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Spencer-Hwang R, Cruz A, Ong MY, Chitanda A, Harvey Y, Hwang J, Shah H, Tamares S, Wilber L. Prevalence of Burnout Among Public Health Professionals: A Systematic Review. J Public Health Manag Pract 2024; 30:384-393. [PMID: 38603744 DOI: 10.1097/phh.0000000000001887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
CONTEXT Since the initial outbreak of COVID-19, health professionals-both clinical health care, as well as public health concentrations-have faced tremendous pressures. A growing body of literature indicates the pandemic has magnified already prevalent burnout rates among clinical health professionals and to what extent for public health professionals remains to be determined. OBJECTIVE This study purpose is to conduct a systematic review of literature examining burnout prevalence among public health professionals before and during the COVID-19 pandemic-nationally and internationally-with identification of potential risk factors. DESIGN We conducted a literature search in PubMed, EMBASE, PsycINFO, SocINDEX, and ClinicalKey since inception through April 4, 2023. Inclusion criteria included peer-reviewed, original research studies (qualitative or quantitative), in English, assessing prevalence of, or risk factors for, burnout in public health professionals. Two authors independently screened abstracts, titles, full report of studies and abstracted data related to burnout. This review was conducted using Joanna Briggs Institute Systematic Reviews guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines with narrative synthesis. Protocol for this review registered on PROSPERO (CRD42023424468). RESULTS Of 3327 health-related articles mentioning burnout, 15 met inclusion criteria (11 quantitative and 4 qualitative) with 10 in international settings and 5 in US majority of quantitative studies were from international settings and only 1 in United States. Seventy-eight percent of studies that included prevalence data, exhibited a burnout prevalence greater than 50% (with a range of 19%-81%). The pandemic likely heightened (13% increase) already elevated burnout prevalence. Major risk factors identified included overwork, lack of support, changing roles, and full-time employment status, though many risk factors had not been studied in the United States. CONCLUSIONS Burnout is prevalent among public health professionals, nationally and internationally, and likely heightened by the COVID-19 pandemic. More research is warranted assessing burnout among differing public health concentrations and interventions developed. Public health is an essential framework for protecting and promoting health nationally and internationally, and we need to ensure and support solidity of that framework.
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Affiliation(s)
- Rhonda Spencer-Hwang
- Author Affiliations: School of Public Health, Loma Linda University Health, Loma Linda, California (Drs Spencer-Hwang, Shah, and Wilber, Mss Cruz, Chitanda, and Harvey, and Mr Hwang); Center for Evidence Synthesis, Loma Linda University Health, Loma Linda, California (Dr Spencer-Hwang and Ms Shanalee); School of Medicine, Loma Linda University Health, Loma Linda, California (Dr Ong); and Loma Linda University Health Library, Loma Linda, California (Ms Shanalee)
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Wolfson-Stofko B, Hirode G, Vanderhoff A, Karkada J, Capraru C, Biondi MJ, Hansen B, Shah H, Janssen HLA, Feld JJ. Real-world hepatitis C prevalence and treatment uptake at opioid agonist therapy clinics in Ontario, Canada. J Viral Hepat 2024; 31:240-247. [PMID: 38385850 DOI: 10.1111/jvh.13931] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/02/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024]
Abstract
Widespread screening for hepatitis C virus (HCV) is necessary for Canada to meet its HCV elimination goals by 2030. People who currently or previously injected drugs are at high risk for HCV. Opioid agonist therapy (OAT, such as methadone and buprenorphine) has been shown to help stabilize the lives of people who are opioid-dependent. The distribution of OAT in North America typically requires daily, weekly, or monthly clinic visits and presents an opportunity for engagement, screening and treatment for those at high-risk of HCV. In this study, HCV screening was conducted by staff at OAT clinics in Ontario from 2016 to 2020 and those with chronic infections were treated on-site with direct-acting antivirals. Point-of-care or dried blood spot (DBS) testing was used for antibodies, DBS or serum for HCV RNA and serum for HCV RNA at SVR12 (sustained virological response). Clinics screened 1954 people (mean age 40 years ±12, 63% male). Forty-five percent were antibody positive, of whom 64% were HCV RNA+. Eighty percent of those RNA+ set an appointment in which 99% attended. Ninety-six percent started treatment with 87% completing treatment. Sixty-eight percent of people who completed treatment submitted a sample for SVR12 testing of which 97% achieved a virological cure. Results suggest that HCV screening and treatment at OAT clinics is feasible, effective and warrants expansion. Data suggest strong treatment adherence due to high rates of SVR12 comparable with other OAT-based HCV treatment programs. The lack of SVR12 sampling could be addressed by either on-site phlebotomy or incentivizing SVR12 sampling.
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Affiliation(s)
- B Wolfson-Stofko
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Center for Drug Use and HIV/HCV Research (CDUHR), College of Global Public Health, New York University, New York, New York, USA
| | - G Hirode
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - A Vanderhoff
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - J Karkada
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - C Capraru
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - M J Biondi
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- School of Nursing, York University, Toronto, Ontario, Canada
| | - B Hansen
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Division of Gastroenterology & Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Biostatistics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - H Shah
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
| | - H L A Janssen
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
- Division of Gastroenterology & Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J J Feld
- Viral Hepatitis Care Network (VIRCAN), Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario, Canada
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Hadad S, Zhitomirsky-Geffet M, Shah H, Rigler D, Celentano U, Tiensuu H, Röning J, Vallverdú J, Csabella EJ, Stepankova O, Gialelis J, Lantavou K, Ignat T, Masone G, Winter J, Dumitrasco M. Modeling intrinsic factors of inclusive engagement in citizen science: Insights from the participants' survey analysis of CSI-COP. PLoS One 2023; 18:e0294575. [PMID: 38015965 PMCID: PMC10684079 DOI: 10.1371/journal.pone.0294575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/04/2023] [Indexed: 11/30/2023] Open
Abstract
Inclusive citizen science, an emerging field, has seen extensive research. Prior studies primarily concentrated on creating theoretical models and practical strategies for diversifying citizen science (CS) projects. These studies relied on ethical frameworks or post-project empirical observations. Few examined active participants' socio-demographic and behavioral data. Notably, none, to our knowledge, explored prospective citizen scientists' traits as intrinsic factors to enhance diversity and engagement in CS. This paper presents a new inclusive CS engagement model based on quantitative analysis of surveys administered to 540 participants of the dedicated free informal education MOOC (Massive Open Online Course) 'Your Right to Privacy Online' from eight countries in the EU funded project, CSI-COP (Citizen Scientists Investigating Cookies and App GDPR compliance). The surveys were filled out just after completing the training stage and before joining the project as active CSs. Out of the 540 participants who completed the surveys analyzed in this study, only 170 (32%) individuals actively participated as CSs in the project. Therefore, the study attempted to understand what characterizes these participants compared to those who decided to refrain from joining the project after the training stage. The study employed descriptive analysis and advanced statistical tests to explore the correlations among different research variables. The findings revealed several important relationships and predictors for becoming a citizen scientist based on the surveys analysis, such as age, gender, culture, education, Internet accessibility and apps usage, as well as the satisfaction with the MOOC, the mode of training and initial intentions for becoming a CS. These findings lead to the development of the empirical model for inclusive engagement in CS and enhance the understanding of the internal factors that influence individuals' intention and actual participation as CSs. The devised model offers valuable insights and key implications for future CS initiatives. It emphasizes the necessity of targeted recruitment strategies, focusing on underrepresented groups and overcoming accessibility barriers. Positive learning experiences, especially through MOOCs, are crucial; enhancing training programs and making educational materials accessible and culturally diverse can boost participant motivation. Acknowledging varying technological proficiency and providing necessary resources enhances active engagement. Addressing the intention-engagement gap is vital; understanding underlying factors and creating supportive environments can transform intentions into active involvement. Embracing cultural diversity through language-specific strategies ensures an inclusive environment for effective contributions.
