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Ko B, Tao K, Brennan L, Rakhade S, Chan CX, Moone JY, Zhu R, Sher A, Wang S, Bracero Y, Fullerton B, McLellan B, Geskin LJ, Saenger YM. Evaluating the efficacy of combination and single-agent immunotherapies in real-world patterns of disease progression and survival of metastatic melanoma patients. Melanoma Res 2024; 34:134-141. [PMID: 38181115 PMCID: PMC10906191 DOI: 10.1097/cmr.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/03/2023] [Indexed: 01/07/2024]
Abstract
The objective of this study is to describe survival outcomes in patients with metastatic melanoma in a real-world setting receiving combination and single-agent immunotherapy outside the clinical trial context. We conducted a retrospective single-institution study of patients with metastatic melanoma in a real-world setting. Survival was calculated using log-rank test. Contingency tables were analyzed using Fisher's Exact test. CD8 + T-cell densities were measured using quantitative immunofluorescence and analyzed using Mann-Whitney U test. The median overall survival (OS) for 132 patients was 45.3 months. Brain metastasis did not confer a higher risk of death relative to liver and/or bone disease (39.53 versus 30.00 months, respectively; P = 0.687). Anti-PD-1 monotherapy was the most common first-line treatment, received by 49.2% of patients. There was no significant difference in OS between patients receiving single-agent anti-PD-1 and combination anti-PD-1 plus CTLA-4 (39.4 months versus undefined; P = 0.643). Patients treated with combination therapy were more likely to be alive without progression at the last follow-up than those who received monotherapy (70.4% versus 49.2%; P = 0.0408). Median OS was 21.8 months after initiation of second-line therapy after anti-PD-1 monotherapy. CD8+ T-cell densities were higher in patients who achieved disease control on first-line immunotherapy ( P = 0.013). In a real-world setting, patients with metastatic melanoma have excellent survival rates, and treatment benefit can be achieved even after progression on first-line therapy. Combination immunotherapy may produce more favorable long-term outcomes in a real-world setting. High pretreatment CD8+ T-cell infiltration correlates with immunotherapy efficacy.
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Affiliation(s)
- Brian Ko
- National Cancer Institute, Bethesda, Maryland
| | - Kevin Tao
- Montefiore Einstein Cancer Center, Albert Einstein College of Medicine, Bronx
| | - Lachlan Brennan
- Department of Medicine, Columbia University Medical Center, New York
| | - Swanand Rakhade
- Department of Medicine, Columbia University Medical Center, New York
| | - Cynthia X. Chan
- Division of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx
| | | | - Richard Zhu
- Division of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx
| | - Ariel Sher
- Division of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx
| | - Samuel Wang
- Montefiore Einstein Cancer Center, Albert Einstein College of Medicine, Bronx
| | - Yadriel Bracero
- Montefiore Einstein Cancer Center, Albert Einstein College of Medicine, Bronx
| | - Ben Fullerton
- Department of Medicine, Columbia University Medical Center, New York
| | - Beth McLellan
- Division of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx
| | - Larisa J. Geskin
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA
| | - Yvonne M. Saenger
- Montefiore Einstein Cancer Center, Albert Einstein College of Medicine, Bronx
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Sher A, Kresch M, Bitterman D, Elbogen E, Lebwohl MG. Sarecycline as a Potential Treatment for Steroid-Induced Rosacea/Perioral Dermatitis: A Case Report. J Drugs Dermatol 2024; 23:e55-e56. [PMID: 38306126 DOI: 10.36849/jdd.7638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
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Islam Z, Toker M, Gandhi IM, Sher A, Campton K. Improvement of Recalcitrant Dissecting Cellulitis of the Scalp After a Trial of Upadacitinib. Cureus 2024; 16:e52377. [PMID: 38361718 PMCID: PMC10868624 DOI: 10.7759/cureus.52377] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Dissecting cellulitis of the scalp (DCS) is a rare condition characterized by painful inflammatory nodules and abscesses on the scalp, often leading to sinus tracts and scarring alopecia. We present a case of DCS in a 26-year-old male who experienced significant clinical improvement following a short course of upadacitinib, a Janus kinase (JAK) inhibitor. The patient received multiple standard treatments such as topical antimicrobials, oral antibiotics, corticosteroids, and intralesional triamcinolone injections, with limited success. However, following the initiation of upadacitinib, the patient reported reduced pain, pustular draining, and bleeding, with significantly improved quality of life. To our knowledge, there is currently a paucity of literature documenting the use of JAK inhibitors for DCS. This case aims to highlight the potential of JAK inhibitors as a therapy for refractory DCS, a condition with limited treatment options.
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Affiliation(s)
- Zahidul Islam
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, USA
| | - Michelle Toker
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, USA
| | - Isha M Gandhi
- Dermatology, University of Minnesota Twin Cities Medical School, Minneapolis, USA
| | - Ariel Sher
- Dermatology, New York Medical College, Valhalla, USA
| | - Kristina Campton
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, USA
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Kohanzadeh A, Sher A, Wind O, Liu Q, Srivastava P, Amin B, Mann R. Pancreatic Panniculitis: A Case Associated With Acute Pancreatic Allograft Rejection. Cureus 2024; 16:e52925. [PMID: 38274602 PMCID: PMC10810171 DOI: 10.7759/cureus.52925] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 01/27/2024] Open
Abstract
We present a unique case of pancreatic panniculitis (PP) in a 42-year-old male with a history of pancreas-after-kidney (PAK) transplant. The patient developed PP due to acute pancreas allograft rejection. Clinical manifestations included fevers, myalgias, arthralgias, and tender erythematous subcutaneous nodules on the lower extremities. A recent hospital admission was noted for acute pancreas allograft rejection related to low tacrolimus levels. Rheumatological and infectious disease workups were negative. Skin nodule punch biopsy confirmed PP with lobular panniculitis, necrotic adipocytes, basophilic debris, and calcification. Pancreatic biopsy showed evidence of parenchymal acute cellular rejection. Lipase and amylase levels were elevated (1781 U/L and 881 U/L, respectively). Treatment involved pulse solumedrol and thymoglobulin for pancreatic rejection, alongside adjustments to immunosuppressive medications. This case highlights the rarity of PP in a PAK recipient and its association with acute pancreas allograft rejection. Importantly, it is the first reported case of PP occurring solely in the context of pancreas transplant rejection, without concurrent kidney damage or rejection. Prompt diagnosis and management led to the resolution of skin and systemic symptoms. In conclusion, this report presents a clinically relevant and unique case of PP resulting from acute pancreas allograft rejection in a PAK transplant recipient. The findings underscore the importance of early diagnosis and management for positive patient outcomes, serving as a reminder to consider underlying pancreatic pathology when encountering PP in transplant recipients.
