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Parker CC, Petersen PM, Cook AD, Clarke NW, Catton C, Cross WR, Kynaston H, Parulekar WR, Persad RA, Saad F, Bower L, Durkan GC, Logue J, Maniatis C, Noor D, Payne H, Anderson J, Bahl AK, Bashir F, Bottomley DM, Brasso K, Capaldi L, Chung C, Cooke PW, Donohue JF, Eddy B, Heath CM, Henderson A, Henry A, Jaganathan R, Jakobsen H, James ND, Joseph J, Lees K, Lester J, Lindberg H, Makar A, Morris SL, Oommen N, Ostler P, Owen L, Patel P, Pope A, Popert R, Raman R, Ramani V, Røder A, Sayers I, Simms M, Srinivasan V, Sundaram S, Tarver KL, Tran A, Wells P, Wilson J, Zarkar AM, Parmar MKB, Sydes MR. Timing of radiotherapy (RT) after radical prostatectomy (RP): long-term outcomes in the RADICALS-RT trial (NCT00541047). Ann Oncol 2024:S0923-7534(24)00105-4. [PMID: 38583574 DOI: 10.1016/j.annonc.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for prostate-specific antigen (PSA) failure. PATIENTS AND METHODS RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, preoperative PSA≥10 ng/ml) for recurrence after radical prostatectomy. Patients were randomised 1:1 to adjuvant RT ('Adjuvant-RT') or an observation policy with salvage RT for PSA failure ('Salvage-RT') defined as PSA≥0.1 ng/ml or three consecutive rises. Stratification factors were Gleason score, margin status, planned RT schedule (52.5 Gy/20 fractions or 66 Gy/33 fractions) and treatment centre. The primary outcome measure was freedom-from-distant-metastasis (FFDM), designed with 80% power to detect an improvement from 90% with Salvage-RT (control) to 95% at 10 years with Adjuvant-RT. Secondary outcome measures were biochemical progression-free survival, freedom from non-protocol hormone therapy, safety and patient-reported outcomes. Standard survival analysis methods were used; hazard ratio (HR)<1 favours Adjuvant-RT. RESULTS Between October 2007 and December 2016, 1396 participants from UK, Denmark, Canada and Ireland were randomised: 699 Salvage-RT, 697 Adjuvant-RT. Allocated groups were balanced with a median age of 65 years. Ninety-three percent (649/697) Adjuvant-RT reported RT within 6 months after randomisation; 39% (270/699) Salvage-RT reported RT during follow-up. Median follow-up was 7.8 years. With 80 distant metastasis events, 10-year FFDM was 93% for Adjuvant-RT and 90% for Salvage-RT: HR=0.68 [95% confidence interval (CI) 0.43-1.07, P=0.095]. Of 109 deaths, 17 were due to prostate cancer. Overall survival was not improved (HR=0.980, 95% CI 0.667-1.440, P=0.917). Adjuvant-RT reported worse urinary and faecal incontinence 1 year after randomisation (P=0.001); faecal incontinence remained significant after 10 years (P=0.017). CONCLUSION Long-term results from RADICALS-RT confirm adjuvant RT after radical prostatectomy increases the risk of urinary and bowel morbidity, but does not meaningfully improve disease control. An observation policy with salvage RT for PSA failure should be the current standard after radical prostatectomy. TRIAL IDENTIFICATION RADICALS, RADICALS-RT, ISRCTN40814031, NCT00541047.
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Affiliation(s)
- C C Parker
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, UK.
| | - P M Petersen
- Department of Oncology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A D Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - N W Clarke
- Department of Urology, The Christie NHS Foundation Trust, Manchester; Manchester Cancer Research Centre, The University of Manchester, Manchester; Department of Urology, Salford Royal NHS Foundation Trust, Manchester, UK, Department of Urology, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - C Catton
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - W R Cross
- Department of Urology, St James's University Hospital, Leeds
| | - H Kynaston
- Division of Cancer and Genetics, Cardiff University, Cardiff, UK
| | - W R Parulekar
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - R A Persad
- Department of Urology, Bristol Urological Institute, Bristol, UK
| | - F Saad
- Department of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - L Bower
- Guy's and St Thomas' NHS Foundation Trust, London; Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - G C Durkan
- Department of Urology, University Hospital Galway, Galway, Ireland
| | - J Logue
- Department of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester
| | - C Maniatis
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - D Noor
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | | | | | - A K Bahl
- Bristol Haematology and Oncology Centre, University Hospitals Bristol & Weston NHS Trust, Bristol
| | - F Bashir
- Queen's Centre for Oncology, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | | | - K Brasso
- Department of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - L Capaldi
- Worcester Oncology Centre, Worcestershire Acute NHS Hospitals Trust, Worcester
| | - C Chung
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - P W Cooke
- Department of Urology, The Royal Wolverhampton NHS Trust, Wolverhampton
| | - J F Donohue
- Department of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone
| | - B Eddy
- East Kent University Hospitals Foundation Trust, Kent
| | - C M Heath
- Department of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton
| | - A Henderson
- Department of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone
| | - A Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds
| | - R Jaganathan
- Department of Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Jakobsen
- Department of Urology, Herlev University Hospital, Herlev, Denmark
| | - N D James
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - J Joseph
- Leeds Teaching Hospitals; York and Scarborough Teaching Hospitals, York
| | - K Lees
- Kent Oncology Centre, Maidstone and Tunbridge Wells NHS Trust, Maidstone
| | - J Lester
- South West Wales Cancer Centre, Singleton Hospital, Swansea, UK
| | - H Lindberg
- Department of Oncology, Herlev University Hospital, Herlev, Denmark
| | - A Makar
- Department of Urology, Worcestershire Acute Hospitals Trust, Worcester
| | - S L Morris
- Guy's and St Thomas' NHS Foundation Trust, London
| | - N Oommen
- Wrexham Maelor Hospital, Wrexham
| | - P Ostler
- Department of Urology, Hillingdon Hospitals NHS Foundation Trust, Hillingdon, London
| | - L Owen
- Bradford Royal Infirmary, Bradford; Leeds Cancer Centre, Leeds
| | - P Patel
- Department of Urology, University College London Hospitals, London
| | - A Pope
- Department of Urology, Hillingdon Hospitals NHS Foundation Trust, Hillingdon, London
| | - R Popert
- Guy's and St Thomas' NHS Foundation Trust, London
| | - R Raman
- Kent Oncology Centre, Kent & Canterbury Hospital, Canterbury
| | - V Ramani
- Department of Urology, The Christie NHS Foundation Trust, Manchester
| | - A Røder
- Department of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen
| | - I Sayers
- Deanesly Centre, New Cross Hospital, Wolverhampton
| | - M Simms
- Department of Urology, Hull University Hospitals NHS Trust, Hull
| | - V Srinivasan
- Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl
| | - S Sundaram
- Department of Urology, Mid Yorkshire Teaching Hospital, Wakefield
| | - K L Tarver
- Department of Oncology, Queen's Hospital, Romford
| | - A Tran
- Department of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester
| | - P Wells
- Barts Cancer Centre, St Bartholomews Hospital, London
| | | | - A M Zarkar
- Department of Oncology, University Hospitals Birmingham, Birmingham, UK
| | - M K B Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London.
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Mason J, Hanson C, Fox EJ, Burns H, Joseph J, Horwitz H, Classen S. Perceptions of Autonomous Shuttles for Adults With Spinal Cord Injuries. OTJR (Thorofare N J) 2024; 44:47-56. [PMID: 37381903 DOI: 10.1177/15394492231182058] [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] [Indexed: 06/30/2023]
Abstract
Individuals with a spinal cord injury (SCI) have challenges using transportation. Autonomous shuttles (ASs), if accessible, may support their transportation needs. This study quantified the perceptions of AS for adults with and without SCI, before and after riding in the AS. We hypothesized that the perceptions of AS for individuals with SCI would improve, by the greatest magnitude, after riding in the AS. This mixed-method quasi-experimental design included 16 adults with SCI and 16 age-matched controls. While there were no differences between the groups, both groups reported having fewer perceived barriers to using AS after riding in the AS (p = .025). After riding in the AS, both groups stated that the AS must be available, accessible, and affordable if they are to use AS. In conclusion, adults with SCI should experience AS if they are to accept and adopt this mode of transportation.
