMC10364822 DOI: 10.2147/ijwh.s410660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
Background Menstruation is a universal, natural, unique, and physiological phenomenon. Despite the fact that menstruation is a natural fact of life, it is still considered taboo in Afghanistan and other developing countries. Objective To assess knowledge, beliefs, and practices related to menstruation among female students of Kabul University of Medical Sciences (KUMS). Methods A cross-sectional descriptive study design was conducted at KUMS in 2022, and a quota sampling technique was used. Results In this study, 339 students participated out of the 346-sample size. The majority of participants (70.02%), were over 20 years of age. About (59.60%) of participants were aware of menstruation before menarche. The main source of their information was their mothers (37.50%). The average age of menarche was 13.5 years old. Above 70% of respondents had normal patterns of menstruation. More than half of them (51.90%) had dysmenorrhea. Frequent menstrual disorders were abdominal pain (58.1%), and backache (56.1%). The majority of respondents had good and acceptable knowledge of menstruation (33.6%), and (63.1%) respectively. A statistically significant relationship between knowledge and academic year was observed (P value = 0.005). The majority of respondents (92.6%) had poor menstrual beliefs. A statistically significant relationship between respondents' age and beliefs was observed (P value = 0.004). Mother education did not affect respondents' level of beliefs (P value = 0.4). In addition, respondents had good practice of menstruation (75%). Conclusion In general participants had a good and acceptable level of knowledge with good practice related to menstruation. Despite the good knowledge and practice, the respondents' beliefs related to menstruation were poorer than what was expected from medical disciplines students. Their frequent source of information was their mothers, which highlights the provision of information and education for mothers and all females.
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Affiliation(s)
- Rohullah Sakhi
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shakila Jalalzai
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Zainab Ahmadi
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Rowaida Almaszada
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | | | - Raihana Mohammadi
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Habiba Ahmad
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shakila Mazhar
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Maryam Faqirzada
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Mozhda Hamidi
- Public Health Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan
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Björklund F, Palm A, Gorani JA, Ahmadi Z, Sundh J, Theorell-Haglöw J, Ljunggren M, Grote L, Wadell K, Ekström M. Breathlessness and exercise performance to predict mortality in long-term oxygen therapy - The population-based DISCOVERY study. Respir Med 2023:107306. [PMID: 37286141 DOI: 10.1016/j.rmed.2023.107306] [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: 04/21/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Patients with chronic respiratory failure treated with long-term oxygen therapy (LTOT) often have severe breathlessness, impaired exercise performance, and high but variable mortality that is difficult to predict. We aimed to evaluate breathlessness and exercise performance upon starting LTOT as predictors of overall and short-term mortality. METHODS This was a longitudinal, population-based study of patients who initiated LTOT between 2015-2018 in Sweden. Breathlessness was measured using the Dyspnea Exertion Scale, and exercise performance using the 30s-Sit-To-Stand test. Associations with overall and three-month mortality were analyzed using Cox-regression. Subgroup analyses were performed for patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) respectively. The predictive capacity of models was assessed using a C-statistic. RESULTS A total of 441 patients (57.6% female, aged 75.4 ± 8.3 years) were analyzed, of whom 141 (32%) died during a median follow-up of 260 (IQR 75-460) days. Both breathlessness and exercise performance were independently associated with overall mortality in the crude models, but only exercise performance remained independently associated with overall mortality when models were adjusted for other predictors, when short-term mortality was analyzed, or when breathlessness and exercise capacity were analyzed concurrently. The multivariable model including exercise performance but not breathlessness provided a relatively high predictive capacity for overall mortality, C-statistic 0.756 (95% CI 0.702-0.810). Similar results were seen in the COPD and ILD subgroups. CONCLUSION Exercise performance as measured by the 30s-STS may be useful to identify patients with higher mortality on LTOT for optimized management and follow-up.
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Affiliation(s)
- Filip Björklund
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
| | - Andreas Palm
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden; Region of Gävleborg, Gävle Hospital, Centre for Research and Development, Gävle, Sweden.
| | | | - Zainab Ahmadi
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
| | - Josefin Sundh
- Örebro University, Faculty of Medicine and Health, Department of Respiratory Medicine, Örebro, Sweden.
| | - Jenny Theorell-Haglöw
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden.
| | - Mirjam Ljunggren
- Uppsala University, Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala, Sweden.
| | - Ludger Grote
- Sahlgrenska University Hospital, Department of Pulmonary Medicine, Gothenburg, Sweden; Sahlgrenska Academy, Center for Sleep and Wake Disorders, Gothenburg, Sweden.
| | - Karin Wadell
- Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå, Sweden.
| | - Magnus Ekström
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology, and Palliative Medicine, Lund, Sweden.
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Jena H, Ahmadi Z, Kumar P, Dhawan G. Bioreducible polyethylenimine core-shell nanostructures as efficient and non-toxic gene and drug delivery vectors. Bioorg Med Chem 2022; 69:116886. [PMID: 35749840 DOI: 10.1016/j.bmc.2022.116886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
Low molecular weight branched polyethylenimine (LMW bPEIs 1.8 kDa) have received considerable attention for the fabrication of nucleic acid carriers due to their biocompatible and non-toxic nature. However, due to the inadequate nucleic acid complexation ability and transportation across the cell membrane, these show poor transfection efficacy, limiting their clinical applications. Therefore, to overcome these challenges, in this study, we have grafted bPEI 1.8 kDa with a disulfide bond containing hydrophobic moiety, 3-(2-pyridyldithio) propionic acid (PDPA), via amide linkages through EDC/NHS-mediated coupling to obtain N-[3-(2-pyridyldithio)] propionoyl polyethylenimine (PDPP) conjugates. The best formulation for nucleic acid transfection was evaluated after preparing a series of PDPP conjugates by varying the amount of PDPA. In an aqueous environment, these PDPP conjugates self-assembled to form spherical shaped core-shell PDPP nanostructures with size ranging from ∼188-307 nm and zeta-potential from ∼ +3 to +19 mV. The positively charged surface of the core-shell nanocomposites helps in the binding of plasmid DNA (pDNA), its transportation inside the cell, and protection against enzymes. Evaluation of PDPP/pDNA complexes on mammalian cells revealed that all these complexes showed significantly improved transfection efficacy without hampering cytocompatibility. Amongst all, the pDNA complex of PDPP-2 exhibited the best transfection efficiency (i.e. >6-fold) in comparison to pDNA complex of the native bPEI. The nanocomposites exhibited the redox responsive behavior advantageous for therapeutic delivery to the tumor cells. The core of the nanostructures facilitate the encapsulation of a hydrophobic model drug, ornidazole. In vitro drug release analysis showed a faster release rate in response to a reductant mimicking the cellular environment. Altogether, these nanostructures have great potential to co-deliver both drug and gene simultaneously in response to tumor cell reductive microenvironment in vitro and could be used as the next-generation delivery system.
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Affiliation(s)
- H Jena
- Department of Biomedical Science, Acharya Narendra Dev College, University of Delhi, Kalkaji, New Delhi 110019, India; CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India
| | - Z Ahmadi
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - P Kumar
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India.
| | - G Dhawan
- Department of Biomedical Science, Acharya Narendra Dev College, University of Delhi, Kalkaji, New Delhi 110019, India; Delhi School of Skill Enhancement & Entrepreneuship Development, Institute of Eminence, University of Delhi, Delhi-110007, India.