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Affiliation(s)
- Avraham Kohanzadeh
- Internal Medicine, Albert Einstein College of Medicine, New York City, USA
| | - Ariel Sher
- Dermatology, New York Medical College, New York City, USA
| | - Olivia Wind
- Dermatology, Mount Sinai Hospital, New York City, USA
| | - Qiang Liu
- Pathology and Laboratory Medicine, Montefiore Medical Center, New York City, USA
| | | | - Bijal Amin
- Dermatopathology, Montefiore Medical Center, New York City, USA
| | - Ranon Mann
- Dermatology, Montefiore Medical Center, New York City, USA
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Todd R, Sher A, Yang A, Shilo D, Garcia-Reyes K, Bishay V, Patel R, Fischman A, Nowakowski F, Lookstein R, Tabrizian P, Kim E. Abstract No. 127 90Y vs. TACE Histopathologic Outcomes in Patients with HCC Who Underwent Orthotopic Liver Transplant: A Single-Center, 7-Year Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Carle PJF, Retière F, Sher A, Underwood R, Starosta K, Hildebrand M, Barsky S, Howard S. Publisher's Note: "Neutron emission spectrometer to measure ion temperature on the Fusion Demonstration Plant" [Rev. Sci. Instrum. 93, 113539 (2022)]. Rev Sci Instrum 2022; 93:129904. [PMID: 36586939 DOI: 10.1063/5.0135254] [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] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Indexed: 06/17/2023]
Affiliation(s)
- P J F Carle
- General Fusion, Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - F Retière
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A Sher
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - R Underwood
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - K Starosta
- Department of Chemistry, Simon Fraser University, 8888 University Dr., Burnaby, British Columbia V5A 1S6, Canada
| | - M Hildebrand
- General Fusion, Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - S Barsky
- General Fusion, Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - S Howard
- General Fusion, Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
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Carle PJF, Retière F, Sher A, Underwood R, Starosta K, Hildebrand M, Barsky S, Howard S. Neutron emission spectrometer to measure ion temperature on the Fusion Demonstration Plant. Rev Sci Instrum 2022; 93:113539. [PMID: 36461414 DOI: 10.1063/5.0101814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
General Fusion is building the Fusion Demonstration Plant to demonstrate a magnetized target fusion scheme in which a deuterium plasma is heated from 200 eV to 10 keV by piston-driven compression of a liquid-lithium liner. The multilayer coaxial time-of-flight neutron emission spectrometer is designed to measure the ion temperature near peak compression at which time the neutron yield will approach 1018 neutrons/s. The neutron energy distribution is expected to be Gaussian since the machine uses no neutral beam or radio-frequency heating. In this case, analysis shows that as few as 500 coincidence events should be sufficient to accurately measure the ion temperature. This enables a fast time resolution of 10 µs, which is required to track the rapid change in temperature approaching peak compression. We overcome the challenges of neutron pile-up and event ambiguity with a compact design having two layers of segmented scintillators. The error in the ion temperature measurement is computed as a function of the neutron spectrometer's geometric parameters and used to optimize the design for the case of reaching 10 keV at peak compression.
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Affiliation(s)
- P J F Carle
- General Fusion Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - F Retière
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A Sher
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - R Underwood
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - K Starosta
- Department of Chemistry, Simon Fraser University, 8888 University Dr., Burnaby, British Columbia V5A 1S6, Canada
| | - M Hildebrand
- General Fusion Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - S Barsky
- General Fusion Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
| | - S Howard
- General Fusion Inc., 320-3600 Lysander Lane, Richmond, British Columbia V7B 1C3, Canada
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Sher A, Bishay V, Patel R, Fischman A, Nowakowski S, Kim E, Lookstein R. Abstract No. 308 Lung shunt fraction before radiation segmentectomy of very early to early stage HCC. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Rafiq H, Ayaz M, Khan HA, Iqbal M, Quraish S, Afridi SG, Khan A, Khan B, Sher A, Siraj F, Shams S. Therapeutic potential of stem cell and melatonin on the reduction of CCl4-induced liver fibrosis in experimental mice model. BRAZ J BIOL 2022; 84:e253061. [PMID: 35293541 DOI: 10.1590/1519-6984.253061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022] Open
Abstract
Liver fibrosis is initial stage of any chronic liver disease and its end stage is develops into cirrhosis. Chronic liver diseases are a crucial global health issue and the cause of approximately 2 million deaths per year worldwide. Cirrhosis is currently the 11th most common cause of death globally. Mesenchymal stem cell (MSCs) treatment is the best way to treat acute and chronic liver disease. The aim of this study is to improve the therapeutic potential of MSCs combined with melatonin (MLT) to overcome CCl4-induced liver fibrosis and also investigate the individual impact of melatonin and MSCs against CCl4-induced liver impairment in animal model. Female BALB/c mice were used as CCL4-induced liver fibrotic animal model. Five groups of animal model were made; negative control, Positive control, CCl4+MSCs treated group, CCl4+MLT treated group and CCl4+MSCs+MLT treated group. Cultured MSCs from mice bone marrow were transplanted to CCl4-induced liver injured mice model, individually as well as together with melatonin. Two weeks after MSCs and MLT administration, all groups of mice were sacrificed for examination. Morphological and Histopathological results showed that combined therapy of MSCs+MLT showed substantial beneficial impact on CCl4-induced liver injured model, compared with MSCs and MLT individually. Biochemically, considerable reduction was observed in serum bilirubin and ALT levels of MLT+MSC treated mice, compared to other groups. PCR results shown down-regulation of Bax and up-regulation of Bcl-xl and Albumin, confirm a significant therapeutic effect of MSCs+MLT on CCI4-induced liver fibrosis. From the results, it is concluded that combined therapy of MSCs and MLT show strong therapeutic effect on CCL4-induced liver fibrosis, compared with MSCs and MLT individually.
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Affiliation(s)
- H Rafiq
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - M Ayaz
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - H A Khan
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - M Iqbal
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - S Quraish
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - S G Afridi
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - A Khan
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - B Khan
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
| | - A Sher
- Bacha Khan University Charsadda, Department of Agriculture, Khyber Pakhtunkhwa, Pakistan
| | - F Siraj
- Isamia College University Peshawar, Department of Zoology, Khyber Pakhtunkhwa, Pakistan
| | - S Shams
- Abdul Wali Khan University Mardan, Department of Biochemistry, Stem Cell Regenerative Medicine Lab, Khyber Pakhtunkhwa, Pakistan
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Arkenau HT, Guthrie T, Mekhail T, Cortinovis D, Antonuzzo L, Bruce J, Gabrail N, Anderson I, Oh S, Oh S, Nott L, Shah M, Sanborn R, Oh DY, Cho J, Lin CC, Lee A, Wang Y, Wang Z, Sher A. 643TiP Open-label, phase II study of ladiratuzumab vedotin (LV) for unresectable locally advanced or metastatic solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Dragan E, Sher A, Xiong P, Cline A, Moy J. Successful implementation of phototherapy guidelines during the COVID-19 pandemic. J Am Acad Dermatol 2021; 85:e319-e320. [PMID: 34403711 PMCID: PMC8364145 DOI: 10.1016/j.jaad.2021.05.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Emma Dragan
- New York Medical College, Valhalla, New York.
