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Chen E, Hollowell A, Truong T, Bentley-Edwards K, Myers E, Erkanli A, Holt L, Swartz JJ. Contraceptive Access and Use Among Undergraduate and Graduate Students During COVID-19: Online Survey Study. JMIR Form Res 2023; 7:e38491. [PMID: 36827491 PMCID: PMC10018798 DOI: 10.2196/38491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic led to widespread college campus closures in the months of March to June 2020, endangering students' access to on-campus health resources, including reproductive health services. OBJECTIVE To assess contraceptive access and use among undergraduate and graduate students in North Carolina during the COVID-19 pandemic. METHODS We conducted a cross-sectional web-based survey of undergraduate and graduate students enrolled at degree-granting institutions in North Carolina. Participants were recruited using targeted Instagram advertisements. The survey queried several aspects of participants' sexual behavior, including sex drive, level of sexual experience, number of sexual partners, digital sexual experience, dating patterns, and types of contraception used. Participants were asked to compare many of these behaviors before and after the pandemic. The survey also assessed several sociodemographic factors that we hypothesized would be associated with contraceptive use based on prior data, including educational background, sexual orientation and gender minority status (ie, lesbian, gay, bisexual, transgender, queer), health insurance status, race, ethnicity, degree of sensation seeking, religiosity, and desire to become pregnant. RESULTS Over 10 days, 2035 Instagram users began our survey, of whom 1002 met eligibility criteria. Of these 1002 eligible participants, 934 completed the survey, for a 93% completion rate. Our respondents were mostly female (665/934, 71%), cisgender (877/934, 94%), heterosexual (592/934, 64%), white (695/934 75%), not Hispanic (835/934, 89%), and enrolled at a 4-year college (618/934, 66%). Over 95% (895/934) of respondents reported that they maintained access to their preferred contraception during the COVID-19 pandemic. In a multivariable analysis, participants who were enrolled in a 4-year college or graduate program were less likely to lose contraceptive access when compared to participants enrolled in a 2-year college (risk ratio [RR] 0.34, 95% CI 0.16-0.71); in addition, when compared to cisgender participants, nonbinary and transgender participants were more likely to lose contraceptive access (RR 2.43, 95% CI 1.01-5.87). Respondents reported that they were more interested in using telehealth to access contraception during the pandemic. The contraceptive methods most commonly used by our participants were, in order, condoms (331/934, 35.4%), oral contraception (303/934, 32.4%), and long-acting reversible contraception (LARC; 221/934, 23.7%). The rate of LARC use among our participants was higher than the national average for this age group (14%). Emergency contraception was uncommonly used (25/934, 2.7%). CONCLUSIONS Undergraduate and graduate students in North Carolina overwhelmingly reported that they maintained access to their preferred contraceptive methods during the COVID-19 pandemic and through changing patterns of health care access, including telehealth. Gender nonbinary and transgender students and 2-year college students may have been at greater risk of losing access to contraception during the first year of the COVID-19 pandemic.
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McNamara JE, Chen E. Proposed Social Drivers Of Health Bonds Offer Promising Improvements But Face Many Challenges To Implementation. Health Aff (Millwood) 2023; 42:395-397. [PMID: 36877898 DOI: 10.1377/hlthaff.2023.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Social drivers of health (SDH) bonds have been proposed as a way of incentivizing investment in SDH interventions by Medicaid managed care organizations. The success of SDH bonds is predicated on the acceptance of shared responsibilities and resources for corporate and public-sector stakeholders. Underwritten against a Medicaid managed care organization's financial strength and promise to pay, SDH bond proceeds would support social services and investments in interventions that may mitigate social drivers that lead to poor health outcomes, which would in turn lower health care costs for low-to-moderate-income populations in communities of need. This systematic public health approach would tie together community-level benefits with the shared cost of care of participating managed care organizations. The Community Reinvestment Act model allows for innovation to meet business needs of health organizations, and cooperative competition can facilitate needed technology improvements for community-based social service organizations.