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Ahmadi Z, Igelström H, Sandberg J, Sundh J, Sköld M, Janson C, Blomberg A, Bornefalk H, Bornefalk-Hermansson A, Ekström M. Agreement of the modified Medical Research Council and New York Heart Association scales for assessing the impact of self-rated breathlessness in cardiopulmonary disease. ERJ Open Res 2021; 8:00460-2021. [PMID: 35083321 PMCID: PMC8784890 DOI: 10.1183/23120541.00460-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background The functional impact of breathlessness is assessed using the modified Medical Research Council (mMRC) scale for chronic respiratory disease and with the New York Heart Association Functional Classification (NYHA) scale for heart failure. We evaluated agreement between the scales and their concurrent validity with other clinically relevant patient-reported outcomes in cardiorespiratory disease. Methods Outpatients with stable chronic respiratory disease or heart failure were recruited. Agreement between the mMRC and NYHA scales was analysed using Cramér's V and Kendall's tau B tests. Concurrent validity was evaluated using correlations with clinically relevant measures of breathlessness, anxiety, depression, and health-related quality of life. Analyses were conducted for all participants and separately in chronic obstructive pulmonary disease (COPD) and heart failure. Results In a total of 182 participants with cardiorespiratory disease, the agreement between the mMRC and NYHA scales was moderate (Cramér's V: 0.46; Kendall's tau B: 0.57) with similar results for COPD (Cramér's V: 0.46; Kendall's tau B: 0.66) and heart failure (Cramér's V: 0.46; Kendall's tau B: 0.67). In the total population, the scales correlated in similar ways to other patient-reported outcomes. Conclusion In outpatients with cardiorespiratory disease, the mMRC and NYHA scales show moderate to strong correlations and similar associations with other patient-reported outcomes. This supports that the scales are comparable when assessing the impact of breathlessness on function and patient-reported outcomes. There is moderate agreement between the mMRC and NYHA scales for assessment of functional impact of breathlessness in outpatients with COPD and heart failure.https://bit.ly/2XBPuXF
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Krilis M, Qi M, Ioannou Y, Zhang JY, Ahmadi Z, Wong JWH, Vlachoyiannopoulos PG, Moutsopoulos HM, Koike T, Sturgess AD, Chong BH, Krilis SA, Giannakopoulos B. Clinical relevance of nitrated beta 2-glycoprotein I in antiphospholipid syndrome: Implications for thrombosis risk. J Autoimmun 2021; 122:102675. [PMID: 34098405 DOI: 10.1016/j.jaut.2021.102675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 02/03/2023]
Abstract
Β2-Glycoprotein I (β2GPI) is an important anti-thrombotic protein and is the major auto-antigen in the antiphospholipid syndrome (APS). The clinical relevance of nitrosative stress in post translational modification of β2GPI was examined.The effects of nitrated (n)β2GPI on its anti-thrombotic properties and its plasma levels in primary and secondary APS were determined with appropriate clinical control groups. β2-glycoprotein I was nitrated at tyrosines 218, 275 and 309. β2-glycoprotein I binds to lipid peroxidation modified products through Domains IV and V. Nitrated β2GPI loses this binding (p < 0.05) and had diminished activity in inhibiting platelet adhesion to vWF under high shear flow (p < 0.01). Levels of nβ2GPI were increased in patients with primary APS compared to patients with either secondary APS (p < 0.05), autoimmune disease without APS (p < 0.05) or non-autoimmune patients with arterial thrombosis (p < 0.01) and healthy individuals (p < 0.05).In conclusion tyrosine nitration of plasma β2GPI is demonstrated and has important implications with regards to the pathophysiology of platelet mediated thrombosis in APS. Elevated plasma levels of nβ2GPI in primary APS may be a risk factor for thrombosis warranting further investigation.
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Affiliation(s)
- M Krilis
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - M Qi
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - Y Ioannou
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Division of Medicine, Centre for Rheumatology Research, University College London, London, UK.
| | - J Y Zhang
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - Z Ahmadi
- Haematology Research Unit, St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - J W H Wong
- Prince of Wales Clinical School and Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia.
| | - P G Vlachoyiannopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - H M Moutsopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - T Koike
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University School of Medicine, Sapporo, Japan.
| | - A D Sturgess
- Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
| | - B H Chong
- Haematology Research Unit, St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
| | - S A Krilis
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia.
| | - B Giannakopoulos
- Department of Infectious Disease, Immunology and Sexual Health, St George Hospital and Department of Medicine, St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia; Department of Rheumatology, St George Hospital, University of New South Wales, Sydney, NSW, Australia.
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Genberg J, Davies JM, Ahmadi Z, Currow D, Johnson MJ, Tanash H, Bajwah S, Ekström M. Indications and patterns of use of benzodiazepines and opioids in severe interstitial lung disease: a population-based longitudinal study. ERJ Open Res 2021; 7:00716-2020. [PMID: 33569492 PMCID: PMC7861020 DOI: 10.1183/23120541.00716-2020] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/04/2020] [Indexed: 11/05/2022] Open
Abstract
Background Despite evidence that opioids might relieve chronic breathlessness, physicians may still be reluctant to prescribe them due to safety concerns. By contrast, benzodiazepine (BDZ) prescribing often seeks to reduce chronic breathlessness despite no evidence of net benefit. Prescribing patterns and indications for these medications in severe interstitial lung disease (ILD) are unknown. Here, our objective was to evaluate the indications, medications and temporal patterns of BDZ and opioid prescriptions in people with oxygen-dependent ILD. Methods This was an observational, population-based, longitudinal study of adults starting long-term oxygen therapy (LTOT) for ILD between 2005 and 2014 in the Swedish National Registry for Respiratory Failure (Swedevox). People dispensed BDZs (n=2000) and opioids (n=2000) from 6 months before start of LTOT throughout follow-up (first of death or study end) were analysed. Results Of 1635 included patients, 651 (39.8%) received BDZs and 710 (43.4%) received opioids during the study period; 373 (22.8%) patients received both. The most frequently prescribed BDZs and opioids were oxazepam (85.6%) and oxycodone (28.7%), respectively. Indications for breathlessness were uncommon for BDZs (1.4%) and opioids (6.4%). During the last year of life, opioid indications for breathlessness increased from 2.5% (12-10 months before death) to 10.2% in the last 3 months of life (p=0.048). Conclusions In oxygen-dependent ILD, opioids are rarely prescribed for breathlessness even in the last months of life, when chronic breathlessness often increases in prevalence and intensity.
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Affiliation(s)
- Jenny Genberg
- Faculty of Science and Technology, Umeå University, Umeå, Sweden
| | - Joanna M Davies
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Zainab Ahmadi
- Division of Respiratory Medicine and Allergology, Dept of Clinical Sciences, Lund University, Lund, Sweden
| | - David Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Hanan Tanash
- Dept of Respiratory Medicine and Allergology Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Sabrina Bajwah
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Magnus Ekström
- Division of Respiratory Medicine and Allergology, Dept of Clinical Sciences, Lund University, Lund, Sweden
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Akbarshahi H, Ahmadi Z, Currow DC, Sandberg J, Vandersman Z, Shanon-Honson A, Ekström M. No gender-related bias in COPD diagnosis and treatment in Sweden: a randomised, controlled, case-based trial. ERJ Open Res 2020; 6:00342-2020. [PMID: 33263044 PMCID: PMC7682677 DOI: 10.1183/23120541.00342-2020] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/18/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction COPD is a major cause of morbidity and mortality. The prevalence, morbidity and mortality of COPD among females have increased. Previous studies indicate a possible gender bias in the diagnosis and management of COPD. The present study aims to determine if there is gender bias in the management of COPD in Sweden. Methods This was a double-blind, randomised (1:1), controlled, parallel-group, web-based trial using the hypothetical case scenario of a former smoker (40 pack-years and quit smoking 3 years ago) who was male or female. The participants were blind to the randomisation and the purpose of the trial. The case progressively revealed more information with associated questions on how the physician would manage the patient. Study participants chose from a list of tests and treatments at each step of the case scenario. Results In total, 134 physicians were randomised to a male (n=62) or a female (n=72) case. There was no difference in initial diagnosis (61 (98%) male cases and 70 (97%) female cases diagnosed with COPD) and planned diagnostic procedures between the male and female cases. Spirometry was chosen by all the physicians as one of the requested diagnostic tests. The management of the hypothetical COPD case did not differ by sex of the responding physician. Conclusion In Sweden, diagnosis and management of a hypothetical patient with COPD did not differ by the gender of the patient or physician. No gender-related bias in COPD managementhttps://bit.ly/3gTsWoG
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Affiliation(s)
- Hamid Akbarshahi
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Zainab Ahmadi
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Jacob Sandberg
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Zac Vandersman
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Aaron Shanon-Honson
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Magnus Ekström
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.,IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Chaudhary P, Lu H, Lipatov A, Ahmadi Z, McConville JPV, Sokolov A, Shield JE, Sinitskii A, Gregg JM, Gruverman A. Low-Voltage Domain-Wall LiNbO 3 Memristors. Nano Lett 2020; 20:5873-5878. [PMID: 32574058 DOI: 10.1021/acs.nanolett.0c01836] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Application of conducting ferroelectric domain walls (DWs) as functional elements may facilitate development of conceptually new resistive switching devices. In a conventional approach, several orders of magnitude change in resistance can be achieved by controlling the DW density using supercoercive voltage. However, a deleterious characteristic of this approach is high-energy cost of polarization reversal due to high leakage current. Here, we demonstrate a new approach based on tuning the conductivity of DWs themselves rather than on domain rearrangement. Using LiNbO3 capacitors with graphene, we show that resistance of a device set to a polydomain state can be continuously tuned by application of subcoercive voltage. The tuning mechanism is based on the reversible transition between the conducting and insulating states of DWs. The developed approach allows an energy-efficient control of resistance without the need for domain structure modification. The developed memristive devices are promising for multilevel memories and neuromorphic computing applications.