| | - Ariel Sher
- New York Medical College, Valhalla, New York
| | - Peter Xiong
- New York Medical College, Valhalla, New York
| | - Abigail Cline
- Department of Dermatology, New York Medical College, Valhalla, New York
| | - Janet Moy
- Department of Dermatology, New York Medical College, Valhalla, New York
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Sharma H, Maron S, Sher A, Galla N, Titano J, Bishay V, Kim E, Nowakowski F, Patel R, Lookstein R, Rastinehad A, Fischman A. Abstract No. 567 Prostatic artery embolization in patients with prior prostatitis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Maron S, Sharma H, Sher A, Radell J, Titano J, Bishay V, Kim E, Nowakowski F, Patel R, Lookstein R, Rastinehad A, Fischman A. Abstract No. 452 Prostatic artery embolization for inpatient and emergent hematuria: a single-system experience. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Galla N, Voutsinas N, Sher A, Maron S, Titano J, Bishay V, Kim E, Nowakowski F, Patel R, Ranade M, Lookstein R, Fischman A, Rastinehad A. Abstract No. 521 Safety and efficacy of coil embolization of the prostate arteries post-particle embolization for lower urinary tract symptoms. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.330] [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: 11/17/2022] Open
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Radell J, Maron S, Sher A, Bishay V, Kim E, Nowakowski F, Patel R, Lookstein R, Rastinehad A, Fischman A. Abstract No. 39 Prostatic artery embolization in patients with recurrent lower urinary tract symptoms following failed transurethral resection of the prostate. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Aguilar-Arevalo A, Aoki M, Blecher M, Britton D, vom Bruch D, Bryman D, Chen S, Comfort J, Cuen-Rochin S, Doria L, Gumplinger P, Hussein A, Igarashi Y, Ito S, Kettell S, Kurchaninov L, Littenberg L, Malbrunot C, Mischke R, Numao T, Protopopescu D, Sher A, Sullivan T, Vavilov D. Search for three body pion decays
π+→l+νX. Int J Clin Exp Med 2021. [DOI: 10.1103/physrevd.103.052006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abba A, Accorsi C, Agnes P, Alessi E, Amaudruz P, Annovi A, Desages FA, Back S, Badia C, Bagger J, Basile V, Batignani G, Bayo A, Bell B, Beschi M, Biagini D, Bianchi G, Bicelli S, Bishop D, Boccali T, Bombarda A, Bonfanti S, Bonivento WM, Bouchard M, Breviario M, Brice S, Brown R, Calvo-Mozota JM, Camozzi L, Camozzi M, Capra A, Caravati M, Carlini M, Ceccanti A, Celano B, Cela Ruiz JM, Charette C, Cogliati G, Constable M, Crippa C, Croci G, Cudmore S, Dahl CE, Dal Molin A, Daley M, Di Guardo C, D'Avenio G, Davignon O, Del Tutto M, De Ruiter J, Devoto A, Diaz Gomez Maqueo P, Di Francesco F, Dossi M, Druszkiewicz E, Duma C, Elliott E, Farina D, Fernandes C, Ferroni F, Finocchiaro G, Fiorillo G, Ford R, Foti G, Fournier RD, Franco D, Fricbergs C, Gabriele F, Galbiati C, Garcia Abia P, Gargantini A, Giacomelli L, Giacomini F, Giacomini F, Giarratana LS, Gillespie S, Giorgi D, Girma T, Gobui R, Goeldi D, Golf F, Gorel P, Gorini G, Gramellini E, Grosso G, Guescini F, Guetre E, Hackman G, Hadden T, Hawkins W, Hayashi K, Heavey A, Hersak G, Hessey N, Hockin G, Hudson K, Ianni A, Ienzi C, Ippolito V, James CC, Jillings C, Kendziora C, Khan S, Kim E, King M, King S, Kittmer A, Kochanek I, Kowalkowski J, Krücken R, Kushoro M, Kuula S, Laclaustra M, Leblond G, Lee L, Lennarz A, Leyton M, Li X, Liimatainen P, Lim C, Lindner T, Lomonaco T, Lu P, Lubna R, Lukhanin GA, Luzón G, MacDonald M, Magni G, Maharaj R, Manni S, Mapelli C, Margetak P, Martin L, Martin S, Martínez M, Massacret N, McClurg P, McDonald AB, Meazzi E, Migalla R, Mohayai T, Tosatti LM, Monzani G, Moretti C, Morrison B, Mountaniol M, Muraro A, Napoli P, Nati F, Natzke CR, Noble AJ, Norrick A, Olchanski K, Ortiz de Solorzano A, Padula F, Pallavicini M, Palumbo I, Panontin E, Papini N, Parmeggiano L, Parmeggiano S, Patel K, Patel A, Paterno M, Pellegrino C, Pelliccione P, Pesudo V, Pocar A, Pope A, Pordes S, Prelz F, Putignano O, Raaf JL, Ratti C, Razeti M, Razeto A, Reed D, Refsgaard J, Reilly T, Renshaw A, Retriere F, Riccobene E, Rigamonti D, Rizzi A, Rode J, Romualdez J, Russel L, Sablone D, Sala S, Salomoni D, Salvo P, Sandoval A, Sansoucy E, Santorelli R, Savarese C, Scapparone E, Schaubel T, Scorza S, Settimo M, Shaw B, Shawyer S, Sher A, Shi A, Skensved P, Slutsky A, Smith B, Smith NJT, Stenzler A, Straubel C, Stringari P, Suchenek M, Sur B, Tacchino S, Takeuchi L, Tardocchi M, Tartaglia R, Thomas E, Trask D, Tseng J, Tseng L, VanPagee L, Vedia V, Velghe B, Viel S, Visioli A, Viviani L, Vonica D, Wada M, Walter D, Wang H, Wang MHLS, Westerdale S, Wood D, Yates D, Yue S, Zambrano V. The novel Mechanical Ventilator Milano for the COVID-19 pandemic. Phys Fluids (1994) 2021; 33:037122. [PMID: 33897243 PMCID: PMC8060010 DOI: 10.1063/5.0044445] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.
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Affiliation(s)
- A. Abba
- Nuclear Instruments S.R.L., Como 22045, Italy
| | - C. Accorsi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - P. Agnes
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - E. Alessi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Amaudruz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Annovi
- INFN Sezione di Pisa, Pisa 56127, Italy
| | - F. Ardellier Desages
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | - S. Back
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - C. Badia
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | - J. Bagger
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - V. Basile
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | | | - A. Bayo
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - B. Bell
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | | | - D. Biagini
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - G. Bianchi
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - S. Bicelli
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - D. Bishop
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Bombarda
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - S. Bonfanti
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | | | - M. Bouchard
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. Breviario
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - S. Brice
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R. Brown
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. M. Calvo-Mozota
- LSC, Laboratorio Subterráneo de Canfranc, Canfranc-Estación 22880, Spain
| | - L. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - M. Camozzi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - A. Capra
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Caravati
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - M. Carlini
- Gran Sasso Science Institute, L'Aquila 67100, Italy
| | | | - B. Celano
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - J. M. Cela Ruiz
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Charette
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Cogliati
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Constable
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Crippa
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - G. Croci
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Cudmore
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Dal Molin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - M. Daley
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - C. Di Guardo
- Dipartimento di Scienze Economiche ed Aziendali, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | - G. D'Avenio
- National Center for Innovative Technologies in Public Health, ISS (Italy National Institute of Health), Roma 00161, Italy
| | - O. Davignon
- Laboratoire Leprince Ringuet, École Polytechnique, Palaiseau, Cedex 91128, France
| | - M. Del Tutto
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J. De Ruiter
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - A. Devoto
- Dipartimento di Fisica, Università degli Studi di Cagliari, Cagliari 09042, Italy
| | | | - F. Di Francesco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - M. Dossi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - E. Druszkiewicz
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - C. Duma
- INFN-CNAF, Bologna 40127, Italy
| | - E. Elliott
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Farina
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | | | - R. Ford
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | | | - D. Franco
- APC, Université de Paris, CNRS, Astroparticule et Cosmologie, F-75013 Paris, France
| | | | - F. Gabriele
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | | | - P. Garcia Abia
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - A. Gargantini
- Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università di Bergamo, Bergamo, 24129, Italy
| | - L. Giacomelli
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | | | - S. Gillespie
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - D. Giorgi
- Camozzi Group S.p.A., Brescia BS 25126, Italy
| | - T. Girma
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - R. Gobui
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - F. Golf
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, Nebraska 68508, USA
| | - P. Gorel
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - G. Gorini
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - E. Gramellini
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Grosso
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - F. Guescini
- Max-Planck-Institut für Physik (Werner-Heisenberg-Institut), 80805 München, Germany
| | - E. Guetre
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hackman
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Hadden
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - K. Hayashi
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Heavey
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Hersak
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - N. Hessey
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. Hockin
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - K. Hudson
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Ianni
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - C. Ienzi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - C. C. James