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Miglianico M, Bolscher JM, Vos MW, Koolen KJM, de Bruijni M, Rajagopal DS, Chen E, Kiczun M, Gray D, Campo B, Sauerwein RW, Dechering KJ. Assessment of the drugability of initial malaria infection through miniaturized sporozoite assays and high-throughput screening. Commun Biol 2023; 6:216. [PMID: 36823266 PMCID: PMC9950425 DOI: 10.1038/s42003-023-04599-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
The sporozoite stages of malaria parasites are the primary cause of infection of the vertebrate host and are targeted by (experimental) vaccines. Yet, little is known about their susceptibility to chemical intervention. Phenotypic high-throughput screens have not been feasible due to a lack of in vitro systems. Here we tested 78 marketed and experimental antimalarial compounds in miniaturized assays addressing sporozoite viability, gliding motility, hepatocyte traversal, and intrahepatocytic schizogony. None potently interfered with sporozoite viability or motility but ten compounds acted at the level of schizogony with IC50s < 100 nM. To identify compounds directly targeting sporozoites, we screened 81,000 compounds from the Global Health Diversity and reFRAME libraries in a sporozoite viability assay using a parasite expressing a luciferase reporter driven by the circumsporozoite promoter. The ionophore gramicidin emerged as the single hit from this screening campaign. Its effect on sporozoite viability translated into reduced gliding motility and an inability of sporozoites to invade human primary hepatocytes and develop into hepatic schizonts. While providing proof of concept for a small molecule sporontocidal mode of action, our combined data indicate that liver schizogony is more accessible to chemical intervention by (candidate) antimalarials.
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Ohzono H, Hu Y, Nagira K, Kanaya H, Okubo N, Olmer M, Gotoh M, Kurakazu I, Akasaki Y, Kawata M, Chen E, Chu AC, Johnson KA, Lotz MK. Targeting FoxO transcription factors with HDAC inhibitors for the treatment of osteoarthritis. Ann Rheum Dis 2023; 82:262-271. [PMID: 36109140 PMCID: PMC11005918 DOI: 10.1136/ard-2021-221269] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/27/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Osteoarthritis (OA) features ageing-related defects in cellular homeostasis mechanisms in articular cartilage. These defects are associated with suppression of forkhead box O (FoxO) transcription factors. FoxO1 or FoxO3 deficient mice show early onset OA while FoxO1 protects against oxidative stress in chondrocytes and promotes expression of autophagy genes and the essential joint lubricant proteoglycan 4 (PRG4). The objective of this study was to identify small molecules that can increase FoxO1 expression. METHODS We constructed a reporter cell line with FoxO1 promoter sequences and performed high-throughput screening (HTS) of the Repurposing, Focused Rescue and Accelerated Medchem (ReFRAME) library . Hits from the HTS were validated and function was assessed in human chondrocytes, meniscus cells and synoviocytes and following administration to mice. The most promising hit, the histone deacetylase inhibitor (HDACI) panobinostat was tested in a murine OA model. RESULTS Among the top hits were HDACI and testing in human chondrocytes, meniscus cells and synoviocytes showed that panobinostat was the most promising compound as it increased the expression of autophagy genes and PRG4 while suppressing the basal and IL-1β induced expression of inflammatory mediators and extracellular matrix degrading enzymes. Intraperitoneal administration of panobinostat also suppressed the expression of mediators of OA pathogenesis induced by intra-articular injection of IL-1β. In a murine OA model, panobinostat reduced the severity of histological changes in cartilage, synovium and subchondral bone and improved pain behaviours. CONCLUSION Panobinostat has a clinically relevant activity profile and is a candidate for OA symptom and structure modification.