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Affiliation(s)
- P Chaudhary
- Department of Physics and Astronomy, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - H Lu
- Department of Physics and Astronomy, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - A Lipatov
- Department of Chemistry, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - Z Ahmadi
- Department of Mechanical & Materials Engineering, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - J P V McConville
- Centre for Nanostructured Media, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, U.K
| | - A Sokolov
- Department of Physics and Astronomy, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - J E Shield
- Department of Mechanical & Materials Engineering, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - A Sinitskii
- Department of Chemistry, University of Nebraska, Lincoln, Nebraska 68588, United States
| | - J M Gregg
- Centre for Nanostructured Media, School of Mathematics and Physics, Queen's University Belfast, Belfast BT7 1NN, U.K
| | - A Gruverman
- Department of Physics and Astronomy, University of Nebraska, Lincoln, Nebraska 68588, United States
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Sundh J, Bornefalk-Hermansson A, Ahmadi Z, Blomberg A, Janson C, Currow DC, McDonald CF, McCaffrey N, Ekström M. REgistry-based randomized controlled trial of treatment and Duration and mortality in long-term OXygen therapy (REDOX) study protocol. BMC Pulm Med 2019; 19:50. [PMID: 30808321 PMCID: PMC6390558 DOI: 10.1186/s12890-019-0809-7] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/11/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Long-term oxygen therapy (LTOT) during 15 h/day or more prolongs survival in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia. No randomized controlled trial has evaluated the net effects (benefits or harms) from LTOT 24 h/day compared with 15 h/day or the effect in conditions other than COPD. We describe a multicenter, national, phase IV, non-superiority, registry-based, randomized controlled trial (R-RCT) of LTOT prescribed 24 h/day compared with 15 h/day. The primary endpoint is all-cause-mortality at 1 year. Secondary endpoints include cause-specific mortality, hospitalizations, health-related quality of life, symptoms, and outcomes in interstitial lung disease. METHODS/DESIGN Patients qualifying for LTOT are randomized to LTOT 24 h/day versus 15 h/day during 12 months using the Swedish Register for Respiratory Failure (Swedevox). Planned sample size in this pragmatic study is 2126 randomized patients. Clinical follow-up and concurrent treatments are according to routine clinical practice. Mortality, hospitalizations, and incident diseases are assessed using national Swedish registries with expected complete follow-up. Patient-reported outcomes are assessed using postal questionnaire at 3 and 12 months. DISCUSSION The R-RCT approach combines the advantages of a prospective randomized trial and large clinical national registries for enrollment, allocation, and data collection, with the aim of improving the evidence-based use of LTOT. TRIAL REGISTRATION Clinical Trial registered with www.clinicaltrials.gov , Title: REgistry-based Treatment Duration and Mortality in Long-term OXygen Therapy (REDOX); ID: NCT03441204.
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Affiliation(s)
- Josefin Sundh
- Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Division of Medicine/Respiratory Medicine, Umeå University, Umeå, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy & Sleep Research, Uppsala University, Uppsala, Sweden
| | - David C. Currow
- Faculty of Health, University of Technology, Sydney, Australia
| | | | - Nikki McCaffrey
- Deakin Health Economics, Deakin University, Burwood, Victoria Australia
| | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden
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Sandberg J, Lansing R, Anderberg P, Currow D, Sundh J, Ahmadi Z, Palmqvist S, Ekström M. Relating Experienced To Recalled breathlessness Observational (RETRO) study: a prospective study using a mobile phone application. BMJ Open Respir Res 2019; 6:e000370. [PMID: 30956800 PMCID: PMC6424247 DOI: 10.1136/bmjresp-2018-000370] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/05/2018] [Indexed: 12/25/2022] Open
Abstract
Background Breathlessness, the subjective sensation of breathing discomfort, is common and appears in the daily life of people with cardiorespiratory diseases. Physicians often rely on patient's history based on symptom recall. The relation between recalled and experienced breathlessness is still poorly understood. This paper presents the protocol for a study primarily aimed at evaluating the relationship between experienced breathlessness and (1) recalled breathlessness and (2) predicted future breathlessness. Methods A mobile phone application will be used to collect data during daily life. Medically stable participants, ≥18 years of age with mean daily breathlessness of Numerical Rating Scale (NRS) 3/10 and able to use a mobile phone with internet will rate their breathlessness intensity on a 0-10 NRS prompted the user several times daily for 1 week. Participants will recall their breathlessness each day and week. Multivariable random effects regression models will be used for statistical analyses. Results Results of the study will be submitted for publication in peer-reviewed journals and presented at relevant conferences. Discussion This protocol describes a study aimed at investigating previously unknown areas of the experience and recall of breathlessness using a new method of data collection. Registration details Prospectively registered with ClinicalTrials.gov (Nr: NCT03468205). Ethics and dissemination The study has received ethical approval from the Regional Ethical Review Board Lund (DNr 2017/149). After a general study information including that participation is entirely voluntary, participants will answer the eligibility criteria and be asked to consent to participate before entering the study questions. Written informed consent to participate will be obtained for participants in the clinical sub-cohort. Participation can be discontinued at the discretion of the participant in which case no further data will be collected.
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Affiliation(s)
- Jacob Sandberg
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Robert Lansing
- Department of Psychology, University of Arizona Tucson, Arizona, USA
| | - Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - David Currow
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Josefin Sundh
- Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Sweden, Lund, University, Neurology Clinic, Skåne University Hospital, Sweden, Europe
| | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
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Ali OH, Sacchi R, Ahmadi Z, Attili A, Cartiglia N, Donetti M, Fausti F, Ferrero M, Giordanengo S, Mandurrino M, Manganaro L, Mazza G, Monaco V, Sola V, Staiano A, Vignati A, Cirio R. 352. Innovative thin silicon detectors for beam monitoring in particle therapy. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yadav S, Mahato M, Jha D, Ahmadi Z, Gautam H, Sharma A. Enhanced antibacterial activity of tetramethylguanidinium-conjugated linear polyethylenimine polymers. INT J POLYM MATER PO 2018. [DOI: 10.1080/00914037.2017.1393679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. Yadav
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - M. Mahato
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - D. Jha
- CSIR-Institute of Genomics and Integrative Biology, Sukhdev Vihar, New Delhi, India
| | - Z. Ahmadi
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - H.K. Gautam
- CSIR-Institute of Genomics and Integrative Biology, Sukhdev Vihar, New Delhi, India
| | - A.K. Sharma
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
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Sundh J, Ahmadi Z, Ekström M. Daily duration of long-term oxygen therapy and risk of hospitalization in oxygen-dependent COPD patients. Int J Chron Obstruct Pulmon Dis 2018; 13:2623-2628. [PMID: 30214180 PMCID: PMC6118242 DOI: 10.2147/copd.s167523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Long-term oxygen therapy (LTOT) improves survival and may reduce hospital admissions in patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia, but the impact of daily duration of LTOT on hospitalization rate is unknown. We aimed to estimate the association between the daily duration of LTOT (24 vs 15 h/d) and hospital admissions in patients with LTOT due to COPD. Materials and methods A population-based, cohort study included patients who started LTOT due to COPD between October 1, 2005 and June 30, 2009 in the Swedish national register for respiratory failure (Swedevox). Time to first hospitalization from all causes and from respiratory or nonrespiratory disease, using the National Patient Registry, was analyzed using Fine-Gray regression, adjusting for potential confounders. Results A total of 2,249 patients with COPD (59% women) were included. LTOT 24 h/d was prescribed to 539 (24%) and LTOT 15-16 h/d to 1,231 (55%) patients. During a median follow-up of 1.1 years (interquartile range, 0.6-2.1 years), 1,702 (76%) patients were hospitalized. No patient was lost to follow-up. The adjusted rate of all-cause hospitalization was similar between LTOT 24 and 15-16 h/d (subdistribution hazard ratio [SHR] 0.96; [95% CI] 0.84-1.08), as was cause-specific hospitalizations analyzed for respiratory disease (SHR: 1.00; 95% CI: 0.86-1.17) and nonrespiratory disease (SHR: 0.92; 95% CI: 0.75-1.14). Conclusion LTOT prescribed for 24 h/d was not associated with decreased hospitalization rates compared with LTOT for 15-16 h/d in patients with oxygen-dependent COPD. The results should be validated in a randomized controlled trial.