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - C. Kendziora
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - S. Khan
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - E. Kim
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - M. King
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. King
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Kittmer
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - I. Kochanek
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - J. Kowalkowski
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - M. Kushoro
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - S. Kuula
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | | | - G. Leblond
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - L. Lee
- Department of APT, Faculty of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
| | - A. Lennarz
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M. Leyton
- INFN Sezione di Napoli, Napoli 80126, Italy
| | - X. Li
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - C. Lim
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lindner
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Lomonaco
- Dipartimento di Chimica e Chimica Industriale, Università di Pisa, Pisa 56124, Italy
| | - P. Lu
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R. Lubna
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - G. A. Lukhanin
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G. Luzón
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - M. MacDonald
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - G. Magni
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - R. Maharaj
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Manni
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - C. Mapelli
- Dipartimento di Meccanica, Politecnico di Milano, Milano 20156, Italy
| | - P. Margetak
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - L. Martin
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Martin
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | | | - N. Massacret
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - P. McClurg
- Department of Respiratory and Anaesthesia Technology, Vanier College, Montréal, Quebec H4L 3X9, Canada
| | | | - E. Meazzi
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - T. Mohayai
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L. M. Tosatti
- Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato, CNR STIIMA, Milano 20133, Italy
| | - G. Monzani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - C. Moretti
- Dipartimento di Pediatria, Sapienza Università di Roma, Roma 00185, Italy
| | | | | | - A. Muraro
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - P. Napoli
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - F. Nati
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - C. R. Natzke
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Norrick
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - K. Olchanski
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Ortiz de Solorzano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
| | - F. Padula
- School of Civil and Mechanical Engineering, Curtin University, Perth (Washington), Australia
| | | | - I. Palumbo
- Azienda Ospedaliera San Gerardo, Monza 20900, Italy
| | - E. Panontin
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - N. Papini
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | | | - K. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Patel
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Paterno
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | | | | | - A. Pocar
- Amherst Center for Fundamental Interactions and Physics Department, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - A. Pope
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - S. Pordes
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - F. Prelz
- INFN Sezione di Milano, Milano 20133, Italy
| | - O. Putignano
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano 20126, Italy
| | - J. L. Raaf
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - C. Ratti
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - M. Razeti
- INFN Sezione di Cagliari, Cagliari 09042, Italy
| | - A. Razeto
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - D. Reed
- Equilibar L.L.C., Fletcher, North Carolina 28732, USA
| | - J. Refsgaard
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - T. Reilly
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - A. Renshaw
- Department of Physics, University of Houston, Houston, Texas 77204, USA
| | - F. Retriere
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E. Riccobene
- Dipartimento di Informatica, Universitá degli Studi di Milano, Milano 20122, Italy
| | - D. Rigamonti
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | | | | | - J. Romualdez
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | - L. Russel
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - D. Sablone
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - S. Sala
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | | | - P. Salvo
- Istituto di Fisiologia Clinica del CNR, IFC-CNR, Pisa 56124, Italy
| | | | - E. Sansoucy
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - R. Santorelli
- CIEMAT, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid 28040, Spain
| | - C. Savarese
- Physics Department, Princeton University, Princeton, New Jersey 08544, USA
| | | | - T. Schaubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - S. Scorza
- SNOLAB, Lively, Ontario P3Y 1N2, Canada
| | - M. Settimo
- SUBATECH, IMT Atlantique, Université de Nantes, CNRS-IN2P3, Nantes 44300, France
| | - B. Shaw
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Shawyer
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - A. Sher
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - A. Shi
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - A. Slutsky
- St. Michael's Hospital, Unity Health Toronto, Ontario M5B 1W8, Canada
| | - B. Smith
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Stenzler
- 12th Man Technologies, Garden Grove, California 92841, USA
| | - C. Straubel
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - P. Stringari
- MINES ParisTech, PSL University, CTP-Centre of Thermodynamics of Processes, 77300 Fontainebleau, France
| | - M. Suchenek
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - B. Sur
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | | | - L. Takeuchi
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - M. Tardocchi
- Istituto per la Scienza e Tecnologia dei Plasmi, ISTP-CNR, Milano 20125, Italy
| | - R. Tartaglia
- INFN Laboratori Nazionali del Gran Sasso, Assergi (AQ) 67100, Italy
| | - E. Thomas
- Arthur B. McDonald Canadian Astroparticle Research Institute, Kingston, Ontario K7L 3N6, Canada
| | - D. Trask
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - J. Tseng
- Department of Physics, University of Oxford, The Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - L. Tseng
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - L. VanPagee
- JMP Solutions, London, Ontario N6N 1E2, Canada
| | - V. Vedia
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B. Velghe
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - A. Visioli
- Dipartimento di Ingegneria Meccanica e Industriale, Università degli Studi di Brescia, Brescia 25123, Italy
| | - L. Viviani
- Elemaster Group S.p.A., Lomagna (LC) 23871, Italy
| | - D. Vonica
- VEXOS, Markham, Ontario L3R 9X6, Canada
| | - M. Wada
- AstroCeNT, Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw 00-614, Poland
| | - D. Walter
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H. Wang
- Physics and Astronomy Department, University of California, Los Angeles, California 90095, USA
| | - M. H. L. S. Wang
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - D. Wood
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - D. Yates
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - S. Yue
- Canadian Nuclear Laboratories, Chalk River K0J 1J0, Canada
| | - V. Zambrano
- CAPA (Centro de Astropartículas y Física de Altas Energías), Universidad de Zaragoza, Zaragoza 50009, Spain
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Gurney L, Al Wattar BH, Sher A, Echevarria C, Simpson H. Comparison of perinatal outcomes for all modes of second stage delivery in obstetric theatres: a retrospective observational study. BJOG 2020; 128:1248-1255. [PMID: 33142034 DOI: 10.1111/1471-0528.16589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare rates of vaginal delivery and adverse outcomes of instrumental delivery trials in obstetric theatre compared to primary emergency full dilation caesarean section. DESIGN Retrospective cohort study. SETTING University teaching hospital. POPULATION Women with singleton, non-anomalous, pregnancy undergoing instrumental delivery trial in obstetric theatre. METHODS Data were collected from consecutive cases during 2014 until 2018 using clinical records. Multivariate regression analysis was used comparing outcomes per first delivery method. MAIN OUTCOME MEASURES Primary outcome was completion of vaginal delivery between all methods of instrumental delivery. Secondary outcome was a composite of immediate perinatal adverse outcomes for instrumental delivery modes and primary full dilation caesarean section. RESULTS From 971 deliveries analysed: ventouse delivery was significantly less likely to achieve vaginal delivery compared with Keilland's forceps delivery (odds ratio [OR] 0.42, 95% CI 0.22-0.79). Once confounding factors were adjusted for, adverse outcome rates were less frequent in the Keilland's forceps group than with primary full dilation caesarean section (OR 0.37, 95% CI 0.16-0.81); however, the receiver operating characteristic curve produced from this model demonstrated a low predictive value (AUC 0.64). CONCLUSIONS Attempting instrumental delivery in delivery suite theatre, as an alternative to primary emergency full dilation caesarean section, is both reasonable and safe. In this study, ventouse delivery performed poorly in comparison with other modes of instrumental delivery. Further research in the form of randomised controlled trials to identify the optimal mode of second stage delivery is paramount. TWEETABLE ABSTRACT Instrumental delivery trials in theatre are safe but use of ventouse was associated with a higher rate of failure.