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Affiliation(s)
- Shlomit Hadad
- Department of Digital Learning Technologies, The Israel Academic College in Ramat-Gan, Raanana, Israel
| | | | - Huma Shah
- Department of Computational Science and Mathematical Modelling, Coventry University, Coventry, United Kingdom
| | | | - Ulrico Celentano
- Biomimetics and Intelligent Systems Group, University of Oulu, Oulu, Finland
| | - Henna Tiensuu
- Biomimetics and Intelligent Systems Group, University of Oulu, Oulu, Finland
| | - Juha Röning
- Biomimetics and Intelligent Systems Group, University of Oulu, Oulu, Finland
| | - Jordi Vallverdú
- Philosophy Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eva Jove Csabella
- Philosophy Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Olga Stepankova
- Department of Biomedical Engineering and Assistive Technology, Czech Institute of Informatics, Robotics and Cybernetics, The Czech Technical University in Prague, Prague, Czech Republic
| | - John Gialelis
- Electrical and Computer Engineering Department, University of Patras, Patras, Greece
| | - Konstantina Lantavou
- Electrical and Computer Engineering Department, University of Patras, Patras, Greece
| | - Tiberius Ignat
- Immer Besser GmbH and SKS Knowledge Services, Munich, Germany
| | - Giacomo Masone
- Department of Computational Science and Mathematical Modelling, Coventry University, Coventry, United Kingdom
| | - Jaimz Winter
- Department of Computational Science and Mathematical Modelling, Coventry University, Coventry, United Kingdom
| | - Marica Dumitrasco
- Department of Science and Innovation Management Academy of Music, Theatre and Fine Arts, Chisinau, Republic of Moldova
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Rittenhouse KJ, Vwalika B, Sebastiao Y, Pokaprakarn T, Sindano N, Shah H, Stringer EM, Kasaro MP, Cole SR, Stringer JSA, Price JT. Accuracy of portable ultrasound for obstetric biometry. Ultrasound Obstet Gynecol 2023. [PMID: 38011589 DOI: 10.1002/uog.27541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE We assessed the accuracy of two portable ultrasound machines (PUM) in obtaining fetal biometry and estimating gestational age. METHODS We analyzed data from the Fetal Age Machine Learning Initiative, an observational study of pregnant women in the United States and Zambia. Each participant underwent assessment by an experienced sonographer using both a high-specification ultrasound machine (HSUM) and a PUM (either Butterfly iQ or Clarius C3) to measure fetal biometry and calculate estimated gestational age (EGA) at each visit. Through comparison of paired PUM-HSUM scans, we estimated agreement between individual biometry measurements and aggregate gestational age estimates by reporting mean difference, along with intraclass correlation coefficient (ICC) and Bland-Altman plots, adjusting for trend. RESULTS 881 participants contributed 1386 paired PUM-HSUM ultrasound studies between April and December 2021. PUM studies included 991 Butterfly and 395 Clarius. Gestational age at scan ranged from 7 to 38 weeks. Compared to HSUM, the Butterfly PUM had a mean difference of -0.20 days (95%CI±0.40) in the 1st trimester and -0.68 days (95%CI±0.68) in the 2nd/3rd trimesters. Also compared to HSUM, the Clarius PUM had a mean difference of 0.47 days (95%CI±0.64) in the 1st trimester and -1.67 days (95%CI±0.43) in the 2nd/3rd trimesters. ICCs were 0.989 or greater throughout. Increasing gestational age was associated with increasing error and absolute error. Both PUM devices demonstrated a modest trend toward underestimation of EGA at advancing gestational ages in 2nd/3rd trimester scans, compared to HSUM. CONCLUSION Both the Butterfly iQ and Clarius C3 PUM devices were highly accurate in performing fetal biometry in a diverse population from the US and Zambia. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- K J Rittenhouse
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - B Vwalika
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
| | - Y Sebastiao
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - T Pokaprakarn
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - N Sindano
- UNC Global Projects - Zambia, LLC, Lusaka, Zambia
| | - H Shah
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - E M Stringer
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - M P Kasaro
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
- UNC Global Projects - Zambia, LLC, Lusaka, Zambia
| | - S R Cole
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - J S A Stringer
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- UNC Global Projects - Zambia, LLC, Lusaka, Zambia
| | - J T Price
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
- UNC Global Projects - Zambia, LLC, Lusaka, Zambia
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Loughran R, Shah H, Monti J, Zhitomirsky-Geffet M. Editorial: Women in language and computation 2022. Front Artif Intell 2023; 6:1299100. [PMID: 37915540 PMCID: PMC10616821 DOI: 10.3389/frai.2023.1299100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Róisín Loughran
- Regulated Software Research Centre, Dundalk Institute of Technology, Dundalk, Ireland
| | - Huma Shah
- EEC School of Computing, Mathematics and Data Sciences, Coventry University, Coventry, United Kingdom
| | - Johanna Monti
- Department of Literary, Linguistic and Comparative Studies, University of Naples “L'Orientale”, Naples, Italy
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Alramadhan F, Herring RP, Beeson WL, Nelson A, Shah H. Religiosity and type 2 diabetes self-management among Muslims residing in California. Heliyon 2023; 9:e19725. [PMID: 37809987 PMCID: PMC10558997 DOI: 10.1016/j.heliyon.2023.e19725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/26/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023] Open
Abstract
Type 2 diabetes (T2D) is a public health issue that needs to be addressed. In the U.S., 11.3% of the population have diabetes. It is estimated that 90-95% of all diabetes cases are T2D cases. One of the best methods to address T2D is self-management. Prior research found a relationship between religiosity and T2D self-management. The purpose of this study was to examine religiosity and T2D self-management. This was a cross-sectional and qualitative study, which included Muslim adults, who have T2D and live in California. We utilized snowballing to recruit participants and the saturation concept to determine the number of participants. Additionally, we used semi-structured design for the interviews and focus groups. We had 30 participants for the interviews (however, only 25 provided demographic data) and 28 for the combined focus groups. Zoom was used to conduct the interviews and two focus groups. The grounded theory was used to deduce themes from the interviews and focus groups. The main themes for religiosity and self-management are Allah sustains life, everything will be ok/hope, faith gives strength, and the role of self within the fate concept. The themes for self-efficacy are diabetes requires new life approach, stress, and Islamic religious practices promote self-management. The main theme for perceived seriousness is taking action and making changes. Our findings provide significant insight about the relationship between religiosity, perceived seriousness, fatalism, and self-efficacy and self-management of T2D. A recommendation based on this study is that providers and health educators should be aware of the different experiences Muslims with T2D face, and tailor recommendations and programs based on that.