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Affiliation(s)
- Josefin Sundh
- Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden,
| | - Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
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Ahmadi Z, Sandberg J, Shannon-Honson A, Vandersman Z, Currow DC, Ekström M. Is chronic breathlessness less recognised and treated compared with chronic pain? A case-based randomised controlled trial. Eur Respir J 2018; 52:13993003.00887-2018. [PMID: 30002106 PMCID: PMC6340635 DOI: 10.1183/13993003.00887-2018] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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: 01/06/2018] [Accepted: 06/30/2018] [Indexed: 12/21/2022]
Abstract
Chronic breathlessness is a major cause of suffering in chronic obstructive pulmonary disease (COPD) [1]. Despite the impact on patients' daily lives, chronic breathlessness might be under-recognised and under-treated. No previous study has explored physicians' ability to identify chronic breathlessness in relation to other chronic symptoms. This study highlights the need for improved assessment and management of chronic breathlessness in clinical practicehttp://ow.ly/S7Ua30kPmjW
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Affiliation(s)
- Zainab Ahmadi
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Jacob Sandberg
- Center for Primary Health Care Research, Dept of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | | | - Zac Vandersman
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Magnus Ekström
- Dept of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.,IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Ahmadi Z, Jha D, Kumar B, Gautam HK, Kumar P. Bifunctionally engineered polyethylenimines as efficient DNA carriers and antibacterials against resistant pathogens. J Biomater Appl 2018; 33:363-379. [PMID: 30103671 DOI: 10.1177/0885328218792139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we have designed and developed two series of bifunctional conjugates by tethering polyethylenimine with streptomycin. By varying the amount of streptomycin, conjugates, polyethylenimine-streptomycin, have been synthesized and characterized spectroscopically. Gel electrophoresis assay revealed a slight decrease in the cationic charge density on the conjugates as these retarded the mobility of pDNA at higher w/w ratios. Further, transfection studies showed that both the series of conjugates transfected the mammalian cells efficiently with low-molecular weight polyethylenimine-streptomycin conjugates were more competent (∼9-fold enhancement with respect to native bPEI) exhibiting high cell viability too. Besides, both the series of conjugates displayed excellent antibacterial activity on pathogenic bacteria, even better than native streptomycin on resistant strains. Altogether, these results ensure the promising potential of the projected bifunctional conjugates as safe and efficient gene delivery vectors as well as antibacterials for future biomedical applications.
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Affiliation(s)
- Z Ahmadi
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - D Jha
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - B Kumar
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - H K Gautam
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
| | - Pradeep Kumar
- CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi, India
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Lee KH, Cavanaugh L, Leung H, Yan F, Ahmadi Z, Chong BH, Passam F. Quantification of NETs-associated markers by flow cytometry and serum assays in patients with thrombosis and sepsis. Int J Lab Hematol 2018. [PMID: 29520957 DOI: 10.1111/ijlh.12800] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Neutrophil extracellular traps (NETs) are networks of extracellular fibres produced from neutrophil DNA with a pathogenic role in infection, thrombosis and other conditions. Reliable assays for measuring NETs are desirable as novel treatments targeting NETs are being explored for the treatment of these conditions. We compare a whole blood flow cytometry method with serum assays to measure NETs-associated markers in patients with sepsis and thrombosis. METHODS Patients with deep venous thrombosis (n = 25), sepsis (n = 21) and healthy controls (n = 23) were included in the study. Neutrophil surface NETs markers were determined by flow cytometry on whole blood samples by gating of neutrophils stained for surface citrullinated histone (H3cit) and myeloperoxidase (MPO). Serum double-stranded (ds) DNA, MPO, myeloid-related protein, nucleosomes, DNAse, elastase, human high-mobility group box 1 and MPO-DNA complexes were quantified as circulating markers of NETs. RESULTS Neutrophil NETs markers by flow cytometry and serum NETs markers were significantly higher in patients with thrombosis and sepsis compared with healthy controls. Neutrophil NETs markers significantly correlated with the serum marker dsDNA. CONCLUSION Flow cytometry detection of neutrophil NETs markers is feasible in whole blood and correlates with serum markers of NETs. We propose the flow cytometry detection of MPO/H3cit positive neutrophils and serum dsDNA as simple methods to quantify cellular and extracellular NET markers in patients with thrombosis and sepsis.
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Affiliation(s)
- K H Lee
- Department of Haematology, St George Hospital, Kogarah, NSW, Australia.,Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
| | - L Cavanaugh
- Department of Haematology, St George Hospital, Kogarah, NSW, Australia
| | - H Leung
- Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
| | - F Yan
- Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
| | - Z Ahmadi
- Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
| | - B H Chong
- Department of Haematology, St George Hospital, Kogarah, NSW, Australia.,Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
| | - F Passam
- Department of Haematology, St George Hospital, Kogarah, NSW, Australia.,Department of Medicine, St George Clinical School, University of New South Wales, Kogarah, NSW, Australia
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Chitsaz H, Akrami R, Ahmadi Z. Effects of mushroom (Lentinula edodes) extract on growth performance, immune response and hemato-biochemical parameters of great sturgeon juvenile (Huso huso Linnaeus, 1754). ACTA ACUST UNITED AC 2018. [DOI: 10.29252/ijaah.4.1.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ekström M, Ahmadi Z, Larsson H, Nilsson T, Wahlberg J, Ström KE, Midgren B. A nationwide structure for valid long-term oxygen therapy: 29-year prospective data in Sweden. Int J Chron Obstruct Pulmon Dis 2017; 12:3159-3169. [PMID: 29133978 PMCID: PMC5669791 DOI: 10.2147/copd.s140264] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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] [Indexed: 11/23/2022] Open
Abstract
Background Long-term oxygen therapy (LTOT) improves prognosis in COPD with severe hypoxemia. However, adherence to criteria for eligibility and quality of LTOT is often insufficient and varies between countries. The aim of this study was to evaluate a national structure for prescription and management of LTOT over three decades in Sweden. Methods The study was a prospective, population-based study of 23,909 patients on LTOT from 1987 to 2015 in the Swedish National Register of Respiratory Failure (Swedevox). We assessed the prevalence, incidence, and structure of LTOT; completeness of registration in Swedevox; and validity of prescription and management of LTOT in Sweden according to seven published quality indicators. Results LTOT was prescribed by 48 respiratory or medicine units and managed mainly by specialized oxygen nurses. Swedevox had a stable completeness of 85% of patients starting LTOT since 1987. The national incidence of LTOT increased from 3.9 to 14.7/100,000 inhabitants over the time period. In 2015, 2,596 patients had ongoing therapeutic LTOT in the registry, a national prevalence of 31.6/100,000. Adherence to prescription recommendations and fulfillment of quality criteria was stable or improved over time. Of patients starting LTOT in 2015, 88% had severe hypoxemia (partial pressure of arterial oxygen [PaO2] <7.4 kPa) and 97% had any degree of hypoxemia (PaO2 <8.0 kPa); 98% were prescribed oxygen ≥15 hours/day or more; 76% had both stationary and mobile oxygen equipment; 75% had a mean PaO2 >8.0 kPa breathing oxygen; and 98% were non-smokers. Conclusion We present a structure for prescription, management, and follow-up of LTOT. The national registry effectively monitored adherence to prescription recommendations and most likely contributed to improved quality of care.