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Affiliation(s)
- Justin Mason
- University of Florida, Gainesville, USA
- University of Iowa, Coralville, USA
| | - C Hanson
- University of Florida, Gainesville, USA
| | - E J Fox
- University of Iowa, Coralville, USA
- Brooks Rehabilitation, Jacksonville, FL, USA
| | - H Burns
- University of Florida, Gainesville, USA
| | - J Joseph
- University of Florida, Gainesville, USA
| | - H Horwitz
- University of Florida, Gainesville, USA
| | - S Classen
- University of Florida, Gainesville, USA
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Beardmore S, Adeley J, Brookes A, Robinson C, Davendralingam N, Joseph J, McManoman B, Morgan B. Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists. Clin Radiol 2023; 78:797-803. [PMID: 37827590 DOI: 10.1016/j.crad.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 05/31/2023] [Accepted: 08/13/2023] [Indexed: 10/14/2023]
Abstract
A significant problem facing routine medicolegal coroner-referred autopsies is a shortfall of pathologists prepared to perform them. This was particularly acute in Lancashire, where the coroner decided to initiate a service that relied on post-mortem computed tomography (PMCT). This involved training anatomical pathology technologists (APTs) to perform external examinations, radiographers to perform scans, and radiologists to interpret them. The service started in 2018 and now examines over 1,500 cases per year. This study outlines the PMCT process using NHS staff, with CT equipment and logistics managed by the commercial sector. It compares the demographics and outcomes of PM investigations for two 6-month periods: the autopsy service prior to 2018, and then the PMCT service. These data were then compared with previous UK PMCT data. Referrals for adult non-suspicious deaths were made in 913 cases of which 793 (87%) had PMCT between 01/10/2018 and 31/03/2019. Fifty-six cases had autopsy after PMCT, so 81% of cases potentially avoided autopsy. The PMCT service did not delay release of bodies to the next-of-kin. Comparing the cause of death given shows no difference in the proportions of natural and unnatural deaths. There was an increase in diagnosis of coronary artery disease for PMCT, with less respiratory diagnoses, a feature not previously demonstrated. These data suggest PMCT is a practical solution for potentially failing autopsy services. By necessity, this involves changes in diagnoses, as PMCT and autopsy have different strengths and weakness, but the ability to pick up unnatural death appears unaffected.
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Affiliation(s)
- S Beardmore
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - J Adeley
- HM Senior Coroner Lancashire and Blackburn with Darwen, Coroner's Court, 2 Faraday Court, Faraday Drive, Preston, Lancashire, PR2 9NB, UK
| | - A Brookes
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - C Robinson
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - N Davendralingam
- Imaging Department, King's College Hospital, Denmark Hill, SE5 9RS, UK
| | - J Joseph
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - B McManoman
- Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane North, Fulwood, Preston, Lancashire, PR2 9HT, UK
| | - B Morgan
- Department of Life Sciences, University of Leicester, Radiology Department, Leicester Royal Infirmary, Infirmary Square, Leicester, LE2 7LX, UK.
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Yalamanchili A, Liu Y, Fisher P, Joseph J, Thomas TO. Cost Analysis of MR-Guided vs. CT-Guided Radiation Therapy for Locally Advanced Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e635. [PMID: 37785895 DOI: 10.1016/j.ijrobp.2023.06.2037] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic magnetic resonance guided on-table adaptive radiotherapy (SMART) is an increasingly utilized radiotherapy (RT) treatment for locally advanced pancreatic cancer (LAPC), providing improved local control and overall survival with reduced toxicity. Computed tomography (CT) guided RT options include stereotactic body radiotherapy (SBRT) and hypofractionated RT with volumetric modulated arc therapy (VMAT). Currently there are no financial comparisons for MR vs CT-guided RT for LAPC. We completed a cost analysis comparing the physician and hospital charges associated with RT options for LAPC. MATERIALS/METHODS To compare RT costs, we identified Current Procedural Terminology (CPT) codes utilized for 5-fraction SMART with adaptation (50 Gy, biological effective dose (BED) 100 Gy), 5-fraction CT-guided SBRT (33 Gy, BED 55 Gy), and 15-fraction CT-guided hypofractionated VMAT (67.5 Gy, BED 98 Gy) in a hospital-based practice setting. Physician and hospital Medicare prices associated with these codes together summarize the overall cost. We determined physician fees using the Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Search to search the Healthcare Common Procedure Coding System (HCPCS) for "professional" costs included within "facility" costs. We determined hospital fees using the Outpatient Prospective Payment System addendum. To standardize costs, we searched for national payment amounts for the 2022 calendar year. RESULTS Total cost of SMART with adaptation was 136% higher than the cost of CT-SBRT and 149% higher than the cost of hypofractionated RT. Physician fees for SMART were 173% higher and 157% higher than the fees for CT-SBRT and hypofractionated RT, respectively. Hospital fees for SMART were 129% higher and 147% higher than the fees for CT-SBRT and hypofractionated RT, respectively. The total cost of CT-SBRT was only 5% higher than cost of hypofractionated RT. The physician fees for hypofractionated RT were 6% higher than those for CT-SBRT, while the outpatient fees for CT SBRT were 7% higher than those for hypofractionated RT. CONCLUSION With recent data demonstrating favorable efficacy and toxicity rates for SMART, practices may increasingly consider investing in this treatment modality. This is the first cost analysis comparing SMART to CT-guided SBRT and hypofractionated RT in LAPC. We demonstrate higher costs of SMART compared to CT-guided RT, attributable primarily to higher number of dosimetry calculations for this modality and for adapted fractions. We also demonstrate comparable costs of lower BED CT-guided SBRT and higher BED hypofractionated RT. Further investigation is needed to assess whether the survival benefit of SMART translates to favorable cost per quality adjusted life year.
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Affiliation(s)
- A Yalamanchili
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Y Liu
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - P Fisher
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - J Joseph
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - T O Thomas
- Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Wang YF, Elliston C, Munbodh R, Savacool M, Tam J, Joseph J, Spina CS, Horowitz DP, Kachnic LA, Price M. Creation and Implementation of an Interdisciplinary Workflow for CBCT-Based Online Adaptive Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e736. [PMID: 37786139 DOI: 10.1016/j.ijrobp.2023.06.2262] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) CBCT-based online adaptive radiotherapy (OART) is an emerging treatment strategy to replan based on the anatomy of the day while the patient remains on the couch. OART is not just an add-on to the current workflow; it necessitates a new approach across the patient's path of care, from CT simulation to treatment delivery. OART requires the addition of duties to clinical personnel, strategies to create auto-plan templates, and monitoring the "black box" adaptation process. Studies have shown that OART implementation is limited by its resource-intensive nature and the risks associated with the treatment approach. We hypothesized that the implementation of an interdisciplinary, streamlined workflow and checklists would enhance the OART treatment efficiency, prevent medical errors from the adaptation, and minimize the burden on clinicians. MATERIALS/METHODS An interdisciplinary OART working group comprising radiation oncologists, medical physicists, dosimetrists, and therapists was created to enable weekly knowledge sharing, workflow design, implementation, and continuous process improvement. 213 adaptive sessions from 5 treatment sites (pancreas, bladder, prostate, rectum, anus) were treated on a CBCT-based OART platform in a single institutional study. An evaluation of the treatment safety and workflow time was performed for each adaptive session. RESULTS The OART workflow was divided into four sub-workflows: 1) pre-treatment site-specific template preparation, 2) pre-treatment initial planning and verification, 3) on-treatment procedure, and 4) post-treatment evaluation. The sub-processes involved 4, 8, 13, and 4 separate, sequentially tasks, respectively, and a total of 11 task checklists. The template preparation is a new process developed for site-specific, standardized physician template directives, automated planning template development, and testing for its accuracy and robustness. The planning templates generated high-quality initial plans automatically within minutes once structures were segmented on the planning CT. This process was replicated during treatment using the CBCT. The median (interquartile range) online procedure time, defined as the time from initial CBCT to plan approval, of the five treatment sites (pancreas, bladder, prostate, rectum, anus) was 22.1 (19.2-24.8) min, 16.5 (15.3-17.5) min, 14.7 (13.9-17.4) min, 17 (15.3-19.7) min, and 24 (21.4-25.8) min, respectively. Safety assessment determined that no treatment deviations were observed. CONCLUSION Creating an interdisciplinary, standardized workflow and checklists allowed the safe delivery of OART with clinically feasible online procedure time and significantly reduced initial planning time compared with traditional EBRT. The unique workflow is essential to minimize the burden on the care team, increase patient safety, and access to OART.