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Shemesh A, Golomb D, Goldberg H, Chen E, Atamna F, Cooper A, Raz O. Effect of urology consult in the emergency department on outcome of patients with renal colic. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00396-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Zhao L, Zhang F, Wang K, Zhang X, Hu G, Chen E, Qiu J, Yuan C, He J. Quinolinic acid catabolism is initiated by a novel four-component hydroxylase QuiA in Alcaligenes faecalis JQ191. ENVIRONMENTAL RESEARCH 2023; 216:114421. [PMID: 36162464 DOI: 10.1016/j.envres.2022.114421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Quinolinic acid (QA) is an essential nitrogen-containing aromatic heterocyclic compounds in organisms and it also acts as an important intermediate in chemical industry, which has strong neurotoxicity and cytotoxicity. The wide range of sources and applications caused the release and accumulation of QA in the environment which might poses a hazard to ecosystems and human health. However, few research on the degradation of QA by microorganisms and toxicity of QA and its metabolites were reported. Alcaligenes faecalis JQ191 could degrade QA but the genetic foundation of QA degradation has not been studied. In this study, the gene cluster quiA1A2A3A4 was identified from A. faecalis JQ191, which was responsible for the initial catabolism step of QA. The quiA1A2A3A4 gene cluster encodes a novel cytoplasmic four-component hydroxylase QuiA. The 1H nuclear magnetic resonance indicated that QuiA catalyzed QA to 6-hydroxyquinolinic acid (6HQA) and the H218O-labeling analysis confirmed that the hydroxyl group incorporating into 6HQA was derived from water. Toxicity tests showed that the QA could approximately inhibit 20%-80% growth of Chlorella ellipsoidea, and 6HQA could relieve at least 50% QA growth inhibition of Chlorella ellipsoidea, indicating that the 6-hydroxylation of QA by QuiA is a detoxification process. This research provides new insights into the metabolism of QA by microorganism and potential application in the bioremediation of toxic pyridine derivatives-contaminated environments.
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Jones AE, McCarty MM, Cameron KA, Cavanaugh KL, Steinberg BA, Passman R, Kansal P, Guzman A, Chen E, Zhong L, Fagerlin A, Hargraves I, Montori VM, Brito JP, Noseworthy PA, Ozanne EM. Development of Complementary Encounter and Patient Decision Aids for Shared Decision Making about Stroke Prevention in Atrial Fibrillation. MDM Policy Pract 2023; 8:23814683231178033. [PMID: 38178866 PMCID: PMC10765759 DOI: 10.1177/23814683231178033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/06/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Decision aids (DAs) are helpful instruments used to support shared decision making (SDM). Patients with atrial fibrillation (AF) face complex decisions regarding stroke prevention strategies. While a few DAs have been made for AF stroke prevention, an encounter DA (EDA) and patient DA (PDA) have not been created to be used in conjunction with each other before. Design Using iterative user-centered design, we developed 2 DAs for anticoagulation choice and stroke prevention in AF. Prototypes were created, and we elicited feedback from patients and experts via observations of encounters, usability testing, and semistructured interviews. Results User testing was done with 33 experts (in AF and SDM) and 51 patients from 6 institutions. The EDA and PDA underwent 1 and 4 major iterations, respectively. Major differences between the DAs included AF pathophysiology and a preparation to meet with the clinician in the PDA as well as different language throughout. Content areas included personalized stroke risk, differences between anticoagulants, and risks of bleeding. Based on user feedback, developers 1) addressed feelings of isolation with AF, 2) improved navigation options, 3) modified content and flow for users new to AF and those experienced with AF, 4) updated stroke risk pictographs, and 5) added structure to the preparation for decision making in the PDA. Limitations These DAs focus only on anticoagulation for stroke prevention and are online, which may limit participation for those less comfortable with technology. Conclusions Designing complementary DAs for use in tandem or separately is a new method to support SDM between patients and clinicians. Extensive user testing is essential to creating high-quality tools that best meet the needs of those using them. Highlights First-time complementary encounter and patient decision aids have been designed to work together or separately.User feedback led to greater structure and different experiences for patients naïve or experienced with anticoagulants in patient decision aids.Online tools allow for easier dissemination, use in telehealth visits, and updating as new evidence comes out.