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Affiliation(s)
- Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund.,Department of Medicine, Blekinge Hospital, Karlskrona, Sweden
| | - Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund
| | - Hillevi Larsson
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund
| | - Tove Nilsson
- Department of Medicine, Blekinge Hospital, Karlskrona, Sweden
| | | | - Kerstin E Ström
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund
| | - Bengt Midgren
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund
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Tripathi SK, Ahmadi Z, Gupta KC, Kumar P. Corrigendum to "Polyethylenimine-polyacrylic acid nanocomposites: Type of bonding does influence the gene transfer efficacy and cytotoxicity" [Colloids Surf. B Biointerfaces 140 (2016) 117-20]. Colloids Surf B Biointerfaces 2017; 153:1. [PMID: 28189036 DOI: 10.1016/j.colsurfb.2017.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- S K Tripathi
- Nucleic Acids Research Laboratory, CSIR-Institute of Genomics and Integrative Biology, Delhi University Campus, Mall Road, Delhi 110007, India
| | - Z Ahmadi
- Nucleic Acids Research Laboratory, CSIR-Institute of Genomics and Integrative Biology, Delhi University Campus, Mall Road, Delhi 110007, India
| | - K C Gupta
- Nucleic Acids Research Laboratory, CSIR-Institute of Genomics and Integrative Biology, Delhi University Campus, Mall Road, Delhi 110007, India
| | - P Kumar
- Nucleic Acids Research Laboratory, CSIR-Institute of Genomics and Integrative Biology, Delhi University Campus, Mall Road, Delhi 110007, India.
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Shahbazi-Gahrouei D, Hashemi-Beni B, Ahmadi Z. Effects of RF-EMF Exposure from GSM Mobile Phones on Proliferation Rate of Human Adipose-derived Stem Cells: An In-vitro Study. J Biomed Phys Eng 2016; 6:243-252. [PMID: 28144594 PMCID: PMC5219575] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 07/12/2015] [Indexed: 06/06/2023]
Abstract
BACKGROUND As the use of mobile phones is increasing, public concern about the harmful effects of radiation emitted by these devices is also growing. In addition, protection questions and biological effects are among growing concerns which have remained largely unanswered. Stem cells are useful models to assess the effects of radiofrequency electromagnetic fields (RF-EMF) on other cell lines. Stem cells are undifferentiated biological cells that can differentiate into specialized cells. Adipose tissue represents an abundant and accessible source of adult stem cells. The aim of this study is to investigate the effects of GSM 900 MHz on growth and proliferation of mesenchymal stem cells derived from adipose tissue within the specific distance and intensity. MATERIALS AND METHODS ADSCs were exposed to GSM mobile phones 900 MHz with intensity of 354.6 µW/cm2 square waves (217 Hz pulse frequency, 50% duty cycle), during different exposure times ranging from 6 to 21 min/day for 5 days at 20 cm distance from the antenna. MTT assay was used to determine the growth and metabolism of cells and trypan blue test was also done for cell viability. Statistical analyses were carried out using analysis of one way ANOVA. P<0.05 was considered to be statistically significant. RESULTS The proliferation rates of human ADSCs in all exposure groups were significantly lower than control groups (P<0.05) except in the group of 6 minutes/day which did not show any significant difference with control groups. CONCLUSION The results show that 900 MHz RF signal radiation from antenna can reduce cell viability and proliferation rates of human ADSCs regarding the duration of exposure.
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Affiliation(s)
- D Shahbazi-Gahrouei
- Professor of Medical Physics, Dept. of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - B Hashemi-Beni
- Department of Anatomical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Z Ahmadi
- MSc of Medical Physics, Dept. of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Ekström M, Ahmadi Z, Bornefalk‐Hermansson A, Abernethy A, Currow D. Oxygen for breathlessness in patients with chronic obstructive pulmonary disease who do not qualify for home oxygen therapy. Cochrane Database Syst Rev 2016; 11:CD006429. [PMID: 27886372 PMCID: PMC6464154 DOI: 10.1002/14651858.cd006429.pub3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Breathlessness is a cardinal symptom of chronic obstructive pulmonary disease (COPD). Long-term oxygen therapy (LTOT) is given to improve survival time in people with COPD and severe chronic hypoxaemia at rest. The efficacy of oxygen therapy for breathlessness and health-related quality of life (HRQOL) in people with COPD and mild or no hypoxaemia who do not meet the criteria for LTOT has not been established. OBJECTIVES To determine the efficacy of oxygen versus air in mildly hypoxaemic or non-hypoxaemic patients with COPD in terms of (1) breathlessness; (2) HRQOL; (3) patient preference whether to continue therapy; and (4) oxygen-related adverse events. SEARCH METHODS We searched the Cochrane Airways Group Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase, to 12 July 2016, for randomised controlled trials (RCTs). We handsearched the reference lists of included articles. SELECTION CRITERIA We included RCTs of the effects of non-invasive oxygen versus air on breathlessness, HRQOL or patient preference to continue therapy among people with COPD and mild or no hypoxaemia (partial pressure of oxygen (PaO2) > 7.3 kPa) who were not already receiving LTOT. Two review authors independently assessed articles for inclusion in the review. DATA COLLECTION AND ANALYSIS Two review authors independently collected and analysed data. We assessed risk of bias by using the Cochrane 'Risk of bias tool'. We pooled effects recorded on different scales as standardised mean differences (SMDs) with 95% confidence intervals (CIs) using random-effects models. Lower SMDs indicated decreased breathlessness and reduced HRQOL. We performed subanalyses and sensitivity analyses and assessed the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. MAIN RESULTS Compared with the previous review, which was published in 2011, we included 14 additional studies (493 participants), excluded one study and included data for meta-analysis of HRQOL. In total, we included in this review 44 studies including 1195 participants, and we included 33 of these (901 participants)in the meta-analysis.We found that breathlessness during exercise or daily activities was reduced by oxygen compared with air (32 studies; 865 participants; SMD -0.34, 95% CI -0.48 to -0.21; I2 = 37%; low-quality evidence). This translates to a decrease in breathlessness of about 0.7 points on a 0 to 10 numerical rating scale. In contrast, we found no effect of short-burst oxygen given before exercise (four studies; 90 participants; SMD 0.01, 95% CI -0.26 to 0.28; I2 = 0%; low-quality evidence). Oxygen reduced breathlessness measured during exercise tests (25 studies; 442 participants; SMD -0.34, 95% CI -0.46 to -0.22; I2 = 29%; moderate-quality evidence), whereas evidence of an effect on breathlessness measured in daily life was limited (two studies; 274 participants; SMD -0.13, 95% CI, -0.37 to 0.11; I2 = 0%; low-quality evidence).Oxygen did not clearly affect HRQOL (five studies; 267 participants; SMD 0.10, 95% CI -0.06 to 0.26; I2 = 0%; low-quality evidence). Patient preference and adverse events could not be analysed owing to insufficient data. AUTHORS' CONCLUSIONS We are moderately confident that oxygen can relieve breathlessness when given during exercise to mildly hypoxaemic and non-hypoxaemic people with chronic obstructive pulmonary disease who would not otherwise qualify for home oxygen therapy. Most evidence pertains to acute effects during exercise tests, and no evidence indicates that oxygen decreases breathlessness in the daily life setting. Findings show that oxygen does not affect health-related quality of life.