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Affiliation(s)
- Y F Wang
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - C Elliston
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - R Munbodh
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - M Savacool
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - J Tam
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - J Joseph
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - C S Spina
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - D P Horowitz
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - L A Kachnic
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - M Price
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
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Sayan M, Eren AA, Alali B, Mohammadipour S, Vahedi F, Daneshmand B, Abbas W, Hawsawi Y, Nader T, Joseph J, Wahby R, Ozgenc I, Mula-Hussain L, Moningi S, Orio PF, Eren MF. Prostate Cancer Awareness in the Middle East. Int J Radiat Oncol Biol Phys 2023; 117:e433-e434. [PMID: 37785413 DOI: 10.1016/j.ijrobp.2023.06.1602] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A better understanding of cancer awareness is crucial to allow the appropriate implementation of interventions to improve screening and diagnosis. While the incidence of prostate cancer has been reported to increase over the last decade in the Middle East, data on prostate cancer awareness in this region remains limited. Therefore, an assessment of prostate cancer awareness is critically needed. The current study addresses this urgent need by investigating the level of awareness of prostate cancer among the general public in the Middle East. MATERIALS/METHODS A cross-sectional survey of men residing in 13 Middle Eastern countries was conducted in 2022. A validated prostate cancer awareness questionnaire was used to assess participants' knowledge on several domains of prostate cancer. Men younger than 40 years of age or history of prostate cancer were excluded from the study. RESULTS A total of 4,431 men completed the survey. The median age was 49 (range, 40-81) and the majority of participants (81%) had a formal education. Most participants (90%) were married and only 30% had a family history of cancer. Most participants (84%) reported hearing about prostate cancer in the past but only 31% of the participants recognized that prostate cancer is the most common malignancy in men and 22% thought that prostate cancer affects both men and women. Awareness of risk factors for prostate cancer was low: 29% of the participants recognized family history as a risk factor and 30% associated increasing age with prostate cancer. Most participants were not aware of screening, specifically only 19% of the participants knew that PSA test is used for PC screening. In terms of prognosis, participants thought that the majority of prostate cancer patients (mean, 75%) die due to their disease as opposed to old age or another cause of death. CONCLUSION Although the Middle Eastern men are familiar with the existence of prostate cancer, they are uninformed about the disease outcomes, risk factors, and screening. Overall, these results indicate critically low levels of awareness of prostate cancer in the Middle East. Thus, there is a vital need to target this population for practical interventions to increase awareness, in addition to screening and earlier diagnosis.
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Affiliation(s)
- M Sayan
- Dana Farber Cancer Institute, Boston, MA
| | - A Ay Eren
- Kartal Dr. Lütfi Kırdar Education and Research Hospital, Istanbul, Turkey
| | - B Alali
- Jaber Al Ahmad Hospital, Kuwait, Kuwait
| | | | - F Vahedi
- University of Tehran, Tehran, Iran (Islamic Republic of Iran)
| | | | - W Abbas
- Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of Iran)
| | - Y Hawsawi
- Al-Faisal University, Jeddah, Saudi Arabia
| | - T Nader
- Faculty of Medicine of Damascus University, Damascus, Syrian Arab Republic
| | - J Joseph
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - R Wahby
- Galala University, Suez, Egypt
| | - I Ozgenc
- University of Nicosia Medical School, Egkomi, Cyprus
| | | | - S Moningi
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - P F Orio
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - M F Eren
- Marmara Universitesi Hastanesi, Istanbul, Turkey
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Stryker K, Farghaly S, Alsunaid S, Joseph J, BORGI J, Forest S, Mansour A. Weight It Out: Use of Semaglutide for Weight Loss in Patients Undergoing Lung Transplant Evaluation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1378] [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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Farghaly S, Alsunaid S, Stryker K, Joseph J, Forest S, Borgi J, Mansour A. Successful Use of Glecapravir/pibrentasvir in the Setting of Extracorporeal Membrane Oxygenation in a Lung Transplant Recipient: A Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.674] [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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Farghaly S, Yun S, Mansour A, Stryker K, Joseph J, Forest S, Borgi J, Alsunaid S. Outcomes and Immunosuppression of Combined Liver-Lung Transplantation: A Single Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1373] [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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Apte S, Bhutda S, Ghosh S, Sharma K, Barton TE, Dibyachintan S, Sahay O, Roy S, Sinha AR, Adicherla H, Rakshit J, Tang S, Datey A, Santra S, Joseph J, Sasidharan S, Hammerschmidt S, Chakravortty D, Oggioni MR, Santra MK, Neill DR, Banerjee A. An innate pathogen sensing strategy involving ubiquitination of bacterial surface proteins. Sci Adv 2023; 9:eade1851. [PMID: 36947610 PMCID: PMC10032600 DOI: 10.1126/sciadv.ade1851] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Sensing of pathogens by ubiquitination is a critical arm of cellular immunity. However, universal ubiquitination targets on microbes remain unidentified. Here, using in vitro, ex vivo, and in vivo studies, we identify the first protein-based ubiquitination substrates on phylogenetically diverse bacteria by unveiling a strategy that uses recognition of degron-like motifs. Such motifs form a new class of intra-cytosolic pathogen-associated molecular patterns (PAMPs). Their incorporation enabled recognition of nonubiquitin targets by host ubiquitin ligases. We find that SCFFBW7 E3 ligase, supported by the regulatory kinase, glycogen synthase kinase 3β, is crucial for effective pathogen detection and clearance. This provides a mechanistic explanation for enhanced risk of infections in patients with chronic lymphocytic leukemia bearing mutations in F-box and WD repeat domain containing 7 protein. We conclude that exploitation of this generic pathogen sensing strategy allows conservation of host resources and boosts antimicrobial immunity.
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Affiliation(s)
- Shruti Apte
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Smita Bhutda
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Sourav Ghosh
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Kuldeep Sharma
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Thomas E. Barton
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, L69 7BE Liverpool, UK
| | - Soham Dibyachintan
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Osheen Sahay
- Cancer Biology and Epigenetics Laboratory, National Centre for Cell Science, Ganeshkhind Road, Pune 411007, Maharashtra, India
| | - Suvapriya Roy
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Akash Raj Sinha
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Harikrishna Adicherla
- CSIR-Centre for Cellular and Molecular Biology, Uppal Road, Habsiguda, Hyderabad 500007 Telangana, India
| | - Jyotirmoy Rakshit
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Shiying Tang
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Akshay Datey
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru 560012, Karnataka, India
| | - Shweta Santra
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Jincy Joseph
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Sreeja Sasidharan
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute of Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, D-17487 Greifswald, Germany
| | - Dipshikha Chakravortty
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bengaluru 560012, Karnataka, India
| | - Marco R. Oggioni
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Manas Kumar Santra
- Cancer Biology and Epigenetics Laboratory, National Centre for Cell Science, Ganeshkhind Road, Pune 411007, Maharashtra, India
| | - Daniel R. Neill
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, L69 7BE Liverpool, UK
| | - Anirban Banerjee
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, Maharashtra, India
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11
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Sagar H, George J, Joseph V, Joseph J, Abdullakutty J, Mathew R. Optical Coherence Tomography (OCT) evaluation of culprit lesions in patients with Non-ST Elevation Acute Coronary Syndromes (NSTE-ACS). Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.089] [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: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
OCT is an excellent tool to determine plaque morphology in Acute Coronary Syndromes. While plaque rupture has been determined to be the dominant morphology in ST Elevation Myocardial Infarction, there is paucity of literature in NSTE-ACS, which includes Non–ST Segment Elevation Myocardial Infarction (NSTEMI) and Unstable angina (UA).
Purpose
To characterize culprit lesion morphology by OCT in NSTE-ACS and to evaluate the frequency of each type of lesion in patients presenting with NSTEMI and UA.
Methods
In this single-centre observational study, OCT imaging of culprit lesion was acquired during coronary angioplasty of culprit lesions of 50 patients presenting with NSTE-ACS between August 2020 to July 2021. A comparison of the frequency of each type of lesion between NSTEMI and UA was performed.
Results
OCT of culprit vessel in the entire cohort of NSTE-ACS showed plaque erosion in 32% (n=16), plaque rupture in 32% (n=16), tight stenosis in 26% (n=13) and calcific nodule in 10% (n= 5) patients. Lipid plaque was seen in a higher number of patients with plaque erosion and plaque rupture (93.8% and 87.5% respectively). Comparison of the frequency of these lesions in NSTEMI and UA, revealed that among NSTEMI patients (n=25), 48% had plaque erosion, 36% had plaque rupture, 12% had tight stenosis and 4% had calcific nodule whereas, among UA patients (n=25), 16% had plaque erosion, 28% had plaque rupture, 40% had tight stenosis and 16% had calcific nodule. There was a statistically significant increase in plaque erosion in NSTEMI compared to UA (p=0.015) while tight stenosis was significantly more common in UA (p=0.024). Similarly, red thrombus and spotty calcium (p=0.002 and 0.008 respectively) were higher in NSTEMI compared to UA. There was no significant difference in frequency of thin cap fibroatheroma, macrophages, cholesterol crystals, white thrombus, and neovascularization among the two groups.
Conclusions
OCT provides unique insights into the mechanisms of NSTE-ACS. In our study plaque erosion and plaque rupture were both equally seen in patients presenting with NSTE- ACS. However, NSTEMI patients had a higher frequency of plaque erosion, red thrombus, and spotty calcium when compared to UA. While UA patients had a higher incidence of tight stenosis.
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Affiliation(s)
- H Sagar
- LISIE HOSPITAL , Kochi , India
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12
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Vuillier L, Joseph J, Greville-Harris M, May L, Somerville MP, Harrison A, Moseley RL. What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders. J Eat Disord 2022; 10:193. [PMID: 36514166 PMCID: PMC9749243 DOI: 10.1186/s40337-022-00715-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males. METHODS In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire. RESULTS We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males. DISCUSSION Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.