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Affiliation(s)
| | | | | | - Anna Nelson
- Loma Linda University, School of Public Health, California, USA
| | - Huma Shah
- Loma Linda University, School of Public Health, California, USA
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Finkbiner S, Mancuso J, Dalia T, Baer J, Farhoud H, Danter M, Zorn T, Hu J, Baker J, Shah H, Shah Z, Downey P, Vidic A. Evaluating Heart Transplant Outcomes Utilizing the Sherpapak Heart Storage System. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1698] [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: 04/05/2023] Open
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Alarfaj M, Dalia T, Bhyan P, Xi C, Jinxiang H, Medley A, Zorn T, Downey P, Shah H, Vidic A, Shah Z, Danter M. Outcomes of Thoracotomy vs Median Sternotomy Approach in Patients Undergoing Heartmate 3 Implant: A Single-Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1079] [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: 04/05/2023] Open
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Pearman J, Shah H, Diafas A, Heimann H, Hussain R. Imaging characteristics of idiopathic scleroma: a retrospective case series and review of the literature. Eye (Lond) 2023; 37:1026-1032. [PMID: 35780188 PMCID: PMC10050395 DOI: 10.1038/s41433-022-02161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Idiopathic scleroma (previously coined solitary idiopathic choroiditis or focal scleral nodule) is an innocuous lesion affecting the sclera with intraocular manifestations. It is often the basis of many misdiagnoses such as amelanotic choroidal melanoma, osteoma or metastatic lesions. Patients are often asymptomatic and the course is benign. With increasing use of community based imaging, more of such cases are being identified. This paper is a retrospective case series investigating the multi-modal imaging findings of idiopathic scleroma. METHODS A retrospective analysis of prospectively collected data were analysed. Over the course of January 2008-January 2022, 44 patients diagnosed with idiopathic scleroma and imaged with wide-field colour fundus photography, fundus autofluorescence, ocular coherence tomography (OCT) and B-scan ultrasonography. Due to a poor image, only 43 images were included for OCT review. We also reviewed our patient's demographics, symptoms and baseline ophthalmic characteristics upon presentation. RESULTS The mean age was 52 years (range 32-79) and there was no predilection towards gender. All lesions were post equatorial with the most common location being inferotemporal (n = 16, 36%); 32 lesions (73%) were yellow on fundus photography. 82% (n = 36/44) of lesions exhibited hyperautoflourescence and 43 lesions (98%) showed hyperechogenicity on B-scan ultrasonography. 100% of lesions originated from the sclera with no lesions showing active inflammation. 20 (47%) lesions had associated blood vessels overlying them on OCT. DISCUSSION Idiopathic scleroma is a yellow, hyperautofluorescent, hyperechogeneic scleral lesion that has no signs of active inflammation. These characteristics help define them from other more sinister cause of amelanotic fundal lesions.
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Affiliation(s)
- J Pearman
- Liverpool Ocular Oncology Unit, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
| | - H Shah
- Liverpool Ocular Oncology Unit, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - A Diafas
- Liverpool Ocular Oncology Unit, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - H Heimann
- Liverpool Ocular Oncology Unit, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - R Hussain
- Liverpool Ocular Oncology Unit, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
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Baer J, Malhotra A, Dalia T, Mancuso J, Zorn T, Downey P, D'Alessandro D, Meyer D, Greer S, Shah H, Shah Z, Danter M, Silvestry S, Vidic A. Sherpapak Reduces Mcs Use Post Heart Transplant in Long Donor Down and Ischemic Times. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1700] [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: 04/05/2023] Open
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Alammari D, Banta JE, Shah H, Reibling E, Talsania S. Use of Electronic Health Records and Quality of Ambulatory Healthcare. Cureus 2022; 14:e30343. [DOI: 10.7759/cureus.30343] [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] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
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Shah H, Ayoub M, Nguyen B, Nagavally S, Mohananey D, Sharma A, Virani S, Al-Kindi S, Sinh P. 466 Coronary Artery Plaque Assessment In Inflammatory Bowel Disease. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Van Heel KL, Nelson A, Handysides D, Shah H. Factors Associated with Confidence in Using the Internet to Access Health Information: A Cross-Sectional Data Analysis (Preprint). JMIR Form Res 2022; 7:e39891. [PMID: 37040161 PMCID: PMC10131683 DOI: 10.2196/39891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/04/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Confidence in health information access is a measure of the perceived ability to obtain health information. One's beliefs or perceived ability to access health information is particularly important in understanding trends in health care access. Previous literature has found that access to health information is lowest among society's most vulnerable population groups. These groups include older, less educated, and low-income populations. While health confidence has previously been used as a scale to measure health outcomes, additional research is needed describing the demographic factors associated with users' confidence in health information access. This may be a key component of health information seeking that affects beneficial health outcomes such as prevention and treatment. OBJECTIVE This study examines the demographic factors associated with the levels of confidence in using the internet to access health information for adults 18 years and older in the United States. METHODS Using a cross-sectional design, secondary data from the Health Information National Trends Survey (HINTS) 5, Cycle 3 (2019) were analyzed (N=5374). An ordinal regression stratified by internet use was used to determine the association between demographic characteristics and level of confidence in health information access. RESULTS When the internet is the primary source for health information, high school graduates (adjusted odds ratio [AOR] 0.58, 95% CI 0.37-0.89) compared to those with a college degree or more had significantly lower odds of being confident in obtaining health information. In addition, non-Hispanic Asian participants (AOR 0.44, 95% CI 0.24-0.82) compared to non-Hispanic White participants, male participants (AOR 0.72, 95% CI 0.54-0.97) compared to female participants, and those who made between US $20,000-$35,000 annually (AOR 0.55, 95% CI 0.31-0.98) compared to those who made US $75,000 or more annually had significantly lower odds of being confident in obtaining health information via the internet. Moreover, when the internet is the primary source for health information, those with health insurance had significantly higher odds of being confident in obtaining health information (AOR 2.91, 95% CI 1.58-5.34) compared to those who do not have health insurance. Lastly, a significant association was observed between confidence in health information access and primary health information source and frequency of visiting a health care provider. CONCLUSIONS Confidence in accessing health information can differ by individual demographics. Accessing health-related information from the internet has become increasingly more common and can provide insight into health information-seeking behaviors. Further exploration of these factors can inform the science of health education by providing deeper insight into improving access to health information for vulnerable populations.