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Affiliation(s)
- L Gurney
- West Midlands Fetal Medicine Centre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - B H Al Wattar
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Sher
- Maternity Department, James Cook University Hospital, Middlesbrough, UK
| | - C Echevarria
- Respiratory Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - H Simpson
- Maternity Department, James Cook University Hospital, Middlesbrough, UK
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Longobardi S, Lewalle A, Coveney S, Sjaastad I, Espe EKS, Louch WE, Musante CJ, Sher A, Niederer SA. Predicting left ventricular contractile function via Gaussian process emulation in aortic-banded rats. Philos Trans A Math Phys Eng Sci 2020; 378:20190334. [PMID: 32448071 PMCID: PMC7287330 DOI: 10.1098/rsta.2019.0334] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Cardiac contraction is the result of integrated cellular, tissue and organ function. Biophysical in silico cardiac models offer a systematic approach for studying these multi-scale interactions. The computational cost of such models is high, due to their multi-parametric and nonlinear nature. This has so far made it difficult to perform model fitting and prevented global sensitivity analysis (GSA) studies. We propose a machine learning approach based on Gaussian process emulation of model simulations using probabilistic surrogate models, which enables model parameter inference via a Bayesian history matching (HM) technique and GSA on whole-organ mechanics. This framework is applied to model healthy and aortic-banded hypertensive rats, a commonly used animal model of heart failure disease. The obtained probabilistic surrogate models accurately predicted the left ventricular pump function (R2 = 0.92 for ejection fraction). The HM technique allowed us to fit both the control and diseased virtual bi-ventricular rat heart models to magnetic resonance imaging and literature data, with model outputs from the constrained parameter space falling within 2 SD of the respective experimental values. The GSA identified Troponin C and cross-bridge kinetics as key parameters in determining both systolic and diastolic ventricular function. This article is part of the theme issue 'Uncertainty quantification in cardiac and cardiovascular modelling and simulation'.
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Affiliation(s)
- S Longobardi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - A Lewalle
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - S Coveney
- Insigneo Institute for in-silico Medicine and Department of Computer Science, University of Sheffield, Sheffield, UK
| | - I Sjaastad
- Institute for Experimental Medical Research and KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - E K S Espe
- Institute for Experimental Medical Research and KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - W E Louch
- Institute for Experimental Medical Research and KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - C J Musante
- Pfizer Worldwide Research, Development and Medical, Cambridge, MA, USA
| | - A Sher
- Pfizer Worldwide Research, Development and Medical, Cambridge, MA, USA
| | - S A Niederer
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Maron S, Radell J, Sher A, Voutsinas N, Galla N, Bishay V, Kim E, Nowakowski F, Patel R, Ranade M, Lookstein R, Rastinehad A, Fischman A. Abstract No. 689 Prostate artery embolization in patients with prior transurethral resection of the prostate: a feasibility study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Galla N, Voutsinas N, Sher A, Maron S, Titano J, Bishay V, Kim E, Nowakowski F, Patel R, Ranade M, Lookstein R, Rastinehad A, Fischman A. 3:09 PM Abstract No. 63 Balloon occlusion embolization in prostate artery embolization: a single-center evaluation of procedural metrics and clinical outcomes. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Caldwell B, Gabr A, Sher A, Salem R, Kim E, Lewandowski R. 3:36 PM Abstract No. 141 Radioembolization for recurrent hepatocellular carcinoma after liver transplant: a multicenter exploratory analysis. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Voutsinas N, Galla N, Sher A, Maron S, Bishay V, Ranade M, Titano J, Nowakowski F, Kim E, Patel R, Lookstein R, Rastinehad A, Fischman A. 4:21 PM Abstract No. 71 Radial versus femoral artery access in prostate artery embolization: a multicenter experience in a major health system. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
Objective: To determine audiology student perceptions of two simulated learning environments (SLE) in paediatric audiology.Design: A one-shot case study design.Study sample: Fifteen audiology students who completed questionnaires after participating in two SLEs, one simulating auditory brainstem response (ABR) assessments of neonates in a hospital ward and one simulating visually reinforced orientation audiometry (VROA) assessments of young children in an audiology clinic.Results: The students responded positively to 11/11 areas of audiometric testing and client interaction in both SLEs, to 7/7 aspects of their interactions with the mannequins in both SLEs, and to 8/8 aspects of their interactions with fellow students playing the role of parent in the ABR SLE and 7/8 of these aspects in the VROA SLE. The students reported low levels of anxiety towards both SLEs but rated the ABR SLE more highly than the VROA SLE in areas of preparedness, effectiveness, realism, pre-SLE training, reinforcement of lecture content, and overall usefulness.Conclusions: The participating students responded positively to almost all aspects of both SLEs. Further research is warranted using research designs capable of determining if these SLEs directly improve student abilities as they transition from academic settings to clinical placements in paediatric audiology.
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Affiliation(s)
- W J Wilson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - D Schmulian
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - A Sher
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - S Morris
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - A E Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Sher A, Lewis S, Bishay V, Ranade M, Nowakowski F, Patel R, Kim E, Lookstein R, Fischman A. 04:12 PM Abstract No. 216 Transarterial chemoembolization with 40-90 micron radiopaque drug-eluting microspheres for treatment of hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Aguilar-Arevalo A, Aoki M, Blecher M, Britton D, vom Bruch D, Bryman D, Chen S, Comfort J, Cuen-Rochin S, Doria L, Gumplinger P, Hussein A, Igarashi Y, Ito S, Kettell S, Kurchaninov L, Littenberg L, Malbrunot C, Mischke R, Numao T, Protopopescu D, Sher A, Sullivan T, Vavilov D. Improved search for heavy neutrinos in the decay
π→eν. Int J Clin Exp Med 2018. [DOI: 10.1103/physrevd.97.072012] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Sher A. Hemoglobinuria (Black Water Fever) in severe falciparum malaria – a case report. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Aguilar-Arevalo A, Aoki M, Blecher M, Britton DI, Bryman DA, Vom Bruch D, Chen S, Comfort J, Ding M, Doria L, Cuen-Rochin S, Gumplinger P, Hussein A, Igarashi Y, Ito S, Kettell SH, Kurchaninov L, Littenberg LS, Malbrunot C, Mischke RE, Numao T, Protopopescu D, Sher A, Sullivan T, Vavilov D, Yamada K. Improved Measurement of the π→eν Branching Ratio. Phys Rev Lett 2015; 115:071801. [PMID: 26317713 DOI: 10.1103/physrevlett.115.071801] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Indexed: 06/04/2023]
Abstract
A new measurement of the branching ratio R_{e/μ}=Γ(π^{+}→e^{+}ν+π^{+}→e^{+}νγ)/Γ(π^{+}→μ^{+}ν+π^{+}→μ^{+}νγ) resulted in R_{e/μ}^{exp}=[1.2344±0.0023(stat)±0.0019(syst)]×10^{-4}. This is in agreement with the standard model prediction and improves the test of electron-muon universality to the level of 0.1%.
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Affiliation(s)
- A Aguilar-Arevalo
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de Mexico, Distrito Federal 04510 México
| | - M Aoki
- Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - M Blecher
- Physics Department, Virginia Tech, Blacksburg, Virginia 24061, USA
| | - D I Britton
- Physics Department, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - D A Bryman
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - D Vom Bruch
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - S Chen
- Department of Engineering Physics, Tsinghua University, Beijing 100084, People's Republic of China
| | - J Comfort
- Physics Department, Arizona State University, Tempe, Arizona 85287, USA
| | - M Ding
- Department of Engineering Physics, Tsinghua University, Beijing 100084, People's Republic of China
| | - L Doria
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - S Cuen-Rochin
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - P Gumplinger
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - A Hussein
- University of Northern British Columbia, Prince George, British Columbia V2N 4Z9, Canada
| | - Y Igarashi
- KEK, 1-1 Oho, Tsukuba-shi, Ibaraki 305-0801, Japan
| | - S Ito
- Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S H Kettell
- Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - L Kurchaninov
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - L S Littenberg
- Brookhaven National Laboratory, Upton, New York 11973-5000, USA
| | - C Malbrunot
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - R E Mischke
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - T Numao
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - D Protopopescu
- Physics Department, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - A Sher
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - T Sullivan
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - D Vavilov
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - K Yamada
- Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
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Abstract
ABSTRACT
Objectives:
To examine the 1999 CAEP/AMUQ research abstracts competition in a scientific fashion, and provide descriptive information about the present and future direction of Canadian emergency medicine (EM) research.