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Affiliation(s)
- L Vuillier
- Department of Psychology, Bournemouth University, Poole, UK.
| | - J Joseph
- Department of Psychology, Bournemouth University, Poole, UK
| | | | - L May
- Dorset Healthcare University NHS Foundation Trust, Poole, UK
| | - M P Somerville
- UCL Institute of Education, University College London, London, UK
| | - A Harrison
- UCL Institute of Education, University College London, London, UK
| | - R L Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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13
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Abeyakoon O, Woitek R, Wallis M, Moyle P, Morscher S, Dahlhaus N, Ford S, Burton N, Manavaki R, Mendichovszky I, Joseph J, Quiros-Gonzalez I, Bohndiek S, Gilbert F. An optoacoustic imaging feature set to characterise blood vessels surrounding benign and malignant breast lesions. Photoacoustics 2022; 27:100383. [PMID: 36068806 PMCID: PMC9441264 DOI: 10.1016/j.pacs.2022.100383] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/21/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Combining optoacoustic (OA) imaging with ultrasound (US) enables visualisation of functional blood vasculature in breast lesions by OA to be overlaid with the morphological information of US. Here, we develop a simple OA feature set to differentiate benign and malignant breast lesions. 94 female patients with benign, indeterminate or suspicious lesions were recruited and underwent OA-US. An OA-US imaging feature set was developed using images from the first 38 patients, which contained 14 malignant and 8 benign solid lesions. Two independent radiologists blindly scored the OA-US images of a further 56 patients, which included 31 malignant and 13 benign solid lesions, with a sensitivity of 96.8% and specificity of 84.6%. Our findings indicate that OA-US can reveal vascular patterns of breast lesions that indicate malignancy using a simple feature set based on single wavelength OA data, which is therefore amenable to application in low resource settings for breast cancer management.
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Affiliation(s)
- O. Abeyakoon
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - R. Woitek
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - M.G. Wallis
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - P.L. Moyle
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - S. Morscher
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - N. Dahlhaus
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - S.J. Ford
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - N.C. Burton
- iThera Medical GmbH, Zielstattstrasse 13, Munich 81379, Germany
| | - R. Manavaki
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - I.A. Mendichovszky
- Department of Nuclear Medicine, Cambridge University Hospitals Foundation Trust, Cambridge CB2 0QQ, UK
| | - J. Joseph
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - I. Quiros-Gonzalez
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - S.E. Bohndiek
- Department of Physics, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge CB2 0RE, UK
| | - F.J. Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
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Gladis EHE, Nagashri K, Anisha M, Joseph J. Synthesis, characterisation, DNA binding, acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities and molecular docking studies of metal(II) complexes with 1,10-phenanthroline scaffold. J Biomol Struct Dyn 2022:1-19. [PMID: 35699274 DOI: 10.1080/07391102.2022.2078412] [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: 10/18/2022]
Abstract
A series of metal complexes containing Phenanthroline scaffold [ML] (L-1,10-Phenanthroline derivative comprises conjugated aromatic core and selenol group); M = Cu(II), Zn(II), Co(II) and Zn(II) ions were designed and synthesised to obtain effective anti-cholinesterase efficiencies of metal chelates. Analytical and spectroscopic studies were used to determine the structural features. An octahedral structure with moderate distortion was attributed to the above metal chelates based on spectroscopic data. The distorted octahedral geometry of copper(II) complex to DNA (Kb = 4.05 × 105 M-1) is stronger than that of ethidium bromide (EB) to DNA (Kb = 3.2 × 105 M-1), other metal complexes, respectively. The synthesised 1,10-Phenanthroline derivative had the best inhibitory effects against acetylcholinesterase (AChE) and butyrylcholinesterase, with IC50 values of 0.45 and 3.6 M, respectively, which were lower than the reference molecules. As a result, nitrogen-containing heterocyclic compounds (H2L) showed significant inhibitory profiles against the metabolic enzymes. Therefore, we believe that these experimental results may contribute to the development of new drug molecules particularly in the treatment of neurological disorders including glaucoma, Alzheimer's disease (AD) and diabetes. Docking, AChE and BuChE inhibition activities results revealed that ligand may be used for AD. The prepared 1,10-phenanthroline analogue, which has a high selectivity for AChE, may be studied further to find potential candidates for treating early-stage Alzheimer's symptoms.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- E H Edinsha Gladis
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, India
| | - K Nagashri
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, India
| | - M Anisha
- Department of Biomedical Engineering, Kalasalingam Academy of Research and Education, Krishnankoil, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, India
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15
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Prakasan A, Krishna J, Kumar A, Mathews S, Sambasivan S, Joseph J, James F. 22P A comparison of new ESGO-ESTRO-ESP endometrial risk classification with previous classification in predicting outcome. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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16
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Van Der Sluijs KM, Bakker EA, Schuijt TJ, Joseph J, Thijssen DHJ, Eijsvogels TMH. Long-term cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients: a case-control study. Eur J Prev Cardiol 2022. [PMCID: PMC9384083 DOI: 10.1093/eurjpc/zwac056.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation (Nederlandse Hartstichting) Background/Introduction SARS-CoV-2 and the associated coronavirus disease 2019 (COVID-19) has substantial acute effects on cardiovascular health and physical functioning, but the long-term effects are less clear, especially in individuals that recover from COVID-19 at home, representing ~95% of all cases. Purpose We compared cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients versus age- and sex-matched healthy peers. Methods We recruited non-hospitalised adults with PCR-proven COVID-19 and age- and sex-matched controls for this case-control study. Duration of COVID-19 illness and presence of residual complaints were inquired. Cardiovascular health status and physical functioning were assessed through a series of measurements: blood pressure, blood biomarkers (NT-proBNP, high-sensitive cardiac troponin I, C-reactive protein), carotid-femoral pulse wave velocity (ARTSENS), handgrip strength, 4-metre gait speed, habitual physical activity (days per week with at least 30 minutes of moderate physical activity) and quality of life based on the 12-item short form. Results We included 101 ex-COVID-19 patients (median age 59.0 [54.5-65.5], 59 (58.4%) male) at a median of 5.0 [4.0-7.0] months post-infection and 101 age- and sex-matched controls (median age 58.0 [54.0-64.5], 58 (57.4%) male). Median duration of COVID-19 illness was 8.0 days [6.0-14.0] and 32.3% of the cases reported residual complaints at the time of inclusion. We found no differences between ex-COVID-19 patients and controls in blood pressure (134-81 vs. 133-81 mmHg, p=0.40 and p=0.30 for systolic and diastolic pressures respectively), concentrations of NT-proBNP (8.50 vs. 7.00 pmol/L, p=0.22), high-sensitive cardiac troponin I (4.11 vs. 3.38 ng/L, p=0.06), C-reactive protein (4.00 vs. 4.00 mg/L, p=0.93) and carotid-femoral pulse wave velocity (6.63 vs. 7.01 m/s, p=0.30). Ex-COVID-19 patients showed higher handgrip strength compared to controls (43 kg vs. 38 kg, p=0.004), but 4-metre gait speed (2.62 vs. 2.56 s, p=0.33), habitual physical activity levels (6.0 vs. 6.0 days, p=0.16) and reported quality of life (86.4% vs. 88.6%, p=0.10) were not different between groups. Conclusion(s) Cardiovascular health and physical functioning parameters were not different between non-hospitalised ex-COVID-19 patients and age- and sex-matched controls at five months post-infection. This suggests that individuals who recovered from COVID-19 at home do not have an increased cardiovascular risk or impaired physical functioning in the long-term.
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Affiliation(s)
- KM Van Der Sluijs
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - EA Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - TJ Schuijt
- Gelderse Vallei Hospital, Clinical Chemistry and Hematology Laboratory, Ede, Netherlands (The)
| | - J Joseph
- Indian Institute of Technology (IIT) Madras, Department of Electrical Engineering, Chennai, India
| | - DHJ Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
| | - TMH Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, Netherlands (The)
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17
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Sundaram V, Rao G, Bhattacharjee M, Joseph J, Balaji B, Patil D. PO-1544 The role of dose rate and gantry speed variations in PRO and PO algorithms for rapidarc delivery. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03508-3] [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]
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18
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O'Brien J, Manning T, Kelly B, Chen K, Merrilees D, Joseph J, Sengupta S, Goad J, Bolton D, Lawrenstchuk N. Sealing the leak: A 10-year multicentre experience managing refractory post retroperitoneal lymph node dissection chylous ascites. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00647-9] [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: 11/04/2022]
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19
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Vijila B, Gladis EHE, Keerthi N, Joseph J. Mesoporous aluminum impregnated rubber seed shell waste enriched with calcium as adsorbent material for the removal of microbial DNA in aqueous solution. Nucleosides Nucleotides Nucleic Acids 2022; 41:183-219. [PMID: 35019823 DOI: 10.1080/15257770.2022.2026382] [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] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 01/01/2022] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Water contamination by pathogens and diseases induced by these pathogens is a major water quality issue all over the world. Poor public health has been linked to tap water polluted with DNA harboring antibiotic resistance genes sequence. According to HSAB concept, surface modification of rubber seed shell waste with alumina (AIRSS) as novel agro-waste adsorbent creates more active surface constituents for DNA adsorption. The proximate, ultimate and EDAX analysis provides the percentage levels of ash concentration, volatile, moisture and fixed carbon content, elemental composition present in the adsorbent. The structural features of AIRSS were determined using FT-IR, SEM and XRD. In order to improve reaction conditions, the effect of pH, temperature, adsorbent amount, and reaction time is also examined. The highest percent of DNA removal (92.5%) was achieved at the optimum conditions: 2 g/L at pH 4, contact time 120 minutes as compared to the conventional methods. The DNA adsorbs onto the surface of AIRSS through physical (vander Waals force) and chemical interactions, as demonstrated by kinetics and spectroscopic analyses. Changes in enthalpy (H), free energy (G), and entropy (S) indicate that adsorption is a spontaneous and exothermic process, according to thermodynamic parameters. The results of the experiments showed that the prepared AIRSP adsorbent could be used to remove DNA from water. The efficacy of AIRSS for the removal of DNA has decreased after nine months of storage and use. Low pH and the presence of AIRSS improved DNA-AIRSS adsorption, according to our findings.
