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Malik H, Goel R, Melito W, Malik A, Engel LS, Boulmay B. A difficult task: determining oral anticoagulation efficacy (OAC) in patients with HIT type II. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00240-9] [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: 01/28/2023]
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Miller W, Provencher D, Chu QC, Jonker D, Oza A, Batist G, Jamal R, Goel R, Hilton J, Spratlin J, Smith P, Darling I, Stille J, Fortier C, Mangat R, Polzer J. 743P A phase Ib dose escalation study of CD137 mAb agonist OC-001 as monotherapy in patients with advanced or metastatic cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Goel R, Babu M, Padiyar S, Joseph G, Danda D. OP0187 COMPARATIVE EFFICACY OF NON-BIOLOGIC IMMUNOSUPPRESSANTS IN TAKAYASU ARTERITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe choice of immunosuppressant (IS) in patients with Takayasu arteritis (TAK) is often arbitrary due to lack of comparison studies.ObjectivesIn this retrospective, we aimed to compare the efficacy of 3 non biologic IS including azathioprine (AZA), mycophenolate mofetil (MMF) and methotrexate (MTX) in inducing and maintaining sustained remission in patients with TAK.MethodsPatients with a diagnosis of TAK, attending our clinics between Jan 2000 and May 2019 were identified. Those who satisfied either ACR or Sharma’s classification or EULAR PRINTO PRES criteria and/or had angiographic evidence of Takayasu arteritis with a minimum 2 follow up visits were included. Patients who received upfront biologics were excluded. The patients were matched for parameters statistically different among three groups using propensity score analysis. Clinical details at the index visit defined as the time of initiation of first IS and follow up visits were prospectively recorded and retrospectively noted from electronic medical records. The primary outcomes were attainment of complete remission and relapses. Disease activity was assessed by Indian Takayasu arteritis score (ITAS), C-reactive protein and angiograms. Relapse was defined as ITAS-A(CRP) >=2 and/or progression in angiograms and/or escalation of steroid dose and/or switching of IS due to active disease. The baseline variables of patients receiving AZA, MMF and MTX were compared using chi square test or Mann Whitney U test. The comparative efficacy of IS to induce complete remission was calculated using logistic regression and presented as odds ratio (95% CI). The cumulative risk of relapse was calculated using Cox-proportional hazards model with hazards ratio and 95% confidence interval (CI) after adjusting for duration of symptoms and juvenile onset disease. The patients were censored at the time of relapse or time of switching to another IS or last follow up whichever was the earliest. AZA was arbitrary chosen as the reference drug for all the analysis. The missing values (visits) were not included in analysis and the last observation was carried forwards. Data after switching of immunosuppressant of interest till the last follow up visit was analysed descriptively. All analysis were done for matched and unmatched patient groups. The results of matched and unmatched cohort were similar, hence the results of unmatched groups are presented here.ResultsOverall, 234 patients satisfying inclusion criteria including 53 (22.6%), 156 (66.7%) and 25 (10.7%) patients receiving AZA, MMF, Mtx respectively were studied. Complete remission (CR) was attained in 183 (78.2%) patients after initiating steroids and IS. 79.2%, 77.6% and 80% of patients receiving AZA, MMF or MTX respectively achieved CR yielding an odds ratio of 1.10 (0.52-2.37), p= 0.80 and 0.96 (0.29-3.12), p= 0.94 for MMF and MTX as compared with AZA. CR was sustained in 22 (52.4%), 80 (66.1%) and 11 (55%) of patients on AZA, MMF and MTX respectively. When compared with AZA, adjusted hazards ratio (AHR) of relapse was 1.51 (0.79-2.89), p=0.21 and 2.45 (1.00-5.99), p= 0.05 with MMF and MTX after adjusting for juvenile onset disease, type 1 and type 4 disease by angiography. The frequency of remission in patients who received MMF was significantly higher in patients who presented with type 4 disease (96%) as compared with the patients who had other types on angiography (74%), p= 0.017. Conversely, 63.6% of patients with type 1 disease responded to MMF which was significantly lower than 81.3% of patients with other angiographic types (p=0.037) while no such differential response was observed for AZA or MTX. Retrospective design and small number of patients in AZA and Mtx group were the major limitations of the study.ConclusionIn our patients with TAK, all the three IS were comparable in inducing remission. Azathioprine was equal to MMF but superior to MTX in maintaining relapse free sustained response. The efficacy of MMF differed across various angiographic types of disease.ReferencesNoneDisclosure of InterestsNone declared