Methods:
Using a standard evaluation form, 3 volunteer CAEP reviewers rated each submitted abstract in blind fashion. The authors of this report then combined abstract review scores with the following data: research topic, province of origin, status of first author (resident or attending physician), number of authors, adherence to submission guidelines, and acceptance status.
Results:
Of 86 abstracts submitted, 80 (93%) originated in Canada. The primary author was a resident in 34 cases (40%), a staff physician in 50 cases (58%) and unspecified in 2 cases (2%). Overall, 77 abstracts (90%) were selected for presentation: 26 (29%) oral, 40 (47%) poster, and 11 (13%) for the Resident Research Competition. The most common topics were clinical care (17%), prehospital care (15%), education/administration (14%), and decision rules (13%). The most common reason for rejection was failure to adhere to submission guidelines.
Conclusions:
Canadian EM research is growing rapidly, as witnessed by the interest in this competition, the publication of these abstracts, and the increased emphasis placed on research at the national meeting. Researchers must adhere to submission guidelines to increase their chances of abstract acceptance. Methods of promoting Canadian EM research are discussed.
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Affiliation(s)
- B H Rowe
- Division of Emergency Medicine, University of Alberta, Edmonton, Alta.
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Gunning DE, Beggs JM, Dabrowski W, Hottowy P, Kenney CJ, Sher A, Litke AM, Mathieson K. Dense arrays of micro-needles for recording and electrical stimulation of neural activity in acute brain slices. J Neural Eng 2012; 10:016007. [PMID: 23234809 DOI: 10.1088/1741-2560/10/1/016007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This paper describes the design, microfabrication, electrical characterization and biological evaluation of a high-density micro-needle array. The array records from and electrically stimulates individual neurons simultaneously in acute slices of brain tissue. APPROACH Acute slices, arguably the closest in-vitro model of the brain, have a damaged surface layer. Since electrophysiological recording methods rely heavily on electrode-cell proximity, this layer significantly attenuates the signal amplitude making the use of traditional planar electrodes unsuitable. To penetrate into the tissue, bypassing the tissue surface, and to record and stimulate neural activity in the healthy interior volume of the slice, an array of 61 micro-needles was fabricated. MAIN RESULTS This device is shown to record extracellular action potentials from individual neurons in acute cortical slices with a signal to noise ratio of up to ∼15:1. Electrical stimulation of individual neurons is achieved with stimulation thresholds of 1.1-2.9 µA. SIGNIFICANCE The novelty of this system is the combination of close needle spacing (60 µm), needle heights of up to 250 µm and small (5-10 µm diameter) electrodes allowing the recording of single unit activity. The array is coupled to a custom-designed readout system forming a powerful electrophysiological tool that permits two-way electrode-cell communication with populations of neurons in acute brain slices.
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Affiliation(s)
- D E Gunning
- IOP, University of Strathclyde, Glasgow G4 0NW, UK.
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Wang L, Mathieson K, Kamins TI, Loudin JD, Galambos L, Goetz G, Sher A, Mandel Y, Huie P, Lavinsky D, Harris JS, Palanker DV. Photovoltaic retinal prosthesis: implant fabrication and performance. J Neural Eng 2012; 9:046014. [PMID: 22791690 DOI: 10.1088/1741-2560/9/4/046014] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this work is to develop and test a photovoltaic retinal prosthesis for restoring sight to patients blinded by degenerative retinal diseases. A silicon photodiode array for subretinal stimulation has been fabricated by a silicon-integrated-circuit/MEMS process. Each pixel in the two-dimensional array contains three series-connected photodiodes, which photovoltaically convert pulsed near-infrared light into bi-phasic current to stimulate nearby retinal neurons without wired power connections. The device thickness is chosen to be 30 µm to absorb a significant portion of light while still being thin enough for subretinal implantation. Active and return electrodes confine current near each pixel and are sputter coated with iridium oxide to enhance charge injection levels and provide a stable neural interface. Pixels are separated by 5 µm wide trenches to electrically isolate them and to allow nutrient diffusion through the device. Three sizes of pixels (280, 140 and 70 µm) with active electrodes of 80, 40 and 20 µm diameter were fabricated. The turn-on voltages of the one-diode, two-series-connected diode and three-series-connected diode structures are approximately 0.6, 1.2 and 1.8 V, respectively. The measured photo-responsivity per diode at 880 nm wavelength is ∼0.36 A W(-1), at zero voltage bias and scales with the exposed silicon area. For all three pixel sizes, the reverse-bias dark current is sufficiently low (<100 pA) for our application. Pixels of all three sizes reliably elicit retinal responses at safe near-infrared light irradiances, with good acceptance of the photodiode array in the subretinal space. The fabricated device delivers efficient retinal stimulation at safe near-infrared light irradiances without any wired power connections, which greatly simplifies the implantation procedure. Presence of the return electrodes in each pixel helps to localize the current, and thereby improves resolution.
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Affiliation(s)
- Lele Wang
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA.
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Sher A, Latif S, Al-Mufti S, Mandkar Y, Shakil A. Assessment of the rapid diagnostic test Immunoquick+4 malaria for the diagnosis of malaria in Kuwait. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.545] [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: 11/28/2022] Open
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Abstract
Photodiode circuits show promise for the development of high-resolution retinal prostheses. While several of these systems have been constructed and some even implanted in humans, existing descriptions of the complex optoelectronic interaction between light, photodiode, and the electrode/electrolyte load are limited. This study examines this interaction in depth with theoretical calculations and experimental measurements. Actively biased photoconductive and passive photovoltaic circuits are investigated, with the photovoltaic circuits consisting of one or more diodes connected in series, and the photoconductive circuits consisting of a single diode in series with a pulsed bias voltage. Circuit behavior and charge injection levels were markedly different for platinum and sputtered iridium-oxide film (SIROF) electrodes. Photovoltaic circuits were able to deliver 0.038 mC/cm(2) (0.75 nC/phase) per photodiode with 50- μm platinum electrodes, and 0.54-mC/cm(2) (11 nC/phase) per photodiode with 50-μ m SIROF electrodes driven with 0.5-ms pulses of light at 25 Hz. The same pulses applied to photoconductive circuits with the same electrodes were able to deliver charge injections as high as 0.38 and 7.6 mC/cm(2) (7.5 and 150 nC/phase), respectively. We demonstrate photovoltaic stimulation of rabbit retina in-vitro, with 0.5-ms pulses of 905-nm light using peak irradiance of 1 mW/mm(2). Based on the experimental data, we derive electrochemical and optical safety limits for pixel density and charge injection in various circuits. While photoconductive circuits offer smaller pixels, photovoltaic systems do not require an external bias voltage. Both classes of circuits show promise for the development of high-resolution optoelectronic retinal prostheses.