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Affiliation(s)
- Magnus Ekström
- Lund UniversityDepartment of Clinical Sciences, Division of Respiratory Medicine & AllergologyLundSweden
| | - Zainab Ahmadi
- Lund UniversityDepartment of Clinical Sciences, Division of Respiratory Medicine & AllergologyLundSweden
| | | | - Amy Abernethy
- Duke University Medical CenterCLHCDurhamNorth CarolinaUSA
| | - David Currow
- Flinders UniversityDepartment of Palliative and Supportive Services700 Goodwood RoadDaw ParkSAAustralia5041
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Ahmadi Z, Bernelid E, Currow DC, Ekström M. Prescription of opioids for breathlessness in end-stage COPD: a national population-based study. Int J Chron Obstruct Pulmon Dis 2016; 11:2651-2657. [PMID: 27799763 PMCID: PMC5085299 DOI: 10.2147/copd.s112484] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Low-dose opioids can relieve breathlessness but may be underused in late-stage COPD due to fear of complications, contributing to poor symptom control. OBJECTIVES We aimed to study the period prevalence and indications of opioids actually prescribed in people with end-stage COPD. METHODS The study was a longitudinal, population-based study of patients starting long-term oxygen therapy (LTOT) for COPD between October 1, 2005 and June 30, 2009 in Sweden. A random sample (n=2,000) of their dispensed opioid prescriptions was obtained from the national Prescribed Drugs Register from 91 days before starting LTOT until the first of LTOT withdrawal, death, or study end (December 31, 2009). We analyzed medication type, dispensed quantity, date of dispensing, and indications categorized as pain, breathlessness, other, or unknown. RESULTS In total, 2,249 COPD patients (59% women) were included. During a median follow-up of 1.1 (interquartile range 0.6-2.0) years, 1,034 patients (46%) were dispensed ≥1 opioid prescription (N=13,722 prescriptions). The most frequently prescribed opioids were tramadol (23%), oxycodone (23%), morphine (16%), and codeine (16%). Average dispensed quantity was 9.3 (interquartile range 3.7-16.7) defined daily doses per prescription. In the random sample, the most commonly stated indication was pain (97%), with only 2% for breathlessness and 1% for other reasons. CONCLUSION Despite evidence that supported the use of opioids for the relief of breathlessness predating this study, opioids are rarely prescribed to relieve breathlessness in oxygen-dependent COPD, potentially contributing to less-than-optimal symptom control. This study creates a baseline against which to compare future changes in morphine prescribing in this setting.
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Affiliation(s)
- Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University Hospital, Lund; Department of Medicine, Blekinge Hospital, Karlskrona, Sweden
| | - Eva Bernelid
- Department of Medicine, Blekinge Hospital, Karlskrona, Sweden
| | - David C Currow
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, SA, Australia
| | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine and Allergology, Lund University Hospital, Lund; Department of Medicine, Blekinge Hospital, Karlskrona, Sweden; Discipline, Palliative and Supportive Services, Flinders University, Adelaide, SA, Australia
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Ahmadi Z, Sundh J, Bornefalk-Hermansson A, Ekström M. Long-Term Oxygen Therapy 24 vs 15 h/day and Mortality in Chronic Obstructive Pulmonary Disease. PLoS One 2016; 11:e0163293. [PMID: 27649490 PMCID: PMC5029935 DOI: 10.1371/journal.pone.0163293] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/05/2016] [Indexed: 11/24/2022] Open
Abstract
Long-term oxygen therapy (LTOT) ≥ 15 h/day improves survival in hypoxemic chronic obstructive pulmonary disease (COPD). LTOT 24 h/day is often recommended but may pose an unnecessary burden with no clear survival benefit compared with LTOT 15 h/day. The aim was to test the hypothesis that LTOT 24 h/day decreases all-cause, respiratory, and cardiovascular mortality compared to LTOT 15 h/day in hypoxemic COPD. This was a prospective, observational, population-based study of COPD patients starting LTOT between October 1, 2005 and June 30, 2009 in Sweden. Overall and cause-specific mortality was analyzed using Cox and Fine-Gray regression, controlling for age, sex, prescribed oxygen dose, PaO2 (air), PaCO2 (air), Forced Expiratory Volume in one second (FEV1), WHO performance status, body mass index, comorbidity, and oral glucocorticoids. A total of 2,249 included patients were included with a median follow-up of 1.1 years (interquartile range, 0.6–2.1). 1,129 (50%) patients died and no patient was lost to follow-up. Higher LTOT duration analyzed as a continuous variable was not associated with any change in mortality rate (hazard ratio [HR] 1.00; (95% confidence interval [CI], 0.98 to 1.02) per 1 h/day increase above 15 h/day. LTOT exactly 24 h/day was prescribed in 539 (24%) patients and LTOT 15–16 h/day in 1,231 (55%) patients. Mortality was similar between the groups for all-cause, respiratory and cardiovascular mortality. In hypoxemic COPD, LTOT 24 h/day was not associated with a survival benefit compared with treatment 15–16 h/day. A design for a registry-based randomized trial (R-RCT) is proposed.
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Affiliation(s)
- Zainab Ahmadi
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden
- * E-mail:
| | - Josefin Sundh
- Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Magnus Ekström
- Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden
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Ekström M, Vergo MT, Ahmadi Z, Currow DC. Prevalence of Sudden Death in Palliative Care: Data From the Australian Palliative Care Outcomes Collaboration. J Pain Symptom Manage 2016; 52:221-7. [PMID: 27220950 DOI: 10.1016/j.jpainsymman.2016.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/20/2016] [Accepted: 02/13/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Advanced, life-limiting illnesses are likely to have a predictable functional decline through a terminal phase to death, but some patients may also die suddenly. To date, empirical evidence characterizing "sudden death" in hospice/palliative care is lacking. OBJECTIVES The aim of this study was to determine prevalence and clinicodemographic predictors of sudden death in hospice/palliative care. METHODS This is a longitudinal consecutive cohort study of prospectively collected national data in 104 specialist palliative care services from the Australian Palliative Care Outcomes Collaboration. Patients who died between July 1, 2013, and June 30, 2014, with one or more measurement of Australian-modified Karnofsky Performance Status (AKPS) in the last 30 days of life were included. "Sudden death" was defined as a lowest AKPS score of 50 or more in the last seven days of life and excluded anyone with "terminal phase" as their last phase before death. Predictors were defined using logistic regression. RESULTS In total, 13,966 patients were included, mean age 73.6 (SD 13.6) years, 46% women, and 77% had cancer. During the seven days before death, there were 20,992 AKPS measurements; median 1 (interquartile range 1-2) per patient. Four percent of deaths (one of 25) were sudden, predicted independently by having lung cancer (odds ratio [OR] 2.64), cardiovascular disease (OR 1.94), other cancers (OR 1.63), being male (OR 1.23), younger, worse fatigue, and worse breathlessness. Sudden death was associated with higher rates of death at home (OR 3.2; 95% CI 2.9 to 3.6). CONCLUSION This study quantifies rates of sudden death in hospice/palliative care and has implications for conversations about prognosis between clinicians, patients, and their families.
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Affiliation(s)
- Magnus Ekström
- Division of Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden; Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia.
| | - Maxwell T Vergo
- Palliative Medicine and Hospice Care, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Zainab Ahmadi
- Division of Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - David C Currow
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia; Palliative Medicine and Hospice Care, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Ahmadi Z, Wysham NG, Lundström S, Janson C, Currow DC, Ekström M. End-of-life care in oxygen-dependent ILD compared with lung cancer: a national population-based study. Thorax 2016; 71:510-6. [PMID: 26865603 DOI: 10.1136/thoraxjnl-2015-207439] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [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: 06/15/2015] [Accepted: 01/03/2016] [Indexed: 11/03/2022]
Abstract
RATIONALE Advanced fibrosing interstitial lung disease (ILD) is often progressive and associated with a high burden of symptoms and poor prognosis. Little is known about the symptom prevalence and access to palliative care services at end of life (EOL). OBJECTIVES Compare prevalence of symptoms and palliative treatments between patients dying with oxygen-dependent ILD and patients dying of lung cancer. METHODS Nationwide registry-based cohort study of patients with oxygen-dependent ILD and patients with lung cancer who died between 1 January 2011 and 14 October 2013. Prevalence of symptoms and treatments during the last seven days of life were compared using data in Swedish Registry of Palliative Care. MEASUREMENTS AND MAIN RESULTS 285 patients with ILD and 10 822 with lung cancer were included. In ILD, death was more likely to be 'unexpected' (15% vs 4%), less likely to occur in a palliative care setting (17% vs 40%) and EOL discussions with the patients (41% vs 59%) were less common than in lung cancer. Patients with ILD suffered more from breathlessness (75% vs 42%) while patients with lung cancer had more pain (51% vs 73%) (p<0.005 for all comparisons). Patients with ILD had more unrelieved breathlessness, pain and anxiety. The survival time from initiation of oxygen therapy in ILD was a median 8.4 months (IQR 3.4-19.2 months). CONCLUSIONS Patients with ILD receive poorer access to specialist EOL care services and experience more breathlessness than patients with lung cancer. This study highlights the need of better EOL care in oxygen-dependent ILD.