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Affiliation(s)
- Kasi Lou Van Heel
- Dr Kiran C Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Anna Nelson
- Loma Linda University, Loma Linda, CA, United States
| | | | - Huma Shah
- Loma Linda University, Loma Linda, CA, United States
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Laghari A, Shah H, Laghari R, Kumar K, Waqan A, Jumani A. A Review on Quantum Computing Trends & Future Perspectives. EAI Endorsed Transactions on Cloud Systems 2022. [DOI: 10.4108/eai.17-5-2022.173979] [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: 11/05/2022] Open
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Selvakumar D, Clayton Z, Prowse A, Dingwall S, George J, Shah H, Paterson H, Jeyaprakesh P, Wu Z, Campbell T, Kotake Y, Turnbull S, Nguyen Q, Grieve S, Palpant N, Pathan F, Kizana E, Kumar S, Gray P, Chong J. Cellular Heterogeneity of Pluripotent Stem Cell Derived Cardiomyocyte Grafts is Mechanistically Linked to Treatable Arrhythmias. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.004] [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: 10/16/2022]
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Griffith T, Parsons M, Tward J, Tao R, Stephens D, Hu B, Shah H, Chipman J, Gaffney D. Risk of Secondary Breast Cancer in Female Non-Hodgkin Lymphoma Survivors: 40 Years of Follow-Up Assessed by Treatment Modality. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.960] [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: 10/20/2022]
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Lithgow K, Venkataraman H, Hughes S, Shah H, Kemp-Blake J, Vickrage S, Smith S, Humphries S, Elshafie M, Taniere P, Diaz-Cano S, Dasari BVM, Almond M, Ford S, Ayuk J, Shetty S, Shah T, Geh I. Well-differentiated gastroenteropancreatic G3 NET: findings from a large single centre cohort. Sci Rep 2021; 11:17947. [PMID: 34504148 PMCID: PMC8429701 DOI: 10.1038/s41598-021-97247-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/21/2021] [Indexed: 11/14/2022] Open
Abstract
Neuroendocrine neoplasms are known to have heterogeneous biological behavior. G3 neuroendocrine tumours (NET G3) are characterized by well-differentiated morphology and Ki67 > 20%. The prognosis of this disease is understood to be intermediate between NET G2 and neuroendocrine carcinoma (NEC). Clinical management of NET G3 is challenging due to limited data to inform treatment strategies. We describe clinical characteristics, treatment, and outcomes in a large single centre cohort of patients with gastroenteropancreatic NET G3. Data was reviewed from 26 cases managed at Queen Elizabeth Hospital, Birmingham, UK, from 2012 to 2019. Most commonly the site of the primary tumour was unknown and majority of cases with identifiable primaries originated in the GI tract. Majority of cases demonstrated somatostatin receptor avidity. Median Ki67 was 30%, and most cases had stage IV disease at diagnosis. Treatment options included surgery, somatostatin analogs (SSA), and chemotherapy with either platinum-based or temozolomide-based regimens. Estimated progression free survival was 4 months following initiation of SSA and 3 months following initiation of chemotherapy. Disease control was observed following treatment in 5/11 patients treated with chemotherapy. Estimated median survival was 19 months; estimated 1 year survival was 60% and estimated 2 year survival was 13%. NET G3 is a heterogeneous group of tumours and patients which commonly have advanced disease at presentation. Prognosis is typically poor, though select cases may respond to treatment with SSA and/or chemotherapy. Further study is needed to compare efficacy of different treatment strategies for this disease.
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Affiliation(s)
- K Lithgow
- Division of Endocrinology, Department of Medicine, Cumming School of Medicine, 1820 Richmond Rd SW, Calgary, AB, T2T 5C7, Canada.
| | - H Venkataraman
- Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Hughes
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Shah
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - J Kemp-Blake
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Vickrage
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Smith
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Humphries
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Elshafie
- Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - P Taniere
- Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Diaz-Cano
- Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - B V M Dasari
- Department of Liver Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Almond
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Ford
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - J Ayuk
- Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Shetty
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - T Shah
- Department of Liver Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - I Geh
- Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Abstract
AbstractObjectives : The brain damage associated with schizophrenia has been established beyond doubt; however, what remains unexplored is the biological nature of transcultural variations. An important reason for this was the lack of mid and high field scanners in developing countries like India.
Material and Methods : We undertook a pilot study using a 0.5 Tesla MRI scanner (General Electric Signa Contour) to explore identifiable structural brain lesions in ten randomly selected individuals with schizophrenia.
Results: Nine of the ten participants in the series had structural brain changes. The most common findings were ventricular dilatation and prominent cerebral cortical sulci and cerebellar folia. Additionally non-focal white matter lesions were observed in three patients and small right hippocampus was noted in one participant.
Conclusions : The study discusses that establishing structural brain lesions with mid field scanners is indeed feasible. The small study sample and heterogeneity of schizophrenia however made it difficult to establish any definite associations
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Affiliation(s)
- S R Parkar
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | - R Seethalakshmi
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
| | - H Shah
- Department of Psychiatry, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
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Shah H, Yazdanian B. 75 Treatment Escalation Plan (TEP) Completion Rates in General Surgery. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
TEPs ensure every patient has a ceiling of care formally documented, including a DNACPR decision. This pre-empts complications and provides guidance on how to appropriately manage acutely unwell patients. There is no national standard for TEPs. Our aim: to formally document the incidence of TEP completion in general surgery at a local District General Hospital.
Method
A multi-phase, cross-sectional study of 1. Inpatients on three general surgical wards, 2. TEP completion at post-take after a typical on-call cycle.
Results
15.4% of TEPs were completed, of which 75% had a DNARCPR form. For the two post-take ward rounds, 5% and 7.7% of admitted patients had a TEP. Elective surgical/Enhanced recovery patients (ERP) did not have a TEP. Findings were presented locally, and posters placed in the surgical offices. Cycle 2: 19.6% and 10% completion rate for ward and post-take patients, respectively.
Conclusions
TEPs are rarely completed. Minimal improvement in completion rate was noted at cycle 2. TEPs are more commonly completed for patients not for resuscitation. Future aims include editing the surgical clerking proforma and the elective surgery/ERP paperwork to encourage completion, improving patient care. Currently we are arranging similar audits across other NHS trusts to determine if this is a national problem.
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Affiliation(s)
- H Shah
- West Hertfordshire Hospitals, Watford, United Kingdom
| | - B Yazdanian
- West Hertfordshire Hospitals, Watford, United Kingdom
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Shah H, Papolos A, Molina E, Najjar S, Kadakkal A, Hofmeyer M, Kenigsberg B, Sheikh F, Lam P, Kitahara H, Cohen J, Peters L, Wllis C, Barnett C. Argatroban as an Alternative Anticoagulant in Impella Supported Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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BRAHMBHATT R, Shah H, Nikam S, Appu J, Deorukhkar D, Tilve P, Kirpalani D, Billa V, Bichu S, Kirpalani A. POS-477 CLINICAL PRESENTATIONS AND OUTCOMES OF RENAL DISEASE IN SARS-COV PATIENTS -A SINGLE CENTRE STUDY. Kidney Int Rep 2021. [PMCID: PMC8049668 DOI: 10.1016/j.ekir.2021.03.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Bachani N, Vadivelu R, Bagchi A, Jadwani JP, Panicker GK, Shah H, Dhirawani B, Rathi C, Lokhandwala Y. Comparison of pulmonary vein sizing by transesophageal echocardiogram and by direct angiogram. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary vein (PV) anatomy and sizing is important to know before performing PV isolation. This information is conventionally obtained by angiography or by CT scan.
Aim
We undertook this study to identify and measure the PVs during TEE studies and validate these against angiography.
Method
17 consecutive patients due to undergo PV isolation for paroxysmal atrial fibrillation were analysed. Using TEE, the PVs were visualised (Upper panel) as follows: i) From the mid-esophageal four chamber view, the chamber probe was turned to the right at 110-130º for the bicaval view, where the RSPV was seen entering the left atrium adjacent to the SVC. ii) At 0º the SVC was imaged in its short axis, and the probe advanced till the interatrial septum was seen. The angle was changed to 30º to visualise the right inferior PV (RIPV). iii) From the two chamber view (70-90º), the probe was turned to the left and withdrawn to display the left superior PV (LSPV) entering the left atrium parallel to the appendage.iv) Keeping the LSPV in focus, the angle was changed to 135º and the probe advanced till the AV groove, where the left inferior PV (LIPV) was visualised. After transseptal puncture, each PV was cannulated. The PV angiograms were performed in several projections to obtain the best PV profile (lower panel). Using electronic callipers, each PV was measured within 1 cm of its entry into the left atrium, after having received all tributaries. Those PVs were considered for analysis which were measured by both TEE and angiography. The paired ‘T’ test was used to compare the PV diameters by TEE and angiography and the Bland Altman analysis was done to see the level of agreement.