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Field G, Gauthier JL, Sher A, Greschner M, Shlens J, Machado TA, Gunning DE, Mathieson K, Litke AM, Chichilnisky EJ. Retinal receptive fields at single cone resolution and implications for color vision. J Vis 2009. [DOI: 10.1167/9.14.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sher A, Latif S, Iqbal J, Hira P, Al-Mandaka Y, Al-Owaish R, Al-Mufti S. Prevalence of Infectious Diseases Among Immigrants Detected in Kuwait. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.1284] [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: 11/15/2022] Open
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Abstract
Host and parasite factors influencing the expression of cutaneous leishmaniasis were investigated in two murine models of different leishmanial diseases. The role of B lymphocytes in the uncontrolled disease manifested by BALB/c mice infected with cutaneous leishmaniasis was investigated in animals of this inbred strain depleted of B cells by neonatal administration of anti-mouse mu-chain antisera. Whereas non-depleted control mice developed chronic metastatic infections with both Leishmania tropica and Leishmania mexicana and showed depressed delayed-type hypersensitivity when skin-tested with leishmanial antigens, the mu-suppressed mice controlled their initial lesions while displaying strong antigen-specific delayed-type hypersensitivity. These findings reveal an inverse relationship between humoral and cell-mediated immunity in the expression of chronic leishmaniasis and suggest that B lymphocytes or their products regulate the delayed-type hypersensitivity response to leishmanial infection. In a separate study, healing and chronic strains of Leishmania were compared for their susceptibility to killing by lymphokine-activated mouse peritoneal macrophages. Whereas amastigotes of the healing strains were readily destroyed by these macrophages, amastigotes of two Leishmania strains, previously shown to produce chronic infections in mice, were resistant to killing by the same cells. These findings suggest that the ability of certain leishmanial strains to induce chronic disease may result from their capacity to evade intracellular destruction by activated macrophages.
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Sher A, Denkers EY, Gazzinelli RT. Induction and regulation of host cell-mediated immunity by Toxoplasma gondii. Ciba Found Symp 2007; 195:95-104; discussion 104-9. [PMID: 8724832 DOI: 10.1002/9780470514849.ch7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Toxoplasma gondii is a highly infectious intracellular parasite which, if left unchecked by the immune system, rapidly overwhelms its intermediate hosts, as illustrated by the pathogenesis of toxoplasmic encephalitis in patients with AIDS. In order to insure both its host's and consequently its own survival simultaneously, T. gondii induces a potent gamma-interferon (IFN-gamma)-dependent cell-mediated immunity early in infection that controls the replication of the protozoan and facilitates transformation into the dormant cyst stage. The protective IFN-gamma is derived from three sources: natural killer cells; and CD4+ and CD8+ T lymphocytes, which can partially compensate for each other in knockout mice lacking the appropriate major histocompatibility complex-restricting elements. At least two properties of the parasite appear to be responsible for the early induction of these effector cells. The first is a hydrophobic molecule (or group of related molecules) that triggers interleukin 12 (IL-12), tumour necrosis factor alpha and IL-1beta synthesis in macrophages. This response can also promote HIV replication in the same cells. The second is a superantigen activity that drives IFN-gamma-producing Vbeta5+ CD8+ T cells. These potentially lethal responses are later regulated through the triggering of IL-10 and by the induction of anergy in the superantigen-stimulated Vbeta5+ T cell population.
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Affiliation(s)
- A Sher
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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Dear JW, Yasuda H, Hu X, Hieny S, Yuen PST, Hewitt SM, Sher A, Star RA. Sepsis-induced organ failure is mediated by different pathways in the kidney and liver: acute renal failure is dependent on MyD88 but not renal cell apoptosis. Kidney Int 2006; 69:832-6. [PMID: 16518342 PMCID: PMC2271059 DOI: 10.1038/sj.ki.5000165] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Toll-like receptors (TLRs) are important in sepsis. Myeloid differentiation factor 88 (MyD88) is a key molecule involved in signal transduction by multiple TLRs. The objective of this study was to investigate the contribution of TLR4 and MyD88 to acute renal failure (ARF) induced by polymicrobial sepsis. Liver dysfunction and apoptosis in the spleen contribute to sepsis severity after cecal ligation and puncture (CLP). Therefore, we also investigated liver injury and splenic apoptosis. We used a mouse model of sepsis-induced ARF using CLP to generate polymicrobial sepsis. Despite fluid and antibiotic resuscitation the mice developed multi-organ failure, including ARF, which resembles human sepsis. We investigated the role of the TLR4 receptor by comparing C3H/HeJ mice (which lack TLR4) with C3H/He0UJ normal controls. The role of MyD88 was investigated by comparing MyD88 knockout mice (MyD88(-/-)) with wild-type controls. Following CLP, mice lacking TLR4 and wild-type mice both developed comparable ARF. However, MyD88(-/-) mice did not develop ARF compared to wild-type controls. In contrast, MyD88(-/-) mice developed liver injury comparable to wild type. After CLP, MyD88(-/-) mice had significantly reduced apoptosis in the spleen compared with wild type. Apoptosis was not detected in the kidney of wild-type or MyD88(-/-) mice after CLP. In summary, ARF induced by polymicrobial sepsis is dependent on MyD88, but not TLR4. The absence of MyD88 dissociates ARF from liver injury; liver injury is MyD88-independent. There was MyD88-dependent apoptosis in the spleen, but no apoptosis in the kidney. MyD88 may be a good drug target for some, but not all, organ dysfunctions following sepsis.
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Affiliation(s)
- J W Dear
- Renal Diagnostics and Therapeutics Unit, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, 10 Center Drive, Bldg. 10, Bethesda, MD, USA
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Sher A, Bresnahan M, Factor-Litvak P. 283: Development of Epidemiological Databases as Standalone Applications. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s71b] [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: 11/12/2022] Open
Affiliation(s)
- A Sher
- Columbia University, Mailman School of Public Health, New York, NY 10032
| | - M Bresnahan
- Columbia University, Mailman School of Public Health, New York, NY 10032
| | - P Factor-Litvak
- Columbia University, Mailman School of Public Health, New York, NY 10032
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Sher A, Factor-Litvak P. 590: Fuzzy Logic Implementation in Modeling of Seroprevalence Changes as a Composition of Three Age-Dependent Processes. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s148a] [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: 11/12/2022] Open
Affiliation(s)
- A Sher
- Columbia University, Mailman School of Public Health, New York, NY 10032
| | - P Factor-Litvak
- Columbia University, Mailman School of Public Health, New York, NY 10032
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Affiliation(s)
- A E Butterworth
- Department o f Pathology, University of Cambridge, Cambridge CB2 IQP, UK
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Abstract
Sensory experience typically depends on the ensemble activity of hundreds or thousands of neurons, but little is known about how populations of neurons faithfully encode behaviorally important sensory information. We examined how precisely speed of movement is encoded in the population activity of magnocellular-projecting parasol retinal ganglion cells (RGCs) in macaque monkey retina. Multi-electrode recordings were used to measure the activity of approximately 100 parasol RGCs simultaneously in isolated retinas stimulated with moving bars. To examine how faithfully the retina signals motion, stimulus speed was estimated directly from recorded RGC responses using an optimized algorithm that resembles models of motion sensing in the brain. RGC population activity encoded speed with a precision of approximately 1%. The elementary motion signal was conveyed in approximately 10 ms, comparable to the interspike interval. Temporal structure in spike trains provided more precise speed estimates than time-varying firing rates. Correlated activity between RGCs had little effect on speed estimates. The spatial dispersion of RGC receptive fields along the axis of motion influenced speed estimates more strongly than along the orthogonal direction, as predicted by a simple model based on RGC response time variability and optimal pooling. on and off cells encoded speed with similar and statistically independent variability. Simulation of downstream speed estimation using populations of speed-tuned units showed that peak (winner take all) readout provided more precise speed estimates than centroid (vector average) readout. These findings reveal how faithfully the retinal population code conveys information about stimulus speed and the consequences for motion sensing in the brain.