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Young IM, Dadario NB, Tanglay O, Chen E, Cook B, Taylor HM, Crawford L, Yeung JT, Nicholas PJ, Doyen S, Sughrue ME. Connectivity Model of the Anatomic Substrates and Network Abnormalities in Major Depressive Disorder: A Coordinate Meta-Analysis of Resting-State Functional Connectivity. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Chavarria-Smith J, Chiu CPC, Jackman JK, Yin J, Zhang J, Hackney JA, Lin WY, Tyagi T, Sun Y, Tao J, Dunlap D, Morton WD, Ghodge SV, Maun HR, Li H, Hernandez-Barry H, Loyet KM, Chen E, Liu J, Tam C, Yaspan BL, Cai H, Balazs M, Arron JR, Li J, Wittwer AJ, Pappu R, Austin CD, Lee WP, Lazarus RA, Sudhamsu J, Koerber JT, Yi T. Dual antibody inhibition of KLK5 and KLK7 for Netherton syndrome and atopic dermatitis. Sci Transl Med 2022; 14:eabp9159. [PMID: 36516271 DOI: 10.1126/scitranslmed.abp9159] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The epidermis is a barrier that prevents water loss while keeping harmful substances from penetrating the host. The impermeable cornified layer of the stratum corneum is maintained by balancing continuous turnover driven by epidermal basal cell proliferation, suprabasal cell differentiation, and corneal shedding. The epidermal desquamation process is tightly regulated by balance of the activities of serine proteases of the Kallikrein-related peptidases (KLK) family and their cognate inhibitor lymphoepithelial Kazal type-related inhibitor (LEKTI), which is encoded by the serine peptidase inhibitor Kazal type 5 gene. Imbalance of proteolytic activity caused by a deficiency of LEKTI leads to excessive desquamation due to increased activities of KLK5, KLK7, and KLK14 and results in Netherton syndrome (NS), a debilitating condition with an unmet clinical need. Increased activity of KLKs may also be pathological in other dermatoses such as atopic dermatitis (AD). Here, we describe the discovery of inhibitory antibodies against murine KLK5 and KLK7 that could compensate for the deficiency of LEKTI in NS. These antibodies are protective in mouse models of NS and AD and, when combined, promote improved skin barrier integrity and reduced inflammation. To translate these findings, we engineered a humanized bispecific antibody capable of potent inhibition of human KLK5 and KLK7. A crystal structure of KLK5 bound to the inhibitory Fab revealed that the antibody binds distal to its active site and uses a relatively unappreciated allosteric inhibition mechanism. Treatment with the bispecific anti-KLK5/7 antibody represents a promising therapy for clinical development in NS and other inflammatory dermatoses.
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Meira e Cruz M, Chen E, Zhou Y, Shu D, Zhou C, Kryger M. Using Circul® for assessing obstructive sleep apnea severity. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cheng Y, Wang J, Yu Y, Zang A, Lv D, Li S, Cao L, Meng Z, Mao W, Zhang J, Liu A, Zhang Y, Tang K, Liu J, Zheng J, Wang Z, Chen E, Zhang X, Guo Q, Huang D. 103P Phase IIIb study of durvalumab plus platinum-etoposide in first-line treatment of Chinese extensive-stage small cell lung cancer (ORIENTAL): Preliminary safety and efficacy results. IMMUNO-ONCOLOGY AND TECHNOLOGY 2022. [DOI: 10.1016/j.iotech.2022.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Meira e Cruz M, Chen E, Zhou Y, Shu D, Zhou C, Kryger M. Circul, a ring wearable in the detection of sleep breathing abnormalities. Preliminary data. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dawson L, Winter K, Knox J, Zhu A, Krishnan S, Guha C, Kachnic L, Gillin M, Hong T, Craig T, Hosni A, Chen E, Noonan A, Koay E, Sinha R, Lock M, Ohri N, Dorth J, Moughan J, Crane C. NRG/RTOG 1112: Randomized Phase III Study of Sorafenib vs. Stereotactic Body Radiation Therapy (SBRT) Followed by Sorafenib in Hepatocellular Carcinoma (HCC) (NCT01730937). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Segal N, Tie J, Kopetz S, Ducreux M, Chen E, Dienstmann R, Hollebecque A, Reilley M, Elez Fernandez M, Cosaert J, Cain J, Hernandez M, Hewson N, Cooper Z, Dressman M, Tabernero J. 160P COLUMBIA-1: A phase Ib/II, open-label, randomized, multicenter study of durvalumab plus oleclumab in combination with chemotherapy and bevacizumab as first-line (1L) therapy in metastatic microsatellite-stable colorectal cancer (MSS-mCRC). IMMUNO-ONCOLOGY AND TECHNOLOGY 2022. [DOI: 10.1016/j.iotech.2022.100272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Daraz U, Chen E, Tang Y. Supersaturated designs with less β-aberration. COMMUN STAT-THEOR M 2022. [DOI: 10.1080/03610926.2022.2150828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Sachar S, Chen E, Harris E, Montero A, Choi S. Impact of Hormone Receptor Status on Development of Brain Metastases from HER2+ Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chen E, Harris E, Amin A, Owusu C, Lyons J. Patterns of Regional Radiotherapy Following Breast Conserving Surgery in Hormone Receptor Positive Breast Cancer with Limited Nodal Disease: A Single Institutional Experience. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tan WP, Kotamarti S, Chen E, Mahle R, Arcot R, Chang A, Ayala A, Michael Z, Seguier D, Polascik TJ. Oncological and functional outcomes of men undergoing primary whole gland cryoablation of the prostate: A 20-year experience. Cancer 2022; 128:3824-3830. [PMID: 36107496 DOI: 10.1002/cncr.34458] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study reports the oncological and functional outcomes in men with localized prostate cancer (Pca) who were treated with primary whole gland cryoablation (WGC) of the prostate. METHODS The authors retrospectively reviewed their prospectively collected cryosurgery database between January 2002 and September 2019 for men who were treated with WGC of the prostate at a tertiary referral center. Primary outcome includes biochemical recurrence-free survival (BRFS). Secondary outcomes include failure-free survival (FFS), metastasis-free survival (MFS) and adverse events. RESULTS A total of 260 men were included in the study. Men having had prior treatment for Pca were excluded. Median follow-up was 107 months (interquartile range [IQR], 68.3-132.5 months). BRFS, FFS, and MFS at 10 years were 84%, 66%, and 96%, respectively. High risk D'Amico classification was associated with a lower BRFS and FFS on multivariable analysis. No patient had any Pca-related death during follow-up. American Urological Association symptoms score and bother index were unchanged following cryoablation. Median International Index of Erectile Function score precryoablation and post-cryoablation was 7 (IQR, 3-11) and 1 (IQR, 1-5), respectively. Stress urinary incontinence, defined as requiring any protective pads only occurred in five patients (2%). No patient developed a fistula. Grade > 2 Clavien-Dindo adverse events occurred in six (2.3%) patients. CONCLUSION WGC of the prostate can achieve excellent oncological and functional outcomes in men with localized Pca at the 10-year mark. Primary WGC may be a good option for men who desire to preserve urinary continence and have an excellent oncologic outcome. LAY SUMMARY Primary whole gland cryoablation is an alternative treatment option to radical prostatectomy and radiotherapy for men with organ-confined prostate cancer. Patients had excellent cancer outcomes 1 years after whole gland cryoablation, and patients with PSA nadir 0.1 ng/ml or lower after treatment were less likely to have disease recurrence.
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Chen E, Ng CE, Toumi Z. OC-052 A CHANGE IN PRESENTATION OF PARAOESOPHAGEAL HIATUS HERNIA REQUIRING SURGICAL INTERVENTION IN A DISTRICT GENERAL HOSPITAL IN THE NORTHERN REGION OF THE UNITED KINGDOM. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
The incidence of paraoesphageal hiatus hernia (PEH) has changed over the last several years. This study aims to ascertain the difference in the presentation of PEH requiring operative intervention at our unit because of the COVID-19 pandemic
Material & Methods
We conducted a retrospective review of procedures performed by a single surgeon for PEH in a district general hospital. We compared cases from 2016 to March 2020 and during the initial period of the COVID-19 pandemic in 2020.
Results
39 consecutive cases were identified undergoing PEH related procedures. The median age was 66 (IQR 26), with slight female predominance (M:F ratio of 5:6). 28 cases (71.8%) were performed as elective cases.
After the 2020 March lockdown, there were 10 cases of PEH repair performed with 78% performed as emergency procedures, compared to 30 cases in the preceding 5 years and 10% performed as emergency cases. Chi-square test to examine the association between COVID-19 pandemic and emergency procedure, X2(1, N=39)=14.199, p=0.000164.