Results
Of a total of 68 PVs, 62 could be adequately visualised by TEE and 50 by angiography. These 50 PVs were measured using both methods. The diameters of the PVs measured by TEE and angiography were not statistically different by the paired t test; LSPV14 ± 1.8 mm v/s 14.4 ± 2.1 mm; RSPV 13 ± 1.8 mm v/s 14.6 ± 3.5 mm; LIPV 11.9 ± 2.1 vs 13.2 ± 2.8 mm and RIPV 10.5 ± 2.7 vs 12.1 ± 2.9 mm. Bland Altman analysis showed most PV sizes estimated by TEE and angiography lay within limits of agreement.
Conclusions
A majority of PVs can be visualised by TEE using a defined protocol. TEE is a good technique to visualise and assess the size of PVs, avoiding the need for contrast medium and radiation.
Abstract Figure. TEE and angiographic images of PVs
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Affiliation(s)
| | | | - A Bagchi
- Holy Family Hospital, Mumbai, India
| | | | - GK Panicker
- Indian Institute of Management, Ahmedabad, India
| | - H Shah
- Holy Family Hospital, Mumbai, India
| | | | - C Rathi
- Holy Family Hospital, Mumbai, India
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Alammari D, Banta JE, Shah H, Reibling E, Ramadan M. Meaningful Use of Electronic Health Records and Ambulatory Healthcare Quality Measures. Cureus 2021; 13:e13036. [PMID: 33665057 PMCID: PMC7924813 DOI: 10.7759/cureus.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction Electronic Health Record (EHR) adoption rates for office-based physicians doubled between 2008 and 2015, from 42% to 89%, and more than 60% of all office-based physicians achieved meaningful use by 2016. The US government has paid billions of dollars in incentives to promote EHR meaningful use. Nonetheless, evidence linking EHR meaningful use to quality measures improvements is limited. Objective This study aims to examine the relationship between EHR meaningful use and capabilities among four quality measures in an ambulatory healthcare setting. Study design A cross-sectional study design of the 2015-2016 National Ambulatory Medical Care Survey dataset. Methods We used adjusted multivariate regression models to examine associations between (a) EHR meaningful use and (b) 10 EHR-computerized capabilities, with four quality measures (blood pressure screening, tobacco use screening, obesity screening, and obesity education). Results We analyzed 30,787 office visits, representing an annual estimate of 680 million national office visits. Results showed that 95% of visits were to offices meeting EHR meaningful use criteria. We found one positive association between EHR meaningful use and obesity screening (OR= 3.5, 95% CI [1.742-6.917]). We also found eight positive associations between EHR capabilities and three quality measures (screening for blood pressure and obesity, and obesity education). These associations included five EHR-computerized capabilities: “record patient problem list”, “view lab results”, “Reminders for interventions/screening”, “Order lab results” and “Recording clinical notes”. No EHR capability was associated with screening for tobacco use. Conclusions We looked at a handful of screening-oriented quality measures in ambulatory healthcare and found limited associations with EHR meaningful use but multiple positively significant associations with EHR capabilities. Although EHR meaningful use has become more commonly used, offering substantial administrative efficiency over paper records, current patterns of EHR meaningful use do not always appear to translate into a better quality of care in physician offices. However, quality measures used represent limited procedures for a handful of specific conditions and not the overall healthcare aspect.
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Affiliation(s)
- Duaa Alammari
- Health System Management, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Jim E Banta
- Public Health, Loma Linda University, Loma Linda, USA
| | - Huma Shah
- Public Health, Loma Linda University, Loma Linda, USA
| | - Ellen Reibling
- Emergency Medicine, Loma Linda University, Loma Linda, USA
| | - Majed Ramadan
- Public Health, Loma Linda University, Loma Linda, USA
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Saraswathi S, Mukhopadhyay A, Shah H, Ranganath TS. Social network analysis of COVID-19 transmission in Karnataka, India. Epidemiol Infect 2020; 148:e230. [PMID: 32972463 PMCID: PMC7550886 DOI: 10.1017/s095026882000223x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/05/2020] [Accepted: 09/18/2020] [Indexed: 01/18/2023] Open
Abstract
We used social network analysis (SNA) to study the novel coronavirus (COVID-19) outbreak in Karnataka, India, and to assess the potential of SNA as a tool for outbreak monitoring and control. We analysed contact tracing data of 1147 COVID-19 positive cases (mean age 34.91 years, 61.99% aged 11-40, 742 males), anonymised and made public by the Karnataka government. Software tools, Cytoscape and Gephi, were used to create SNA graphics and determine network attributes of nodes (cases) and edges (directed links from source to target patients). Outdegree was 1-47 for 199 (17.35%) nodes, and betweenness, 0.5-87 for 89 (7.76%) nodes. Men had higher mean outdegree and women, higher mean betweenness. Delhi was the exogenous source of 17.44% cases. Bangalore city had the highest caseload in the state (229, 20%), but comparatively low cluster formation. Thirty-four (2.96%) 'super-spreaders' (outdegree ⩾ 5) caused 60% of the transmissions. Real-time social network visualisation can allow healthcare administrators to flag evolving hotspots and pinpoint key actors in transmission. Prioritising these areas and individuals for rigorous containment could help minimise resource outlay and potentially achieve a significant reduction in COVID-19 transmission.
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Affiliation(s)
- S. Saraswathi
- Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
| | | | | | - T. S. Ranganath
- Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
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25
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Maharaj V, Masotti M, Schultz J, Murray T, Teigen L, Shah H, Shaffer A, Alexy T, John R, Cogswell R. Worsening Creatinine Trend in the Year Prior to LVAD Implantation is Associated with Lower Pectoralis Muscle Measures and Increased Post LVAD Mortality. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.223] [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: 11/29/2022] Open
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26
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Saeed D, Muslem R, Rasheed M, Caliskan K, Kalampokas N, Sipahi F, Lichtenberg A, Jawad K, Borger M, Huhn S, Cogswell R, John R, Schultz J, Shah H, Hsu S, Gilotra N, Tomashitis B, Hajj ME, Lozonschi L, Houston B, Tedford R. Less Invasive Surgical Implant Strategy is Associated with Significant Reduction in INTERMACS Defined Right Heart Failure Following LVAD Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Shah H, Belanger E, Chong A, So D, Beanlands R, Stadnick E, Mielniczuk L, Chih S. Discordant Microvascular and Epicardial Disease in Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.543] [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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28
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Kirpalani D, Nikam S, Kirpalani A, Shah H. SUN-087 EVALUATION OF CENTRAL BP PATTERN IN A LARGE COHORT OF CKD PATIENTS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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Shah H, Le VK. P636 A unique case of purulent pericarditis resulting in cardiac tamponade. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction and case report description
A 54-year-old male with no past cardiac disease was experiencing a productive cough, fevers, chills, and shortness of breath for 3 days in the community. His dyspnea worsened significantly, and he then presented to the emergency room. He admitted to using intravenous recreational drugs. His initial vital signs included a temperature of 38.2 degrees Celsius, a heart rate of 116 beats per minute, and a blood pressure of 88/42 mmHg. He had a positive pulses paradoxus with a decrease in systolic blood pressure of 14 mmHg on inspiration.