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Affiliation(s)
- E S Frechette
- The Salk Institute and University of California, San Diego, USA
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Frechette ES, Grivich MI, Kalmar RS, Litke AM, Petrusca D, Sher A, Chichilnisky EJ. Retinal motion signals and limits on speed discrimination. J Vis 2004. [DOI: 10.1167/4.8.570] [Citation(s) in RCA: 2] [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: 11/24/2022] Open
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Sher A, Appel R, Atoyan GS, Bassalleck B, Bergman DR, Cheung N, Dhawan S, Do H, Egger J, Eilerts S, Fischer H, Herold W, Issakov VV, Kaspar H, Kraus DE, Lazarus DM, Lichard P, Lowe J, Lozano J, Ma H, Majid W, Pislak S, Poblaguev AA, Rehak P, Sher A, Thompson JA, Truöl P, Zeller ME. High statistics measurement of the K+-->pi0e+nu (K+e3) branching ratio. Phys Rev Lett 2003; 91:261802. [PMID: 14754040 DOI: 10.1103/physrevlett.91.261802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Indexed: 05/24/2023]
Abstract
E865 at the Brookhaven National Laboratory AGS collected about 70 000 K(+)(e3) events to measure the K(+)(e3) branching ratio relative to the observed K+-->pi(+)pi(0), K+-->pi(0)micro(+)nu, and K+-->pi(+)pi(0)pi(0) decays. The pi(0) in all the decays was detected using the e(+)e(-) pair from pi(0)-->e(+)e(-)gamma decay and no photons were required. Using the 2002 Particle Data Group branching ratios for the normalization decays, we obtain BR(K(+)(e3(gamma)))=(5.13+/-0.02(stat)+/-0.09(syst)+/-0.04(norm))%, where K(+)(e3(gamma)) includes the effect of virtual and real photons. This result is approximately 2.3sigma higher than the current Particle Data Group value. Implications for the V(us) element of the CKM matrix, and the matrix's unitarity are discussed.
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Affiliation(s)
- A Sher
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
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Iqbal J, Hira PR, Al-Ali F, Khalid N, Sher A. Modified Giemsa staining for rapid diagnosis of malaria infection. Med Princ Pract 2003; 12:156-9. [PMID: 12766332 DOI: 10.1159/000070751] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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] [Received: 03/30/2002] [Accepted: 01/11/2003] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To develop and evaluate a rapid method for the diagnosis of malaria infection by microscopy of stained blood films. SUBJECTS AND METHODS Blood specimens were collected from randomly selected confirmed malaria cases (n = 75) and suspected malaria cases (n = 175). The microscopy was done on each set of blood films stained by modified and the standard Giemsa staining methods. RESULTS All the 75 previously diagnosed malaria cases were confirmed by the microscopy of blood films stained by both methods. Forty-nine (28%) of the 175 cases suspected for malaria infection showed malarial parasites on microscopy of blood films stained by both methods. However, due to homogeneous staining and clearer background of the blood films it was possible to determine the parasite species in 65% of the cases on microscopy of the thick films stained with the modified method compared to only 20% with the standard method. Further, the turnaround time for reporting the microscopy test result was 15-20 and 45-50 min with modified and standard staining methods, respectively. CONCLUSION Our data showed that performance of the modified staining method in detecting malarial parasites was comparable to that of the standard staining method. Moreover, the modified staining method was rapid, easy to use, and reliable.
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Affiliation(s)
- J Iqbal
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
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Abstract
OBJECTIVE To detect the incidence of drug-resistant Plasmodium falciparum malaria infection in immigrants and travellers in non-endemic Kuwait. METHODS Over a period of 3 years, July 1995 to September 1998, 1352 malaria patients were enrolled in the study. Of these, 1293 were immigrants from countries where malaria is endemic and 59 were non-immune travellers with a recent history of travel to these countries. The in vitro drug sensitivity was determined in 892 patients. RESULTS In all, 892 of 1352 (66.0%) P. falciparum isolates were successfully cultured in vitro for drug sensitivity and 419 (47.0%) isolates showed in vitro resistance to chloroquine or mefloquine. Fifty-six (13.4%) isolates were resistant to both drugs. Chloroquine resistance was observed in > 70% of the isolates from Africa and India followed by Pakistan (39.9%) and Bangladesh (35.9%). The resistance to mefloquine ranged from 26.2% in isolates from Sri Lanka to 47.5% in isolates from African countries. CONCLUSION The study highlights the important trend in drug resistance in P. falciparum malaria in immigrants from south-east Asian and African countries.
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Affiliation(s)
- J Lqbal
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
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Poblaguev AA, Appel R, Atoyan GS, Bassalleck B, Bergman DR, Cheung N, Dhawan S, Do H, Egger J, Eilerts S, Herold W, Issakov VV, Kaspar H, Kraus DE, Lazarus DM, Lichard P, Lowe J, Lozano J, Ma H, Majid W, Pislak S, Rehak P, Sher A, Thompson JA, Truöl P, Zeller ME. Experimental study of the radiative decays K+-->mu(+)nue(+)e(-) and K+-->e(+)nue(+)e(-). Phys Rev Lett 2002; 89:061803. [PMID: 12190577 DOI: 10.1103/physrevlett.89.061803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2002] [Indexed: 05/23/2023]
Abstract
Experiment 865 at the Brookhaven Alternating Gradient Synchrotron obtained 410 K+-->e(+)nue(+)e(-) and 2679 K+-->mu(+)nue(+)e(-) events including 10% and 19% background. The branching ratios were measured to be [2.48+/-0.14(stat)+/-0.14(syst)]x10(-8) (m(ee)>150 MeV) and (7.06+/-0.16+/-0.26)x10(-8) (m(ee)>145 MeV), respectively. Results for the decay form factors are presented.
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Affiliation(s)
- A A Poblaguev
- Institute for Nuclear Research of Russian Academy of Sciences, Moscow 117 312, Russia
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Abstract
The induction of IL-12 from dendritic cells (DC) is a major initiating step in host resistance to intracellular pathogens. We have studied the regulation of this response using an in vivo model in which IL-12 production by splenic CD8alpha+ DC is followed after injection of a soluble extract (STAg) of the protozoan parasite Toxoplasma gondii. Our findings indicate that the potent IL-12 response observed is highly dependent on both the chemokine receptor CCR5 and G(i)-protein coupled signaling. In addition, we have examined the basis of the unresponsiveness of DC to secondary STAg injection which occurs following primary exposure to this parasite stimulus. Our results demonstrate that this refractory state correlates with the down-regulation of CCR5 expression on DC which, in turn, appears to depend on the induction of endogenous lipoxin A(4) (LXA(4)), a product of arachidonic acid metabolism. Since LXA(4) is known to also signal through a G-protein coupled receptor pathway, these findings taken together support a major role for G-protein signaling in the regulation of microbial-induced DC function.
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Affiliation(s)
- J Aliberti
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
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Aliberti J, Hieny S, Reis e Sousa C, Serhan CN, Sher A. Lipoxin-mediated inhibition of IL-12 production by DCs: a mechanism for regulation of microbial immunity. Nat Immunol 2002; 3:76-82. [PMID: 11743584 DOI: 10.1038/ni745] [Citation(s) in RCA: 207] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Lipoxins are eicosanoid mediators that show potent inhibitory effects on the acute inflammatory process. We show here that the induction of lipoxin A(4) (LXA(4)) accompanied the in vivo suppression of interleukin 12 (IL-12) responsiveness of murine splenic dendritic cells (DCs) after microbial stimulation with an extract of Toxoplasma gondii. This paralysis of DC function could not be triggered in mice that were deficient in a key lipoxygenase involved in LXA(4) biosynthesis. In addition, DCs pre-treated with LXA(4) became refractory to microbial stimulation for IL-12 production in vitro and mice injected with a stable LXA(4) analog showed reduced splenic DC mobilization and IL-12 responses in vivo. Together, these findings indicate that the induction of lipoxins in response to microbial stimulation can provide a potent mechanism for regulating DC function during the innate response to pathogens.
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Affiliation(s)
- J Aliberti
- Immunobiology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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