Pre-COVID19 the types of procedures included 76.7% were fundoplication with suture crural closure, 10% were fundoplication with mesh repair, 3.3% biological mesh repair, 3.3% with suture closure of the crural and 6.7% had suture gastropexy. During the COVID-19 period, 44.4% were gastropexy, 33.3% were gastrostomy tube insertion and 22.2% fundoplication performed.
Conclusion
We have seen significantly more emergency PEH related procedures performed and using a variety of procedures. This leads to the consideration of whether current emergency general surgery training can equip trainees for future independent practice.
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L'official G, Vely M, Guerin A, Chen E, Dreyfus J, Sportouch C, Oger E, Donal E. Isolated functional tricuspid regurgitation, how define patient at-risk for event? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Functional tricuspid regurgitation (TR) is a turning point in cardiac diseases. Symptoms typically appear late, and the optimal timing for proposing a valve repair remains a challenge. We sought to analyse the characteristics of right heart remodelling in patients with significant functional TR to identify the parameters that could be used in an easily achievable and fair prognostic model predicting clinical events.
Methods
We designed a prospective observational French multicentre study including 160 patients with significant functional TR (effective regurgitant orifice area >30mm2) and LVEF >40%. Clinical, echocardiographic, and ECG data were collected at baseline, and at the 1- and 2-year follow-up. The primary outcome was all-cause death or hospitalization for heart failure.
Results
At 2 years, 56 patients (35%) achieved the primary outcome. The subset with events showed more advanced right heart remodelling at baseline, but similar TR severity. Right atrial volume index (RAVI) and the TAPSE/sPAP ratio, reflecting right-ventricle-pulmonary artery coupling, were 73 mL/m2 and 0.40 versus 64.7 mL/m2 and 0.50 in the event vs event-free group, respectively (both p<0.05). None among all the clinical and imaging parameters tested had a significant group × time interaction. In multivariable analysis, the model including TAPSE/sPAP ratio >0.4 (OR=0.41, 95%CL 0.2 to 0.82) and RAVI >60 mL/m2 (OR=2.13, 95%CL 0.96 to 4.75) permitted the fairest and most parsimonious prognostic evaluation.
Conclusion
RAVI and TAPSE/sPAP are relevant for predicting the risk for event at 2-year follow-up in patient with an isolated functional TR.
Funding Acknowledgement
Type of funding sources: None.
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Murtha A, Warner E, van der Eecken K, Kwan E, Herberts C, Sipola J, Ng S, Chen E, Fonseca N, Schönlau E, Bernales C, Donnellan G, Verbeke S, Lumen N, van Dorpe J, De Laere B, Annala M, Vandekerkhove G, Ost P, Wyatt A. 4MO Multi-focal genomic dissection of synchronous primary and metastatic tissue from de novo metastatic prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Yong Z, Yap LW, Shi Q, Chesman ASR, Chen E, Fu R, Cheng W. Omnidirectional Hydrogen Generation Based on a Flexible Black Gold Nanotube Array. ACS NANO 2022; 16:14963-14972. [PMID: 36044034 DOI: 10.1021/acsnano.2c05933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Solar-driven hydrogen generation is emerging as an economical and sustainable means of producing renewable energy. However, current photocatalysts for hydrogen generation are mostly powder-based or rigid-substrate-supported, which suffer from limitations, such as difficulties in catalyst regeneration or poor omnidirectional light-harvesting. Here, we report a two-dimensional (2D) flexible photocatalyst based on elastomer-supported black gold nanotube (GNT) arrays with conformal CdS coating and Pt decoration. The highly porous GNT arrays display a strong light-trapping effect, leading to near-complete absorption over almost the entire range of the solar spectrum. In addition, they offer high surface-to-volume ratios promoting efficient photocatalytic reactions. These structural features result in high H2 generation efficiencies. Importantly, our elastomer-supported photocatalyst displays comparable photocatalytic activity even when being mechanically deformed, including bending, stretching, and twisting. We further designed a three-dimensional (3D) tree-like flexible photocatalytic system to mimic Nature's photosynthesis, which demonstrated omnidirectional H2 generation. We believe our strategy represents a promising route in designing next-generation solar-to-fuel systems that rival natural plants.