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Affiliation(s)
- Zainab Ahmadi
- Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University Hospital, Lund, Sweden
| | - Nicholas G Wysham
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke University, Center for Learning Health Care, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Staffan Lundström
- Palliative Care Services, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine & Allergology, Uppsala University, Uppsala, Sweden
| | - David C Currow
- Department of Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - Magnus Ekström
- Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University Hospital, Lund, Sweden Department of Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
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Hosseini SM, Ahmadi Z, Nemati M, Parvizian F, Madaeni SS. Electrodialysis heterogeneous ion exchange membranes modified by SiO2 nanoparticles: fabrication and electrochemical characterization. Water Sci Technol 2016; 73:2074-2084. [PMID: 27148708 DOI: 10.2166/wst.2016.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In the current study mixed matrix heterogeneous cation exchange membranes were prepared by solution casting technique. The effect of SiO(2) nanoparticles in the polymeric solution on the physicochemical properties of prepared membranes was studied. Scanning optical microscope images showed uniform particle distribution and relatively uniform surfaces for the prepared membranes. The membrane water content was reduced by silica nanoparticles in the membranes' matrix. The membrane ion exchange capacity, membrane potential, transport number and selectivity were improved initially by an increase of SiO(2) nanoparticles concentration up to 1%wt in prepared membranes and then showed a decreasing trend with a further increase in additive ratio from 1 to 4%wt. The ionic permeability and flux were also decreased initially by an increase of silica nanoparticles concentration up to 0.5%wt in the membrane matrix and then increased again with a further increase in nanoparticles concentration from 0.5 to 4%wt. Moreover, the results exhibited that using silica nanoparticles in the membrane matrix caused an obvious decrease in areal electrical resistance. The opposite trend was found for membrane mechanical strength using SiO(2) nanoparticles.
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Affiliation(s)
- S M Hosseini
- Department of Chemical Engineering, Faculty of Engineering, Arak University, Arak 38156-8-8349, Iran E-mail: ;
| | - Z Ahmadi
- Department of Chemical Engineering, Faculty of Engineering, Arak University, Arak 38156-8-8349, Iran E-mail: ;
| | - M Nemati
- Department of Chemical Engineering, Faculty of Engineering, Arak University, Arak 38156-8-8349, Iran E-mail: ;
| | - F Parvizian
- Department of Chemical Engineering, Faculty of Engineering, Arak University, Arak 38156-8-8349, Iran E-mail: ;
| | - S S Madaeni
- Membrane Research Centre, Department of Chemical Engineering, Faculty of Engineering, Razi University, Kermanshah 67149, Iran
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Wysham N, Ahmadi Z, Ekström M. End of Life Care in Oxygen-Dependent Pulmonary Fibrosis Compared to Cancer: A National Population-Based Study. Chest 2015. [DOI: 10.1378/chest.2249896] [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: 11/01/2022] Open
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Ahmadi Z, Lundström S, Janson C, Strang P, Emtner M, Currow DC, Ekström M. End-of-life care in oxygen-dependent COPD and cancer: a national population-based study. Eur Respir J 2015; 46:1190-3. [DOI: 10.1183/09031936.00035915] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/16/2015] [Indexed: 11/05/2022]
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30
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Ahmadi Z, Bornefalk-Hermansson A, Franklin KA, Midgren B, Ekström MP. Hypo- and hypercapnia predict mortality in oxygen-dependent chronic obstructive pulmonary disease: a population-based prospective study. Respir Res 2014; 15:30. [PMID: 24625018 PMCID: PMC3995652 DOI: 10.1186/1465-9921-15-30] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prognostic role of the arterial blood gas tension of carbon dioxide (PaCO2) in severe Chronic Obstructive Pulmonary Disease (COPD) remains unknown. The aim of this study was to estimate the association between PaCO2 and mortality in oxygen-dependent COPD. METHODS National prospective study of patients starting long-term oxygen therapy (LTOT) for COPD in Sweden between October 1, 2005 and June 30, 2009, with all-cause mortality as endpoint. The association between PaCO2 while breathing air, PaCO2 (air), and mortality was estimated using Cox regression adjusted for age, sex, arterial blood gas tension of oxygen (PaO2), World Health Organization performance status, body mass index, comorbidity, and medications. RESULTS Of 2,249 patients included, 1,129 (50%) died during a median 1.1 years (IQR 0.6-2.0 years) of observation. No patient was lost to follow-up. PaCO2 (air) independently predicted adjusted mortality (p < 0.001). The association with mortality was U-shaped, with the lowest mortality at approximately PaCO2 (air) 6.5 kPa and increased mortality at PaCO2 (air) below 5.0 kPa and above 7.0 kPa. CONCLUSION In oxygen-dependent COPD, PaCO2 (air) is an independent prognostic factor with a U-shaped association with mortality.
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Affiliation(s)
- Zainab Ahmadi
- Department of Medicine, Blekinge Hospital, 37185 Karlskrona, Sweden
| | | | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, University Hospital of Umeå, Umeå, Sweden
| | - Bengt Midgren
- Department of Clinical Sciences, Lund, Division of Respiratory Medicine & Allergology, Lund University Hospital, Lund, Sweden
| | - Magnus P Ekström
- Department of Medicine, Blekinge Hospital, 37185 Karlskrona, Sweden
- Department of Clinical Sciences, Lund, Division of Respiratory Medicine & Allergology, Lund University Hospital, Lund, Sweden
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Mostafaiyan M, Saeb M, Ahmadi Z, Khonakdar H, Wagenknecht U, Heinrich G. A numerical study on deformation of Newtonian droplets through converging cylindrical dies. e-Polymers 2013. [DOI: 10.1515/epoly-2013-0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract In this work, the dynamic deformation of a viscose Newtonian droplet passing through cylindrical converging dies has been studied. The changes in the interfacial area between two immiscible Newtonian fluids have been considered as a variable representing the time-dependent deformation of a circular droplet along converging dies. To do so, a surface tracking method has been incorporated into a finite element code, developed by the authors, which quantifies the deformation of the droplet through the converging path, and where the surface area of the deformed drop has been consequently chosen as a criterion for a two-phase interface. In this study, it has been revealed that by changing both rheological and geometrical parameters it is possible to manage the value of interface area between two phases. Ultimately, a unique curve is developed for each droplet to primary phase viscosity ratio which can correlate drop deformation with geometrical parameters.
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Affiliation(s)
- M. Mostafaiyan
- 1Department of Polymer Engineering and Color Technology, Amirkabir University of Technology, P.O.Box 15875-4411, Tehran, Iran
| | - M.R. Saeb
- 2Department of Resin and Additives, Institute for Color Science and Technology, P.O.Box: 16765-654, Tehran, Iran
| | - Z. Ahmadi
- 3Color and Polymer Research Center (CPRC), Amirkabir University of Technology, P.O.Box 15875-4413, Tehran, Iran
| | - H.A. Khonakdar
- 4Department of Polymer Processing, Iran Polymer and Petrochemical Institute, 14965-115, Tehran, Iran
| | - U. Wagenknecht
- 5Leibniz-Institut für Polymerforschung Dresden e. V., Hohe Strasse 6, D-01069 Dresden, Germany
| | - G. Heinrich
- 5Leibniz-Institut für Polymerforschung Dresden e. V., Hohe Strasse 6, D-01069 Dresden, Germany
- 6Technische Universität Dresden, Institut für Werkstoffwissenschaft, D-01069 Dresden, Germany
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Nasseri M, Aghdami N, Ahmadi H, Moshkani Farahani M, Madani H, Kazemi-Saleh D, Hossein-neghad H, Hosseini S, Hekmat S, Ahmadi Z, Dehghani M, Saadat A, Mardpour S, Hosseini E, Esmaeelzadeh M, Sadeghi M, Bahoosh G, Bassi A, Amin A, Fazeli R, Sharafi Y, Arab L, Movahed M, Ramazanzadeh N, Kohkan A, Hezavee A, Namiri M, Kashfi F, Akhlaghi A, Baharvand H, Vosough A, Gourabi H, Shahverdi A. Phase III randomized clinical trial comparing the effects of autologous bone marrow derived MNC and CD133 cells transplantation in ami patients during CABG. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saadat I, Ahmadi Z, Farvardin-Jahromi M, Saadat M. Association between cataract and genetic polymorphisms of GSTM1, GSTT1, and GSTO2 with respect of work place. Mol Vis 2012; 18:1996-2000. [PMID: 22876127 PMCID: PMC3413443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 07/15/2012] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate whether genetic polymorphisms of glutathione S-transferases (GSTM1, GSTT1, and GSTO2) in relation to the work place contribute to the development of cataract. METHODS The present case-control study consisted of 186 patients (108 females, 78 males) with cataract and 195 gender-matched healthy controls (111 females, 84 males) were randomly selected from unrelated volunteers in the same clinic. The GSTM1, GSTT1, and GSTO2 genotypes were determined using polymerase chain reaction (PCR) based methods. RESULTS The null genotype of GSTM1 increased the risk of cataract (OR=1.51, 95%CI: 1.01-2.26, p=0.045). The prevalence of GSTT1 and GSTO2 genotypes was similar between cases and controls. There was significant difference between cases and controls for work place (χ(2)=4.16, df=1, p=0.041). Genetic polymorphisms (GSTM1, GSTO2) and work place that were significant by p<0.3 in the univariate analysis were included in the analysis for investigating the additive effects of the genotypes and work place on risk of cataract. Statistical analysis showed that the risk of cataract increased as a function of number of putative high risk factors (χ(2)=8.001, p=0.005). CONCLUSIONS This finding suggests that the polymorphisms of GSTM1 and GSTO2 and also work place may act additively for developing cataract.