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Affiliation(s)
- B Vijila
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - E H Edinsha Gladis
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - N Keerthi
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
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20
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Anil A, Apte S, Joseph J, Parthasarathy A, Madhavan S, Banerjee A. Pyruvate Oxidase as a Key Determinant of Pneumococcal Viability during Transcytosis across Brain Endothelium. J Bacteriol 2021; 203:e0043921. [PMID: 34606370 PMCID: PMC8604078 DOI: 10.1128/jb.00439-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/23/2021] [Indexed: 01/23/2023] Open
Abstract
Streptococcus pneumoniae invades a myriad of host tissues following efficient breaching of cellular barriers. However, strategies adopted by pneumococcus for evasion of host intracellular defenses governing successful transcytosis across host cellular barriers remain elusive. In this study, using brain endothelium as a model host barrier, we observed that pneumococcus containing endocytic vacuoles (PCVs), formed following S. pneumoniae internalization into brain microvascular endothelial cells (BMECs), undergo early maturation and acidification, with a major subset acquiring lysosome-like characteristics. Exploration of measures that would preserve pneumococcal viability in the lethal acidic pH of these lysosome-like vacuoles revealed a critical role of the two-component system response regulator, CiaR, which was previously implicated in induction of acid tolerance response. Pyruvate oxidase (SpxB), a key sugar-metabolizing enzyme that catalyzes oxidative decarboxylation of pyruvate to acetyl phosphate, was found to contribute to acid stress tolerance, presumably via acetyl phosphate-mediated phosphorylation and activation of CiaR, independent of its cognate kinase CiaH. Hydrogen peroxide, the by-product of an SpxB-catalyzed reaction, was also found to improve pneumococcal intracellular survival by oxidative inactivation of lysosomal cysteine cathepsins, thus compromising the degradative capacity of the host lysosomes. As expected, a ΔspxB mutant was found to be significantly attenuated in its ability to survive inside the BMEC endocytic vacuoles, reflecting its reduced transcytosis ability. Collectively, our studies establish SpxB as an important virulence determinant facilitating pneumococcal survival inside host cells, ensuring successful trafficking across host cellular barriers. IMPORTANCE Host cellular barriers have innate immune defenses to restrict microbial passage into sterile compartments. Here, by focusing on the blood-brain barrier endothelium, we investigated mechanisms that enable Streptococcus pneumoniae to traverse through host barriers. Pyruvate oxidase, a pneumococcal sugar-metabolizing enzyme, was found to play a crucial role in this via generation of acetyl phosphate and hydrogen peroxide. A two-pronged approach consisting of acetyl phosphate-mediated activation of acid tolerance response and hydrogen peroxide-mediated inactivation of lysosomal enzymes enabled pneumococci to maintain viability inside the degradative vacuoles of the brain endothelium for successful transcytosis across the barrier. Thus, pyruvate oxidase is a key virulence determinant and can potentially serve as a viable candidate for therapeutic interventions for better management of invasive pneumococcal diseases.
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Affiliation(s)
- Anjali Anil
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
| | - Shruti Apte
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
| | - Jincy Joseph
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
| | - Akhila Parthasarathy
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
| | - Shilpa Madhavan
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
| | - Anirban Banerjee
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Powai, Mumbai, Maharashtra, India
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Zuberi S, Mushtaq Y, Patel K, Joseph J, Gurprashad R. 684 The Standard of Emergency Operation Note Documentation at A District General Hospital Compared Against The Royal College of Surgeons of England (RCSEng) Standard. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.746] [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
Introduction
Meticulous operation note documentation is essential for seamless, safe continuity of care in postoperative surgical patients. This study evaluated the standard of emergency operation note documentation at a district general hospital, when compared to the Royal College of Surgeons of England (RCSEng) guidelines and assessed the impact of a new operation note proforma.
Method
A retrospective review of 50 emergency operation notes was conducted between December 2019 and March 2020 and compared to RCSEng guidelines. Initial findings were presented at a local clinical governance meeting and a new electronic operation note was introduced. A further 50 emergency operation notes using the new proforma were analysed between August 2020 and December 2020.
Results
RCSEng mentions 19 main points that all operation notes must include. A total of 100 operation notes were reviewed and each given a score out of 19. Intervention of the new proforma showed significant improvement to the average score (15.64 vs 17.94; p < 0.0001) when compared to RCSEng guidelines. In particular, there was significant improvement in the documentation of assistants involved in the procedure (58% vs 98%; p < 0.0001), estimated blood loss (2% vs 63%; p < 0.0001) and specific mention whether the operation was emergency or elective (20% vs 86%; p < 0.0001).
Conclusions
Implementation of the new proforma showed significant improvement in operation note documentation when compared to the RCSEng standard. Therefore, this study emphasises the need for surgeons to familiarise themselves with the current guidelines and highlights the importance of tailoring local operation note proformas to match this national standard closely.
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Affiliation(s)
- S Zuberi
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - Y Mushtaq
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - K Patel
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - J Joseph
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
| | - R Gurprashad
- Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton, United Kingdom
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Shrodes J, Spees C, Radabaugh J, Braun A, Joseph J, Williams A. Adaptation, Implementation, and Impact of Cooking Matters® for Diabetes on Dietary Outcomes, Food Security, and Quality of Life. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.050] [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]
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Stienbarger CD, Joseph J, Athey SN, Monteleone B, Andrady AL, Watanabe WO, Seaton P, Taylor AR, Brander SM. Direct ingestion, trophic transfer, and physiological effects of microplastics in the early life stages of Centropristis striata, a commercially and recreationally valuable fishery species. Environ Pollut 2021; 285:117653. [PMID: 34380229 DOI: 10.1016/j.envpol.2021.117653] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/01/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Microplastics are ubiquitous in marine and estuarine ecosystems, and thus there is increasing concern regarding exposure and potential effects in commercial species. To address this knowledge gap, we investigated the effects of microplastics on larval and early juvenile life stages of the Black Sea Bass (Centropristis striata), a North American fishery. Larvae (13-14 days post hatch, dph) were exposed to 1.0 × 104, 1.0 × 105, and 1.0 × 106 particles L-1 of low-density polyethylene (LDPE) microspheres (10-20 μm) directly in seawater and via trophic transfer from microzooplankton prey (tintinnid ciliates, Favella spp.). We also compared the ingestion of virgin and chemically-treated microspheres incubated with either phenanthrene, a polycyclic aromatic hydrocarbon, or 2,4-di-tert-butylphenol (2,4-DTBP), a plastic additive. Larval fish did not discriminate between virgin or chemically-treated microspheres. However, larvae did ingest higher numbers of microspheres through ingestion of microzooplankton prey than directly from the seawater. Early juveniles (50-60 dph) were directly exposed to the virgin and chemically-treated LDPE microspheres, as well as virgin LDPE microfibers for 96 h to determine physiological effects (i.e., oxygen consumption and immune response). There was a significant positive relationship between oxygen consumption and increasing microfiber concentration, as well as a significant negative relationship between immune response and increasing virgin microsphere concentration. This first assessment of microplastic pollution effects in the early life stages of a commercial finfish species demonstrates that trophic transfer from microzooplankton can be a significant route of microplastic exposure to larval stages of C. striata, and that multi-day exposure to some microplastics in early juveniles can result in physiological stress.
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Affiliation(s)
| | - Jincy Joseph
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Samantha N Athey
- Department of Earth Sciences, University of Toronto, Ontario, Canada
| | - Bonnie Monteleone
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Anthony L Andrady
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Wade O Watanabe
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Pamela Seaton
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Alison R Taylor
- Department of Biology and Marine Biology, University of North Carolina, Wilmington, USA
| | - Susanne M Brander
- Department of Fisheries, Wildlife and Conservation Sciences, Coastal Oregon Marine Experiment Station, Oregon State University, USA.