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Zhu Y, Tan H, Wu Z, Li T, Ma L, Liu J, Zhang H, Gu Y, Li T, Guan S, Xie X, Jiang C, Zhao Z, Duan C, Wan J, Zhang X, Feng W, He X, Shi H, Wang Q, Lin D, Li Q, Jiang W, Mao G, Zhong S, Chen E, Shi H, Ren S, Wang D, Liu Y, Liu Z, Wu J, Wang F, Hu X, Wang J, Zhang F, Cao W, Yang D, Zhang Q, Wang L, Gu B, Cheng G, Zhang Y, Fang C, Li M. Use of covered stents to treat complex cerebrovascular diseases: Expert consensus. Front Cardiovasc Med 2022; 9:934496. [PMID: 36186960 PMCID: PMC9524574 DOI: 10.3389/fcvm.2022.934496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022] Open
Abstract
The treatment of complex cerebrovascular diseases (CCVDs) at the skull base, such as complex intracranial aneurysms, carotid-cavernous sinus fistulas, and intracranial artery traumatic injuries, is a difficult clinical problem despite advances in endovascular and surgical therapies. Covered stents or stent graft insertion is a new concept for endovascular treatment that focuses on arterial wall defect reconstruction, differing from endovascular lesion embolization or flow diverter therapies. In recent years, covered stents specifically designed for cerebrovascular treatment have been applied in the clinical setting, allowing thousands of patients with CCVDs to undergo intraluminal reconstruction treatment and achieving positive results, even in the era of flow diverters. Since there is no unified reference standard for the application of covered stents for treating CCVDs, it is necessary to further standardize and guide the clinical application of this technique. Thus, we organized authoritative experts in the field of neurointervention in China to write an expert consensus, which aims to summarize the results of covered stent insertion in the treatment of CCVDs and propose suitable standards for its application in the clinical setting. Based on the contents of this consensus, clinicians can use individualized intraluminal reconstruction treatment techniques for patients with CCVDs.
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Wang W, Favaro M, Chen E, Trotochaud L, Bluhm H, Choi KS, van de Krol R, Starr DE, Galli G. Influence of Excess Charge on Water Adsorption on the BiVO 4(010) Surface. J Am Chem Soc 2022; 144:17173-17185. [PMID: 36074011 PMCID: PMC9501793 DOI: 10.1021/jacs.2c07501] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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We present a combined computational and experimental
study of the
adsorption of water on the Mo-doped BiVO4(010) surface,
revealing how excess electrons influence the dissociation of water
and lead to hydroxyl-induced alterations of the surface electronic
structure. By comparing ambient pressure resonant photoemission spectroscopy
(AP-ResPES) measurements with the results of first-principles calculations,
we show that the dissociation of water on the stoichiometric Mo-doped
BiVO4(010) surface stabilizes the formation of a small
electron polaron on the VO4 tetrahedral site and leads
to an enhanced concentration of localized electronic charge at the
surface. Our calculations demonstrate that the dissociated water accounts
for the enhanced V4+ signal observed in ambient pressure
X-ray photoelectron spectroscopy and the enhanced signal of a small
electron polaron inter-band state observed in AP-ResPES measurements.
For ternary oxide surfaces, which may contain oxygen vacancies in
addition to other electron-donating dopants, our study reveals the
importance of defects in altering the surface reactivity toward water
and the concomitant water-induced modifications to the electronic
structure.
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Sacher A, Lau S, Allen M, Corke L, Makarem M, Chen E, Jang RJ, Elimova E, Grant R, Shepherd F, Bradbury P, Eng L, Rogalla P, Liu G, Tsao MS, Leighl N, Garonce-Hediger R, Wang B, Ohashi P, Knox J. 1202TiP Evolution of the tumor immune microenvironment in hepatocellular carcinoma (HCC) and non-squamous non-small cell lung cancer (NSCLC) with liver metastases treated with atezolizumab and bevacizumab (INTEGRATE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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