Description of the problem and procedures
This presentation was consistent with cardiac tamponade. He had an emergent echocardiogram showing a large pericardial effusion in the apical-four-chamber view (Image 1, A), including collapse of the right ventricle during diastole (Image 1, B, Green Arrow). There were also fibrin strands seen in a modified parasternal long axis view (Image 1, C, Blue Arrow). He had an emergency pericardiocentesis using real-time ultrasound guidance, which drained 400 mL of thick brown purulent fluid. A pigtail catheter was inserted to allow for continued drainage. Immediately afterwards, the patient’s blood pressure normalized, and his shortness of breath improved significantly.
Using the ultrasound, the physician also saw bilateral pleural effusions. The larger left pleural effusion was drained, and a pigtail catheter was inserted into the left pleural space. After confirming that there was no post-procedure left pneumothorax, the right pleural effusion was also drained.
An echocardiogram after the pericardiocentesis showed a significant decrease in the size of the pericardial effusion (Image 1, D).
The patient was started on broad-spectrum antibiotics, which was then narrowed after cultures from both the pericardial fluid and pleural fluid grew methicillin-susceptible Staphylococcus aureus.
Discussion
Cardiac tamponade results in increased compression of the cardiac chambers due to raised pericardial pressures. As it progresses, it can result in significant impairment in venous return, cardiac output, and blood pressure. This is a life-threatening condition if it is not promptly treated. In this case, the patient had a methicillin-susceptible Staphylococcus aureus empyema which spread contiguously into the pericardium and resulted in cardiac tamponade.
Conclusions and implications for clinical practice
This case highlights the clinical benefits of being proficient in performing a point-of-care ultrasound because a bedside echocardiogram by the physician immediately confirmed the diagnosis and allowed for safer drainage of the pericardial effusion using ultrasound guidance to decrease the chance of causing a perforation of the ventricle. Using ultrasound, the clinician was also able to promptly diagnose the pleural effusions and urgently drain them, which was necessary for achieving source control in order to fully treat the infection.
Abstract P636 Figure. Image 1. Cardiac Tamponade
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Affiliation(s)
- H Shah
- Northern Ontario School of Medicine, Thunder Bay, Canada
| | - V K Le
- Northern Ontario School of Medicine, Thunder Bay, Canada
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Uttarilli A, Shah H, Shukla A, Girisha KM. A review of skeletal dysplasia research in India. J Postgrad Med 2019; 64:98-103. [PMID: 29692401 PMCID: PMC5954821 DOI: 10.4103/jpgm.jpgm_527_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We aimed to review the contributions by Indian researchers to the subspecialty of skeletal dysplasias (SDs). Literature search using specific keywords in PubMed was performed to retrieve all the published literature on SDs as on July 6, 2017. All published literature on SDs wherein at least one author was from an Indian institute was included. Publications were grouped into different categories based on the major emphasis of the research paper. Five hundred and forty publications in English language were retrieved and categorized into five different groups. The publications were categorized as reports based on: (i) phenotypes (n = 437), (ii) mutations (n = 51), (iii) novel genes (n = 9), (iv) therapeutic interventions (n = 31), and (v) reviews (n = 12). Most of the publications were single-patient case reports describing the clinical and radiological features of the patients affected with SDs (n = 352). We enlisted all the significant Indian contributions. We have also highlighted the reports in which Indians have contributed to discovery of new genes and phenotypes. This review highlights the substantial Indian contributions to SD research, which is poised to reach even greater heights given the size and structure of our population, technological advances, and expanding national and international collaborations.
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Affiliation(s)
- A Uttarilli
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Kim S, Khushalani N, Eroglu Z, Russell J, Wuthrick E, Caudell J, Harrison L, Aoki M, Shah H, Blakaj D, Markowitz J, Chen DT, Messina J, Rose T, Tsai K, Brohl A. A phase II, randomized study of nivolumab (NIVO) and Ipilimumab (IPI) versus NIVO, IPI and stereotactic body radiation therapy (SBRT) for metastatic Merkel cell carcinoma (MCC, NCT03071406): A preliminary report. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barilla D, Shah H, Rawson R. Bold leadership is needed for transforming health care. J Healthc Leadersh 2019; 11:81-85. [PMID: 31354376 PMCID: PMC6588797 DOI: 10.2147/jhl.s200952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/19/2019] [Indexed: 11/23/2022] Open
Abstract
Health care in the United States is going through significant changes and is at the forefront of the political landscape. While the health care debate rages on, leaders need to forge ahead and continue to work towards population-based health care and investing in their communities in a fiscally conscious way. Many innovations are happening but more needs to be done, especially in upstream services improving the health of the community. Research shows that investing in social care services and community-based investments results in lower health care expenditures and better health outcomes. Efforts should be placed on exploring a blended medical/social model of care while considering blended funding sources wherein the community needs to be active participants in this explorative process.
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Affiliation(s)
- Dora Barilla
- Community Health Investment, Providence St. Joseph Health, Renton, WA 98057, USA
| | - Huma Shah
- Loma Linda University School of Public Health , Loma Linda, CA 92354, USA
| | - Rick Rawson
- Administration, Adventist Health and Rideout, Marysville, CA, 95901, USA
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Shah H, Murray T, El Rafei A, Schultz J, Thenappan T, Alexy T, John R, Martin C, Pritzker M, Cogswell R. External Assessment of EUROMACS Right-Sided Heart Failure Risk Score. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Shaffer A, Goodwin K, Cogswell R, Shah H, Schultz J, Martin C, John R. Surgical Outcomes of HeartMate2 to HeartMate3 Pump Exchange: A Single Center Experience. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1092] [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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35
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Shah H, Cogswell R, Misialek J, Schultz J, Nitzkowski A, John R, Martin C, Pritzker M, Shaffer A. Concentrated Factor Administration and Subsequent Pump Thrombosis on HeartMate II LVAD Support. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.182] [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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Nelson A, De Leon A, Modeste N, Marshak HH, Banta J, Shah H. Association of Covered California and Healthcare Access and Utilization among Latino Population. CALIF J HEALTH PROMOT 2018. [DOI: 10.32398/cjhp.v16i2.2089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background and Purpose: The Patient Protection and Affordable Care Act resulted in establishment of Covered California (Covered CA), a marketplace providing federally subsidized health insurance in California. This study explored whether obtaining Covered CA coverage improves healthcare access and utilization among Latinos, and whether acculturation plays a role in utilization of healthcare. Methods: 270 Latino adults in San Diego community completed a self-report survey. Results: Those with Covered CA were significantly more likely to have a main provider (p
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Hayes A, Banks J, Shah H, Luong T, Navalkissoor S, Grossman A, Mandair D, Toumpanakis C, Caplin M. Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) in patients with pulmonary carcinoid tumours: Prevalence and prognosis of an under-recognised disease. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy293.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dall'Asta A, Shah H, Masini G, Paramasivam G, Yazbek J, Bourne T, Lees CC. Evaluation of tramline sign for prenatal diagnosis of abnormally invasive placenta using three-dimensional ultrasound and Crystal Vue rendering technology. Ultrasound Obstet Gynecol 2018; 52:403-404. [PMID: 29205615 DOI: 10.1002/uog.18975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/09/2017] [Accepted: 11/26/2017] [Indexed: 06/07/2023]
Affiliation(s)
- A Dall'Asta
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology, University of Parma, Parma, Italy
| | - H Shah
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - G Masini
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - G Paramasivam
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - J Yazbek
- Department of Gynaecologic Oncology, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - T Bourne
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - C C Lees
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Salian S, Shukla A, Shah H, Bhat SN, Bhat VR, Nampoothiri S, Shenoy R, Phadke SR, Hariharan SV, Girisha KM. Seven additional families with spondylocarpotarsal synostosis syndrome with novel biallelic deleterious variants in FLNB. Clin Genet 2018; 94:159-164. [PMID: 29566257 DOI: 10.1111/cge.13252] [Citation(s) in RCA: 8] [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] [Received: 01/18/2018] [Revised: 03/15/2018] [Accepted: 03/17/2018] [Indexed: 02/01/2023]
Abstract
The location and/or type of variants in FLNB result in a spectrum of osteochondrodysplasias ranging from mild forms, like spondylocarpotarsal synostosis syndrome and Larsen syndrome, to severe perinatal lethal forms, such as atelosteogenesis I and III and Boomerang dysplasia. Spondylocarpotarsal synostosis syndrome is characterized by disproportionate short stature, vertebral anomalies and fusion of carpal and tarsal bones. Biallelic loss-of-function variants in FLNB are known to cause spondylocarpotarsal synostosis syndrome and 9 families and 9 pathogenic variants have been reported so far. We report clinical features of 10 additional patients from 7 families with spondylocarpotarsal synostosis syndrome due to 7 novel deleterious variants in FLNB, thus expanding the clinical and molecular repertoire of spondylocarpotarsal synostosis syndrome. Our report validates key clinical (fused thoracic vertebrae and carpal and tarsal coalition) and molecular (truncating variants in FLNB) characteristics of this condition.