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Joseph J, Moll M, Hessamfar M. Proposition systématique d’un suivi alterné ville–hôpital aux patients sous PrEP : enquête de pratique auprès des médecins généralistes. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.288] [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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Joy A, Kumar A, Joseph J, Krishna K M J, Natarajan N, M Nair L, V James F. PO-0191 Plan evaluation of the interstitial contribution in brachytherapy for cancer cervix. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06350-7] [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]
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Bell JF, Maki JN, Mehall GL, Ravine MA, Caplinger MA, Bailey ZJ, Brylow S, Schaffner JA, Kinch KM, Madsen MB, Winhold A, Hayes AG, Corlies P, Tate C, Barrington M, Cisneros E, Jensen E, Paris K, Crawford K, Rojas C, Mehall L, Joseph J, Proton JB, Cluff N, Deen RG, Betts B, Cloutis E, Coates AJ, Colaprete A, Edgett KS, Ehlmann BL, Fagents S, Grotzinger JP, Hardgrove C, Herkenhoff KE, Horgan B, Jaumann R, Johnson JR, Lemmon M, Paar G, Caballo-Perucha M, Gupta S, Traxler C, Preusker F, Rice MS, Robinson MS, Schmitz N, Sullivan R, Wolff MJ. The Mars 2020 Perseverance Rover Mast Camera Zoom (Mastcam-Z) Multispectral, Stereoscopic Imaging Investigation. Space Sci Rev 2021; 217:24. [PMID: 33612866 PMCID: PMC7883548 DOI: 10.1007/s11214-020-00755-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/25/2020] [Indexed: 05/16/2023]
Abstract
Mastcam-Z is a multispectral, stereoscopic imaging investigation on the Mars 2020 mission's Perseverance rover. Mastcam-Z consists of a pair of focusable, 4:1 zoomable cameras that provide broadband red/green/blue and narrowband 400-1000 nm color imaging with fields of view from 25.6° × 19.2° (26 mm focal length at 283 μrad/pixel) to 6.2° × 4.6° (110 mm focal length at 67.4 μrad/pixel). The cameras can resolve (≥ 5 pixels) ∼0.7 mm features at 2 m and ∼3.3 cm features at 100 m distance. Mastcam-Z shares significant heritage with the Mastcam instruments on the Mars Science Laboratory Curiosity rover. Each Mastcam-Z camera consists of zoom, focus, and filter wheel mechanisms and a 1648 × 1214 pixel charge-coupled device detector and electronics. The two Mastcam-Z cameras are mounted with a 24.4 cm stereo baseline and 2.3° total toe-in on a camera plate ∼2 m above the surface on the rover's Remote Sensing Mast, which provides azimuth and elevation actuation. A separate digital electronics assembly inside the rover provides power, data processing and storage, and the interface to the rover computer. Primary and secondary Mastcam-Z calibration targets mounted on the rover top deck enable tactical reflectance calibration. Mastcam-Z multispectral, stereo, and panoramic images will be used to provide detailed morphology, topography, and geologic context along the rover's traverse; constrain mineralogic, photometric, and physical properties of surface materials; monitor and characterize atmospheric and astronomical phenomena; and document the rover's sample extraction and caching locations. Mastcam-Z images will also provide key engineering information to support sample selection and other rover driving and tool/instrument operations decisions.
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Affiliation(s)
| | | | | | - M. A. Ravine
- Malin Space Science Systems, Inc., San Diego, CA USA
| | | | | | - S. Brylow
- Malin Space Science Systems, Inc., San Diego, CA USA
| | | | | | | | | | | | | | - C. Tate
- Cornell Univ., Ithaca, NY USA
| | | | | | - E. Jensen
- Malin Space Science Systems, Inc., San Diego, CA USA
| | - K. Paris
- Arizona State Univ., Tempe, AZ USA
| | | | - C. Rojas
- Arizona State Univ., Tempe, AZ USA
| | | | | | | | - N. Cluff
- Arizona State Univ., Tempe, AZ USA
| | | | - B. Betts
- The Planetary Society, Pasadena, CA USA
| | | | - A. J. Coates
- Mullard Space Science Laboratory, Univ. College, London, UK
| | - A. Colaprete
- NASA/Ames Research Center, Moffett Field, CA USA
| | - K. S. Edgett
- Malin Space Science Systems, Inc., San Diego, CA USA
| | - B. L. Ehlmann
- JPL/Caltech, Pasadena, CA USA
- Caltech, Pasadena, CA USA
| | | | | | | | | | | | - R. Jaumann
- Inst. of Geological Sciences, Free University Berlin, Berlin, Germany
| | | | - M. Lemmon
- Space Science Inst., Boulder, CO USA
| | - G. Paar
- Joanneum Research, Graz, Austria
| | | | | | | | - F. Preusker
- DLR/German Aerospace Center, Berlin, Germany
| | - M. S. Rice
- Western Washington Univ., Bellingham, WA USA
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Naik P, Dave V, Joseph J. Multidrug-resistant Pseudomonas aeruginosa accelerates innate immune response in human microglial cells. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.102] [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: 11/16/2022] Open
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Gladis EHE, Nagashri K, Suman A, Joseph J. Multifunctional 1,10-phenanthroline derivative and its metal complexes as an anti-Alzheimer’s agent: structure-based drug design, synthesis, characterization and pharmacological studies. J COORD CHEM 2020. [DOI: 10.1080/00958972.2020.1852223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- E. H. Edinsha Gladis
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamilnadu, India
| | - K. Nagashri
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
| | - A. Suman
- Department of Chemistry, Manonmaniam Sundaranar University, Tirunelveli, Tamilnadu, India
| | - J. Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamilnadu, India
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Edinsha Gladis E, Nagashri K, Joseph J. Design, synthesis, characterization, DNA binding, acetyl and butyryl cholinesterase activities of metal chelates with 1,10-Phenanthroline derivative. INORG CHEM COMMUN 2020. [DOI: 10.1016/j.inoche.2020.108232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Gandhi J, Dave V, Joseph J. Cytokine profiling plays a crucial role in activating immune system in fungal endophthalmitis. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.11.062] [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: 11/27/2022] Open
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32
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Nair L, Krishna KJ, Kumar A, Mathews S, Joseph J, James F. 208P Prognostic factors and outcomes of non-seminomatous germ cell tumours of testis: Experience from a tertiary cancer centre in India. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.220] [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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Abstract
Abstract
The fourth target of Sustainable Development Goal (SDG) 3 advocates for the promotion of mental health and wellbeing. The Indian state of Kerala is recognized for its gains in health and development but has substantial burden of mental health ailments. Historical analysis is vital to understand the pattern of mental health morbidity. The current study focusses on comparable estimates available from three largescale population-based surveys in India to explore trends in prevalence of mental health disorders over the years and map resources and infrastructure available for mental health care in Kerala.
We undertook a secondary analysis of national demographic surveys from 2002 to 2018 which reported information on mental health and availability of health infrastructure and human resources. Data were collated and descriptive analyses were conducted. We compared the national and state level estimates over the years to study the trend in the prevalence of mental health disability.
The prevalence of mental retardation and intellectual disability in Kerala increased from 194 per hundred thousand persons in 2002 to 300 per hundred thousand persons in 2018, two times higher to the national average. The prevalence of mental illness increased from 272 per hundred thousand people to 400 per hundred thousand people in sixteen years. The prevalence was higher among males (statistical significance was not indicated) in mental illness and mental retardation. 2018 data showed that the public sector had 0.01 hospitals and 5.53 beds per hundred thousand persons available for mental health treatment.
Results showed a substantial increase in mental health illness over the 16-year study period that has affected males and females, as well as all social classes of the state. The current health infrastructure and human resources in the public sector of the state are inadequate to meet the current burden of the problem and to ensure universal access to care for its population.
Key messages
The trend in prevalence of mental health disorders in the state is increasing across the years. There is a mismatch between the extend of the problem and resources available in public sector.