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Affiliation(s)
- Iraj Saadat
- Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran,Institute of Biotechnology, Shiraz University, Shiraz, Iran
| | - Zainab Ahmadi
- Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran
| | - Majid Farvardin-Jahromi
- Poostchi Eye Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Saadat
- Department of Biology, College of Sciences, Shiraz University, Shiraz, Iran,Institute of Biotechnology, Shiraz University, Shiraz, Iran
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Monjezi M, Ahmadi Z, Varjani AY, Khandelwal M. Backbreak prediction in the Chadormalu iron mine using artificial neural network. Neural Comput Appl 2012. [DOI: 10.1007/s00521-012-1038-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
According to importance of the safety issues especially in air industry, fire-resisted parts and interiors consumption are increasing. Seat foam has a huge fraction of the airplane interior and this makes it essential to become safer. From another point, planning to phase out some of the halogenated flame retardants because of persistence in the environment, bioaccumulation, and toxicity. In recent years, halogen-free fire retardants have been more investigated. In this work, we have concentrated more on two well-known, solid, halogen-free fire retardants, expandable graphite and melamine, and compared their performance according to their fire behavior, physical properties, and production phenomena.
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Affiliation(s)
| | - R Bashirzadeh
- Department of Industrial Engineering, K.N. Toosi University, Tehran, Iran
| | - Z Ahmadi
- Color and Polymer Research Center, Amirkabir University of Technology, Tehran, Iran
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Liang SX, Khachigian LM, Ahmadi Z, Yang M, Liu S, Chong BH. In vitro and in vivo proliferation, differentiation and migration of cardiac endothelial progenitor cells (SCA1+/CD31+ side-population cells). J Thromb Haemost 2011; 9:1628-37. [PMID: 21615679 DOI: 10.1111/j.1538-7836.2011.04375.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Side-population (SP) cells are a select population identified by a capacity to efflux Hoechst dye and are enriched for stem/progenitor cell activity. Previous studies suggested that cardiac SP (CSP) cells could be divided into SCA1(+)/CD31(-) and SCA1(+)/CD31(+) CSP cells. SCA1(+)/CD31(-) CSP cells have been shown to be cardiac stem/progenitor cells. However, SCA1(+)/CD31(+) CSP cells have not been fully characterized. OBJECTIVE The aim of the present study was to characterize SCA1(+)/CD31(+) CSP cells in the adult mouse heart, and investigate their abilities to proliferate, differentiate, vascularize and migrate in vitro and in vivo. RESULTS Using fluorescence-activated cell sorting (FACS), RT-PCR, and assays of cell proliferation, differentiation and migration, and a murine model of myocardial infarction (MI), we showed that SCA1(+)/CD31(+) CSP cells express stem cell and endothelial-specific genes, and reside in the blood vessels. These cells were able to proliferate, differentiate, migrate and vascularize in vitro and in vivo. After MI, SDF-1α and CXCR4 were up-regulated in the damaged myocardium and on SCA1(+)/CD31(+) CSP cells, respectively. Our results further showed that SDF-1α induced migration of these cells in vitro. Importantly, we found that SCA1(+)/CD31(+) CSP cells could migrate into the ischemic region from the non-ischemic area within the myocardium and form a vascular tube-like structure after MI. CONCLUSIONS Based on the gene expression profile, localization of SCA1(+)/CD31(+) CSP cells, and their ability to proliferate, differentiate, migrate and vascularize in vitro and in vivo, we postulate that SCA1(+)/CD31(+) CSP cells may represent endothelial progenitor cells in the mouse heart.
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Affiliation(s)
- S X Liang
- Center for Vascular Research, University of New South Wales, Sydney, NSW, Australia
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Nourozi A, Talebi H, Fateh S, Mohammadzadeh A, Eghtesadi-Araghi P, Ahmadi Z, Savarabadi A, Mohebbi A. Effect of adding ketamine to pethidine on postoperative pain in patients undergoing major abdominal operations: a double blind randomized controlled trial. Pak J Biol Sci 2011; 13:1214-8. [PMID: 21313903 DOI: 10.3923/pjbs.2010.1214.1218] [Citation(s) in RCA: 4] [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: 11/15/2022]
Abstract
To determine the effect of adding ketamine to pethidine in reducing post-operative pain in patients undergoing major abdominal operations, in a double blind randomized controlled trial, 100 patients aged 15-60 years who were candidate for elective major abdominal surgery allocated into two groups of pethidine + ketamine group (5 mg pethidine and 0.25 mg kg(-1) ketamine) or pethidine and placebo group (10 mg pethidine and NS) according to the regimen prescribed in postanesthesia care unit. Severity of pain (using visual analogue scale), prescribed dose of pethidine and side effects were recorded until 24 h after operation. Regarding post-operative pain, pethidine + ketamine group showed significant lower scores in all the times except 0 min, 2, 6 and 16 h. Nausea was significantly less frequent amongst pethidine + placebo group at times of 0, 15, 30 and 45 min (p < 0.05). Comparison of two groups did not show significant differences in prescribed pethedine dose in 0, 9, 12, 16, 20 and 24 h (p > 0.05). Yet, the mean dose of administered pethidine as rescue analgesic was significant lower in pethidine + ketamine group compared to pethidine + placebo group (112 +/- 31.5 mg vs. 133.5 +/- 24.5 mg, p < 0.001). In conclusion, our results showed that co-administration of ketamine and pethidine in postanesthesia care unit will improve postoperative pain and reduce narcotic consumption. It may, however, increase rate of postoperative nausea in the first hour after operation.
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Affiliation(s)
- A Nourozi
- Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran
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Safavi M, Parsania Z, Azizzadeh F, Ahmadi Z. The surveillance of mental health and the strategies that families of the patients with seizure need to cope with stresses. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionSeizure is a common disease happening in all countries that surely affects life style of patient and his/her family; such patient needs helps of others to obviate his/her needs and delayed help leads to mental health impairment of the patient and his/her family.Method & materialsThis was a descriptive-correlative study in which 150 ones of patients families were selected via the systematic sampling method.We used three kinds of questionnaires to gather data including personal information questionnaire, General health questionnaire and Carver-Scheier-Veintrab’s questionnaire of stress coping Strategies.FindingsThe results showed that 56.7% of investigated units had inappropriate state of mental health and 92% used moderate-level guidelines to cope with stresses.The majority of family members of the patients with seizure (93.8%) had moderate level of mental health and similarly used moderate-level stress coping strategies(P = 0.000, S = 0.3).ConclusionThe findings of this study can result in a new plan to elevate the mental health level and also can train families of the patients with seizure and other chronic diseases how to cope with stresses.
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Parsania Z, Safavi M, Ahmadi Z. P02-113 - Mental health and coping strategies in families caring for patient with epilepsy in Iran. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70711-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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