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Affiliation(s)
- S Salian
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - S N Bhat
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - V R Bhat
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - S Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | - R Shenoy
- Department of Pediatrics, KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - S R Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - S V Hariharan
- Department of Pediatrics, Sree Avittom Thirunal Hospital, Government Medical College, Trivandrum, Kerala, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Alcalay RN, Wolf P, Levy OA, Kang UJ, Waters C, Fahn S, Ford B, Kuo SH, Vanegas N, Shah H, Liong C, Narayan S, Pauciulo MW, Nichols WC, Gan-Or Z, Rouleau GA, Chung WK, Oliva P, Keutzer J, Marder K, Zhang XK. Alpha galactosidase A activity in Parkinson's disease. Neurobiol Dis 2018; 112:85-90. [PMID: 29369793 PMCID: PMC5811339 DOI: 10.1016/j.nbd.2018.01.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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: 12/18/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/11/2022] Open
Abstract
Glucocerebrosidase (GCase, deficient in Gaucher disease) enzymatic activity measured in dried blood spots of Parkinson's Disease (PD) cases is within healthy range but reduced compared to controls. It is not known whether activities of additional lysosomal enzymes are reduced in dried blood spots in PD. To test whether reduction in lysosomal enzymatic activity in PD is specific to GCase, we measured GCase, acid sphingomyelinase (deficient in Niemann-Pick disease types A and B), alpha galactosidase A (deficient in Fabry), acid alpha-glucosidase (deficient in Pompe) and galactosylceramidase (deficient in Krabbe) enzymatic activities in dried blood spots of PD patients (n = 648) and controls (n = 317) recruited from Columbia University. Full sequencing of glucocerebrosidase (GBA) and the LRRK2 G2019S mutation was performed. Enzymatic activities were compared between PD cases and controls using t-test and regression models adjusted for age, gender, and GBA and LRRK2 G2019S mutation status. Alpha galactosidase A activity was lower in PD cases compared to controls both when only non-carriers were included (excluding all GBA and LRRK2 G2019S carriers and PD cases with age-at-onset below 40) [2.85 μmol/l/h versus 3.12 μmol/l/h, p = 0.018; after controlling for batch effect, p = 0.006 (468 PD cases and 296 controls)], and when including the entire cohort (2.89 μmol/l/h versus 3.10 μmol/l/h, p = 0.040; after controlling for batch effect, p = 0.011). Because the alpha galactosidase A gene is X-linked, we stratified the analyses by sex. Among women who were non-carriers of GBA and LRRK2 G2019S mutations (PD, n = 155; control, n = 194), alpha galactosidase A activity was lower in PD compared to controls (2.77 μmol/l/h versus 3.10 μmol/l/h, p = 0.044; after controlling for a batch effect, p = 0.001). The enzymatic activity of acid sphingomyelinase, acid alpha-glucosidase and galactosylceramidase was not significantly different between PD and controls. In non-carriers, most lysosomal enzyme activities were correlated, with the strongest association in GCase, acid alpha-glucosidase, and alpha galactosidase A (Pearson correlation coefficient between 0.382 and 0.532). In a regression model with all five enzymes among non-carriers (adjusted for sex and age), higher alpha galactosidase A activity was associated with lower odds of PD status (OR = 0.54; 95% CI:0.31-0.95; p = 0.032). When LRRK2 G2019S PD carriers (n = 37) were compared to non-carriers with PD, carriers had higher GCase, acid sphingomyelinase and alpha galactosidase A activity. We conclude that alpha galactosidase A may have a potential independent role in PD, in addition to GCase.