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Affiliation(s)
- J Joseph
- Health Systems, The George Institute for Global Health, New Delhi, India
| | - H Sankar
- Health Systems, The George Institute for Global Health, New Delhi, India
| | - D Nambiar
- Health Systems, The George Institute for Global Health, New Delhi, India
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Sakthivel A, Thangagiri B, Raman N, Joseph J, Guda R, Kasula M, Mitu L. Spectroscopic, SOD, anticancer, antimicrobial, molecular docking and DNA binding properties of bioactive VO(IV), Cu(II), Zn(II), Co(II), Mn(II) and Ni(II) complexes obtained from 3-(2-hydroxy-3-methoxybenzylidene)pentane-2,4-dione. J Biomol Struct Dyn 2020; 39:6500-6514. [PMID: 32794423 DOI: 10.1080/07391102.2020.1801508] [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] [Indexed: 10/24/2022]
Abstract
Novel macrocyclic Schiff base complexes [[ML]X; where M = Cu(II), Co(II), Ni(II), Zn(II), Mn(II) and VO(IV); L = macrocyclic ligand; X = Cl2 and SO42-] have been synthesized and characterized by microanalytical, 1H, 13C NMR, IR, Mass, UV-Vis, EPR spectral studies, as well as conductivity data. All the complexes exhibit square-planar geometry except vanadium complex. Magnetic susceptibility measurements and high conductance data reveal the monomeric and electrolytic nature of the complexes. Electronic absorption, cyclic voltammetry, viscosity measurements have been carried out on the interaction of the complexes with DNA. The results suggest that the complexes bind to DNA by intercalation via the aromatic ring of the macrocycle into the base pairs of DNA. Using gel electrophoresis experiment in the presence and absence of oxidant (H2O2) the nuclease cleavage activity of the complexes has been performed on plasmid DNA. The results demonstrate that most of the complexes have promising superoxide dismutase (SOD)-mimetic activity. The in vitro cytotoxicity of ligand and its complexes has also been evaluated against human breast and colon carcinoma cells. Binding interactions and energies of ligand and its metal complexes [ML]2+ (M = VO(IV), Mn(II), Co(II), Ni(II), Cu(II), Zn(II)) against the receptors EGFR and HER2 are performed using the Auto dock module. Consequently, it is found that the ligand is strong inhibitor for EGFR and HER2 while [VOL]SO4 is good inhibitor for EGFR and [ZnL]Cl2 is moderate inhibitor for HER2. The antimicrobial activity of the ligand and its complexes against bacteria Salmonella typhi, Staphylococcus aureus, Escherichia coli and Bacillus subtilis and fungi Aspergillus niger, Aspergillus flavus, Candida Albicans and Rhizoctonia bataicola. The complexes have higher activities than the macrocyclic free Schiff base. Interaction of [VOL]SO4 to the binding sites of target protein EGFR (PDB ID: 4HJ0). Research HighlightsMacrocyclic Schiff base and its metal complexes were synthesized.Complexes bind to DNA by intercalation via the aromatic ring of the macrocycle into the base pairs of DNA.Vanadyl complex is a good inhibitor for EGFR.The complexes of copper, zinc and vanadium show efficient antitumor activity.Copper and vanadium complexes have superior antimicrobial activity than the standards.
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Affiliation(s)
- A Sakthivel
- Department of Chemistry, Mepco Schlenk Engineering College, Sivakasi, India
| | - B Thangagiri
- Department of Chemistry, Mepco Schlenk Engineering College, Sivakasi, India
| | - N Raman
- Research Department of Chemistry, VHNSN College, Virudhunagar, India
| | - J Joseph
- Department of Chemistry, Noorul Islam Centre for Higher Education, Kumaracoil, Tamil Nadu, India
| | - Ramu Guda
- Department of Chemistry, Kakatiya University, Warangal, India
| | - Mamatha Kasula
- Department of Chemistry, Kakatiya University, Warangal, India
| | - L Mitu
- Department of Nature Sciences, University of Pitesti, Pitesti, Romania
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Paul M, Karthik S, Joseph J, Sivaprakasam M, Kumutha J, Leonhardt S, Hoog Antink C. Non-contact sensing of neonatal pulse rate using camera-based imaging: a clinical feasibility study. Physiol Meas 2020; 41:024001. [PMID: 32148333 DOI: 10.1088/1361-6579/ab755c] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Neonates and infants are patients who would benefit from less invasive vital sign sensing, especially from fewer cables and the avoidance of adhesive electrodes. Photoplethysmography imaging (PPGI) has been studied for medical applications in recent years: it is possible to assess various vital signs remotely, non-invasively, and without contact by using video cameras and light. However, studies on infants and especially on neonates in clinical settings are still rare. Hence, we conducted a single-center study to assess heart activity by estimating the pulse rate (PR) of 19 neonates. APPROACH Time series were generated from tracked regions of interest (ROIs) and PR was estimated via a joint time-frequency analysis using a short-time Fourier transform. Artifacts, for example, induced by movement, were detected and flagged by applying a signal quality index in the frequency domain. MAIN RESULTS The feasibility of PR estimation was demonstrated using visible light and near-infrared light at 850 nm and 940 nm, respectively: the estimated PR was as close as 3 heartbeats per minute in artifact-free time segments. Furthermore, an improvement could be shown when selecting the best performing ROI compared to the ROI containing the whole body. The main challenges are artifacts from motion, light sources, medical devices, and the detection and tracking of suitable regions for signal retrieval. Nonetheless, the PR extracted was found to be comparable to the contact-based photoplethysmography reference and is, therefore, a viable replacement if robust signal retrieval is ensured. SIGNIFICANCE Neonates are seldom measured by PPGI and studies reporting measurements on darker skin tones are rare. In this work, not only a single camera was used, but a synchronized camera setup using multiple wavelengths. Various ROIs were used for signal extraction to examine the capabilities of PPGI. In addition, qualitative observations regarding camera parameters and noise sources were reported and discussed.
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Affiliation(s)
- M Paul
- Medical Information Technology (MedIT), Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, Aachen, 52074, Germany
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Abstract
Vision assessments were provided to 297 Head Start children in nine Westchester County, New York programs. An optometrist and an orthoptist administered a protocol which included retinoscopy, visual acuity, fly, cover, motility and convergence tests. Sixty-three children (21.2%) were referred for further evaluation. The visual deficits detected by this screening included decreased acuity, strabismus combined with decreased acuity, astigmatism, and nonspecific visual problems. The protocol used provided a thorough evaluation of the visual system and required only seven minutes per patient.
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Affiliation(s)
- A. R. Morse
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
| | - E. Trief
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
| | - J. Joseph
- The Jewish Guild for the Blind. 15 W. 65th Street, New York, NY 10023
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Joseph J, Maharaj S. Otorrhoea - a parotid connection. S AFR J SURG 2020; 58:45. [PMID: 32243117] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 36-year-old patient presented with an 18-month history of intermittent right parotid swelling accompanied by otorrhoea. The symptoms started subsequent to a palm leaf injury to the right ear. At right parotidectomy, a fistula connecting the right external auditory canal and the right parotid was demonstrated. A small fibrotic mass probably due to a remnant of the palm leaf was found intraoperatively. The symptoms resolved completely after the mass was excised by superficial parotidectomy, and the fistula closed spontaneously.
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Affiliation(s)
- J Joseph
- Department of Otorhinolaryngology, University of the Witwatersrand, Johannesburg, South Africa
| | - S Maharaj
- Department of Otorhinolaryngology, University of the Witwatersrand, Johannesburg, South Africa
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Huang M, Krigstein M, Joseph J, Field A. 46. Classic histological features of gaucher disease: A case report. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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39
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Cashman H, Joseph J, Roberts D. Idarucizumab resistance due to a markedly elevated dabigatran concentration – A case report. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.372] [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]
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40
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Jacob-Mclimby J, Joseph J, Bannick F, Amoa A. Investigating the common clinical and histopathological features in dysfunctional uterine bleeding. Pathology 2020. [DOI: 10.1016/j.pathol.2020.01.249] [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]
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41
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Joseph J, Hebert K, Ziegelmann M, Habermann E, Gettman M, Viers B. 146 Opioid and Non-Opioid Pain Management Pathways for Male Anterior Urethroplasty: Evidence-Based Approach for Opioid Stewardship. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.091] [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]
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42
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Joseph J, Maharaj S. Otorrhoea - a parotid connection. S AFR J SURG 2020. [DOI: 10.17159/2078-5151/2020/v58n1a3157] [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]
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43
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Patel S, Carter B, Balmes G, Rider H, Joseph J, Zobniw C, Trinh V, Anderson J, Sheth R, Murthy R, Wachter E. A Phase I Study of Percutaneous Oncolytic Rose Bengal Disodium for Metastatic Uveal Melanoma Patients with Hepatic Metastases: A Single-Center Cohort Summary. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.032] [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: 11/13/2022] Open
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McConkey HZR, Marber M, Lee J, Ellis H, Joseph J, Allen C, Rahman H, Patterson T, Scannell C, Pibarot P, Chiribiri A, Redwood S, Prendergast BD. P6484Invasive and non-invasive characterisation of low gradient aortic stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1074] [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
Background
Low gradient severe aortic stenosis (LGAS) is associated with unfavourable outcomes when compared to high gradient aortic stenosis (HGAS), yet the contributing pathophysiology is poorly understood.
Methods
Symptomatic LGAS and HGAS patients undergoing trans-catheter aortic valve implantation (TAVI) underwent 3T stress perfusion cardiac magnetic resonance imaging (CMR) pre-(within 24 hours) and post-(4–6 months) TAVI. Left ventricular (LV) contractility and coronary flow/pressure were measured during hyperaemia and rapid pacing, immediately before and after TAVI, using a conductance LV catheter and dual-pressure and Doppler sensor–tipped guidewire in the mid-left anterior descending coronary artery.
Results
24 patients were recruited resulting in 19 suitable datasets (LGAS N=9, HGAS N=10, equally matched for comorbidities and B-natriuretic peptide level). LGAS patients had a smaller LV end diastolic volume index (p=0.035) and lower LV mass index (LVMI) (p=0.037). Pre-TAVI stress global endocardium-epicardium gradient was 0.88±0.09 and global myocardial perfusion reserve (MPR) 2.0±0.48 in 14 patients (6 LGAS and 8 HGAS patients, no difference between groups). Pre-TAVI, baseline coronary data demonstrated lower augmentation pressure (AP, p=0.035) and augmentation index (AIx, p=0.02) in the LGAS group. LGAS patients also exhibited a shorter ejection time (p=0.015), larger forward compression waves during rest, hyperaemia and rapid pacing, and smaller backward expansion waves (BEW) (p=0.001). Lower baseline end systolic pressure (p=0.004), inotropy (dP/dt+, p=0.045), lusitropy (dP/dt-, p=0.069), and stroke work (p=0.019) were observed in the LGAS group. Whilst LV size was smaller the LGAS group, rapid pacing induced a more significant drop in end systolic volume (p=0.045) and ejection fraction (p=0.015) in patients with HGAS. Post-TAVI, the hyperaemic BEW fell sharply (p<0.001), along with coronary VTI (p=0.02), and average pulse velocity (p=0.028), and AP and AIx remained lower (p=0.034 and p=0.031, respectively). The forward expansion wave was reduced in LGAS during rapid pacing. The HGAS group displayed a more profound drop in dP/dt+ (p=0.011) and dP/dt- p=0.014) at rest following intervention. Repeat CMR demonstrated statistically significant reduction in LV size and LVMI (p=0.012 and p<0.001, respectively) with significant increase in 3D global peak radial, circumferential and longitudinal strain (p=0.004, p=0.001 and p=0.018, respectively). Post-TAVI stress global endocardium-epicardium gradient was 0.88±0.13 and MPR 2.46±0.59 (improved from pre-TAVI, p=0.05). There was no difference in remodelling patterns or perfusion between the two groups.
Conclusion
This is the first study detailing the combined invasive and CMR pathophysiological changes in LGAS. Despite invasive parameters indicating a disease of less severe AS, the level of perfusion abnormality is disproportionate which may in part, relate to their adverse prognosis.
Acknowledgement/Funding
This research is funded by a Clinical Research Training Fellowship grant from the British Heart Foundation (FS/16/51/32365).
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Affiliation(s)
- H Z R McConkey
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - M Marber
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - J Lee
- Kings College London, School of Biomedical Engineering and Imaging Sciences, London, United Kingdom
| | - H Ellis
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - J Joseph
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - C Allen
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - H Rahman
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - T Patterson
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - C Scannell
- Kings College London, School of Biomedical Engineering and Imaging Sciences, London, United Kingdom
| | - P Pibarot
- Centre de Recherche de lInstitut Universitaire de Cardiologie et de Pneumologie de Quebec, Department of Medicine, Laval University, Quebec, Canada
| | - A Chiribiri
- Kings College London, School of Biomedical Engineering and Imaging Sciences, London, United Kingdom
| | - S Redwood
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
| | - B D Prendergast
- Kings College London, British Heart Foundation Centre of Excellence, The Rayne Institute, London, United Kingdom
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45
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Govindaraj V, Joseph J, Kumar BN, Soman R. Isolated left-sided pulmonary artery agenesis with left lung hypoplasia: A report of two cases. J Postgrad Med 2019; 63:262-264. [PMID: 28862244 PMCID: PMC5664872 DOI: 10.4103/jpgm.jpgm_562_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA) is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI. There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation. Presence of pulmonary hypertension carries a bad prognosis. We present two adult patients with isolated left sided unilateral pulmonary artery agenesis with ipsilateral lung hypoplasia. The diagnosis was confirmed by CT chest and perfusion scan.
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Affiliation(s)
- V Govindaraj
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - J Joseph
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - B Nagamalli Kumar
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Soman
- Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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46
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Joseph J, Ziegelmann M, Savage J, Meng Y, Kohler T, Trost L. 170 6-month Outcomes of RestoreX Penile Traction Therapy in Men with Peyronie's Disease: A Randomized, Controlled Trial. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.179] [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]
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47
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Sindone J, Day R, Stefani M, Joseph J. Perioperative Management of Antiplatelets in Elective Surgery at a Tertiary Hospital. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Nair P, Kumar A, Mathews S, Joseph J, Suchetha S, Krishna J, James F. Dysgerminoma ovary: Clinical features and treatment outcome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.002] [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: 11/13/2022] Open
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49
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Molina R, Agusti C, Mañe JM, Filella X, Jo J, Joseph J, Giménez N, Estapé J, Ballesta AM. Cyfra 21–1 in Lung Cancer: Comparison with Cea, Ca 125, Scc and Nse Serum Levels. Int J Biol Markers 2018; 9:96-101. [PMID: 7523548 DOI: 10.1177/172460089400900206] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 11/16/2022]
Abstract
CYFRA 21–1, CEA, CA 125, SCC and NSE serum levels were determined in 50 healthy subjects and in 189 patients with primary lung cancer (101 with locoregional disease, 68 with recurrence and 20 patients with no evidence of residual disease (NED). Abnormal CYFRA 21–1 serum levels were found in 53.6% (90/168) of the patients with active cancer. Neither healthy subjects nor NED patients had abnormal serum levels. CYFRa 21–1 serum concentrations were significantly higher in patients with active cancer than in healthy subjects or in NED patients (p < 0.0001). CYFRA 21–1 sensitivity was related to tumor histology with abnormal levels in 64.7% of patients with NSCLC and in 30% of patients with SCLC (P <0.0001). In NSCLC, serum CYFRA 21–1 concentrations were also related to histological type, the highest values being found in squamous cell carcinomas and LCLC and the lowest in adenocarcinomas (p < 0.04). There was also a clear relationship between CYFRA 21–1 and tumor extension, with significantly higher values in patients with metastases than in those without metastases (p < 0.0001). Abnormal CEA values were found in 49.1%, CA 125 in 39%, SCC in 27.8% and NSE in 21.3% of the patients with active cancer. With respect to histological type, CYFRA was elevated in 68.3% of squamous cell carcinomas (CEA: 46.7%, SCC: 50%, CA 125:31.7%, NSE: 11.7%), in 54.8% of adenocarcinomas (CEA: 62%, SCC: 26.2%, CA 125: 59.5%, NSE: 9.5%), in 78.6% of LCLC (CEA: 64.3%, SCC: 28.6%, CA 125: 78.6%, NSE: 7.1%) and in 30% of SCLC (CEA: 37.7%, SCC: 3.8%, CA 125:20.8%, NSE: 45.3%). In summary, CYFRA 21–1 is the most sensitive tumor marker in patients with lung cancer, especially in NSCLC patients.
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Affiliation(s)
- R Molina
- Laboratory of Clinical Chemistry, Hospital Clínic, School of Medicine, Barcelona-Spain
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50
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Molina R, Jo J, Filella X, Zanon G, Grau JJ, Joseph J, Bedini JL, Biete A, Ballesta AM. Mucin-Like Carcinoma-Associated Antigen (MCA) in Tissue and Serum of Patients with Breast Cancer: Clinical Applications in Prognosis and Disease Monitoring. Int J Biol Markers 2018; 8:113-23. [PMID: 8366294 DOI: 10.1177/172460089300800208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/16/2022]
Abstract
Mucin-like Carcinoma-associated Antigen (MCA) has been associated with many breast cancers. The aim of this study was to evaluate MCA in tumor tissue and serum as a potential tumor marker for prognosis and disease monitoring. MCA levels were determined in the tissue of 196 patients with primary breast cancer, 25 with metastatic disease and 25 patients with benign diseases, in pellet and/or cytosol. MCA levels were also determined in the serum of 50 patients with benign diseases, 148 with primary breast cancer (Mo), 150 with metastatic breast cancer (MT), and 200 with no clinical evidence of disease (NED). MCA tissue concentrations in pellet and cytosol were similar: 66.7 + 251 U/mg and 41.1 + 53 U/mg, respectively. No relationship between MCA levels and tumor size or nodal involvement was found. Higher MCA levels were observed in patients with ER + or PgR + tumors than in those with ER- or PgR- tumors (p < 0.01). Patients with MCA pellet concentrations lower than 10 U/mg of protein had shorter disease - free intervals (DFI) than those with higher values (p < 0.05). Abnormally high serum levels of MCA were found in 8% of patients with benign diseases, 4% of NED patients, 22% of Mo patients, and in 76% of MT cases. In primary breast cancer MCA values were related to tumor size and nodal involvement. A trend toward a lower DFI in patients with elevated presurgical MCA levels was observed but was of no statistical significance. These differences became statistically significant when patients were subdivided according to nodal status, with shorter DFI in those without nodal invasion (p < 0.05). In metastatic patients, changes in serum MCA were related to the tumor's response to treatment in 82% of cases. The highest MCA values were found in patients with liver or bone metastasis and the lowest values were found in those with locoregional recurrence. In conclusion, although MCA is not a specific tumor marker, it can be useful as a prognostic factor (tissue and serum) and in monitoring metastatic patients.
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Affiliation(s)
- R Molina
- Laboratory of Clinical Biochemistry (Unit for Cancer Research), Hospital Clinico, Medical School, Barcelona, Spain
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