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Affiliation(s)
- R N Alcalay
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
| | - P Wolf
- Translational Sciences, Sanofi R&D, Framingham, MA, USA
| | - O A Levy
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - U J Kang
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - C Waters
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - S Fahn
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - B Ford
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - S H Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - N Vanegas
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - H Shah
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - C Liong
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - S Narayan
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - M W Pauciulo
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - W C Nichols
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Z Gan-Or
- Montréal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada; Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - G A Rouleau
- Montréal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada; Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - W K Chung
- Department of Pediatrics and Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - P Oliva
- Translational Sciences, Sanofi R&D, Framingham, MA, USA
| | - J Keutzer
- Translational Sciences, Sanofi R&D, Framingham, MA, USA
| | - K Marder
- Department of Neurology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - X K Zhang
- Translational Sciences, Sanofi R&D, Framingham, MA, USA
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Ahmed O, Brahmania M, Kelley M, Kowgier M, Khalili K, Beecroft R, Renner E, Wong D, Shah H, Feld J, Janssen HL, Sherman M. A77 TRACKING WAIT TIMES AND OUTCOMES OF RADIOFREQUENCY ABLATION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA: A QUALITY IMPROVEMENT INITIATIVE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.078] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- O Ahmed
- University of Toronto, Toronto, ON, Canada
| | - M Brahmania
- Gastroenterology, University of Toronto, Toronto, ON, Canada
| | - M Kelley
- Queen’s University, Kingston, ON, Canada
| | - M Kowgier
- University of Toronto, Toronto, ON, Canada
| | - K Khalili
- University of Toronto, Toronto, ON, Canada
| | - R Beecroft
- University of Toronto, Toronto, ON, Canada
| | - E Renner
- University of Toronto, Toronto, ON, Canada
| | - D Wong
- University of Toronto, Toronto, ON, Canada
| | - H Shah
- University of Toronto, Toronto, ON, Canada
| | - J Feld
- Medicine, University Health Network University of Toronto, Toronto, ON, Canada
| | - H L Janssen
- Liver Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - M Sherman
- University of Toronto, Toronto, ON, Canada
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Mason A, Vincent C, Aspinall A, Swain M, Hirschfield GM, Minuk G, Shah H, Owens-Grillo J, Malecha ES, MacConell L. A200 AN INTEGRATED ANALYSIS OF EFFICACY OF OBETICHOLIC ACID IN CANADIAN PATIENTS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.201] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Mason
- University of Alberta, Edmonton, AB, Canada
| | - C Vincent
- Centre Hospitalier de I’Universite de Montreal, Montreal, QC, Canada
| | - A Aspinall
- University of Calgary, Calgary, AB, Canada
| | - M Swain
- University of Calgary, Calgary, AB, Canada
| | | | - G Minuk
- University of Manitoba, Canada, Winnipeg, MB, Canada
| | - H Shah
- University of Toronto, Toronto, ON, Canada
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Yoshida EM, Fischer A, Mason A, Shah H, Peltekian KM, Hux M, Thiele SL, Borrelli R. A197 PREVALENCE OF PRIMARY BILIARY CHOLANGITIS IN CANADA: FIRST NATIONAL STUDY. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.198] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E M Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | | | - A Mason
- University of Alberta, Edmonton, AB, Canada
| | - H Shah
- University of Toronto, Toronto, ON, Canada
| | | | - M Hux
- QuintilesIMS, Toronto, ON, Canada
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Shah H, Kniestedt C, Bostrom A, Stamper R, Lin S. Role of Central Corneal Thickness on Baseline Parameters and Progression of Visual Fields in Open Angle Glaucoma. Eur J Ophthalmol 2018; 17:545-9. [PMID: 17671929 DOI: 10.1177/112067210701700411] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate the relationship of central corneal thickness (CCT) to baseline visual field parameters and visual field progression in patients with primary open-angle glaucoma (POAG). Methods Charts of consecutive patients with POAG were reviewed to obtain visual field data. Visual field was measured by standard threshold static perimetry. Variables analyzed included mean deviation (MD) and pattern standard deviation (PSD). Results A total of 121 eyes examined over 4 years were evaluated. A significant negative relationship between CCT and PSD (correlation coefficient: −0.02, p<0.05) was found. Analyses comparing CCT to change in PSD and MD (visual field progression) were statistically not significant. Conclusions Patients with thinner corneas initially present with a greater visual field defect, indicating that thin corneas may contribute to advanced glaucomatous damage at the time of diagnosis. However, CCT does not seem to be a significant risk factor for progression of the disease.
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Affiliation(s)
- H Shah
- Department of Glaucoma, University of California-San Francisco, San Francisco, CA, USA
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Rogers S, Shah H, Yin M, Folefac E, Lee R, Verschraegen C. NKTR-214. PEGylated engineered interleukin-2 (IL-2), CD122-biased immunostimulatory cytokine, Cancer immunotherapy. DRUG FUTURE 2018. [DOI: 10.1358/dof.2018.043.05.2781505] [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: 10/14/2022]
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Diaz-Aguilar D, Niu T, Terterov S, Scharnweber R, Tucker A, Woodard J, Brara H, Merna C, Shah H, Wang S, Rahman S. Neurenteric cyst of the conus medullaris. Surg Neurol Int 2018. [PMID: 29527391 PMCID: PMC5838830 DOI: 10.4103/sni.sni_315_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Neurenteric cysts (NECs) are rare developmental malformations of the central nervous system (CNS) which originate as benign congenital lesions. They originate from developmental foregut precursors, and are presumed to be the result of abnormal partitioning of the embryonic notochord plate. Such NECs predominantly arise in the cervical region in patients around 6 years of age or in their twenties or thirties. Notably, NECs of the conus medullaris are exceedingly rare, especially in patients of advanced age. Case Description: A 70-year-old male presented with bilateral upper thigh and leg pain of over 20 years duration. His pain worsened over the past 3 years, and he sought surgical management. Although his neurological exam was normal, the lumbar magnetic resonance imaging revealed an intradural, nonenhancing, thin-walled, cystic lesion at L1/conus medullaris. The lesion was successfully resected without any adverse sequelae. Conclusions: NECs are rare congenital legions that involve the spine. Here, an L1 intradural extramedullay neuroenteric cyst of the conus medullaris was resected without complications.
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Sunny S, Girish S, Lanjewar C, Shah H, Kerkar P. Clinical profile and outcomes of primary percutaneous coronary angioplasty through radial route in a tertiary government hospital under government. Indian Heart J 2017. [DOI: 10.1016/j.ihj.2017.09.154] [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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Sunny S, Girish S, Lanjewar C, Shah H, Kerkar P. Clinical and angiographic profile with percutaneous endovascular management of the middle aortic syndrome – A single center experience. Indian Heart J 2017. [DOI: 10.1016/j.ihj.2017.09.155] [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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Webb GJ, Shah H, David MD, Tiew S, Beare N, Hirschfield GM. Post-prophylaxis Toxoplasma chorioretinitis following donor-recipient mismatched liver transplantation. Transpl Infect Dis 2017; 18:805-808. [PMID: 27500398 PMCID: PMC5053268 DOI: 10.1111/tid.12589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/19/2016] [Accepted: 06/06/2016] [Indexed: 11/28/2022]
Abstract
Toxoplasmosis may be transferred by organ transplantation. The most common clinical presentation is with multisystem disease, although isolated ocular toxoplasmosis has been described. Many centers have suggested that universal use of co-trimoxazole prophylaxis obviates the need for specific Toxoplasma testing. We report a case of donor-acquired ocular toxoplasmosis after liver transplantation despite co-trimoxazole prophylaxis. The diagnosis was confirmed by Toxoplasma polymerase chain reaction assay in conjunction with seroconversion. The fact that the infection was donor acquired was confirmed by serological mismatch and the absence of sporozoite-specific antigen antibody in the recipient.
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Affiliation(s)
- G J Webb
- National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK
| | - H Shah
- National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK
| | - M D David
- Clinical Microbiology, Queen Elizabeth Hospital, Birmingham, UK
| | - S Tiew
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - N Beare
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - G M Hirschfield
- National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK.
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Kotabagi S, Shah H, Shukla A, Girisha KM. Second family provides further evidence for causation of Steel syndrome by biallelic mutations in COL27A1. Clin Genet 2017; 92:323-326. [PMID: 28276056 DOI: 10.1111/cge.13006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/20/2017] [Accepted: 03/01/2017] [Indexed: 11/27/2022]
Abstract
Steel syndrome is a rare disorder of the skeleton characterized by facial dysmorphism, short stature, carpal coalition, dislocated radial heads, bilateral hip dislocation and vertical talus. Homozygous variants in COL27A1 were reported in an extending family from Puerto Rico. Here, we report a 5-year-old girl from a non-consanguineous family with facial dysmorphism, short stature, carpal coalition, dislocation of radial heads, bilateral hip dislocation, scoliosis and vertical talus. Exome sequencing identified 2 novel compound heterozygous variants c.521_528del (p.(Cys174Serfs*34)) and c.2119C>T (p.(Arg707*)) in COL27A1 in this child and the parents were heterozygous carriers. We hence report the second molecularly proven case of Steel syndrome and the first case to be reported among non-Puerto Rican population. Our report further validates the role of COL27A1 mutations in causation of Steel syndrome.
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Affiliation(s)
- S Kotabagi
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
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