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Hwee J, Fu Q, Harper L, Nirantharakumar K, Goel R, Jakes R. POS0320 EPIDEMIOLOGY AND HEALTHCARE RESOURCE UTILIZATION OF PATIENTS WITH EGPA IN THE UNITED KINGDOM. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundEosinophilic granulomatosis with polyangiitis (EGPA) is characterized by eosinophilic inflammation of small with or without medium arteries. EGPA is a rare disease with varying prevalence and incidence rates globally. To date, limited information is available on the prevalence, incidence and burden of disease in the United Kingdom (UK).ObjectivesThe objectives were to estimate the prevalence and incidence of EGPA, and to describe the healthcare resource utilization (HCRU) among patients with EGPA in the UK.MethodsThis retrospective database study used the UK-based Clinical Practice Research Datalink (CPRD)-AURUM database linked to the Hospital Episode Statistics (HES). Prevalence was estimated from 2005 to 2019, and incidence was estimated from 2006 to 2019. HCRU was assessed in the 12-months following the first recorded diagnosis of EGPA (index date), and included hospitalizations, emergency room visits, procedures, outpatient specialist visits, primary care visits, and oral corticosteroid use.Results764 people were identified with EGPA in the UK. The prevalence of EGPA, reported in the database, increased from 22.7 to 45.6 per 1,000,000 persons from 2005 to 2019 (Figure 1), whereas the incidence of EGPA from 2006 to 2019 ranged from 2.28 to 4.00 per 1,000,000 person-years. 377 patients with EGPA were successfully linked to the CPRD-HES database. Patient characteristics were as follows: mean age (SD) was 57 years (14.2); 49% were male; 81% had asthma; and 11% had peripheral neuropathy prior to the index date. For patients with EGPA, 19% had an EGPA-related hospitalization and 50% had any-cause hospitalization within 1 year of the index date (Table 1). The mean length of stay was, 18 days and 16 days for EGPA-related and any-cause hospitalizations, respectively. 52% of patients with EGPA had undergone a medical procedure, 89% of patients with EGPA had an outpatient visit to a specialist. Almost all patients with EGPA visited a general practitioner within 1 year of their EGPA diagnosis (97%) and averaged 16.0 visits in 1 year. A significant proportion of the EGPA population were prescribed OCS; most EGPA patients had a prescription in the 0–3 months after the index date (64%), and patients on average had a prescription for OCS for 6 out of the 12 months after the index date.Table 1.HCRU among patients with EGPAHCRUNumber of patients N (%) [total days]Number of events per patient, Mean (SD)Total EGPA cohort (N)377 EGPA-specific hospitalizations72 (19.10)1.2 (1) EGPA-specific hospitalizations length of stay[1283]17.8 (23.3) Any-cause hospitalizations188 (49.87)1.7 (1) Any-cause hospitalizations length of stay[2992]15.9 (23.7) Any-cause A & E events19 (5.04)1.8 (2) Any-cause outpatient visits334 (88.59)9.8 (7) Any procedures undertaken196 (51.99)6.8 (6) General Practitioner visits366 (97.08)16.0 (11)A&E, Accident and Emergency; EGPA, eosinophilic granulomatosis with polyangiitis; HCRU, healthcare resource utilization.Figure 1.Prevalence of EGPA in the UK from 2005 to 2019Prevalence is expressed as cases per 1,000,000 persons. EGPA, eosinophilic granulomatosis with polyangiitis; UK, United Kingdom.ConclusionThe prevalence of EGPA increased over the study period in the UK, and the data show significant HCRU within 1 year of the first recorded diagnosis of EGPA. Almost all of the patients with EGPA were found to frequently visit the primary care physician and seek specialist care, and almost half required hospitalization. Funding: GSK [207888]AcknowledgementsFunding: GSK [207888]Disclosure of InterestsJeremiah Hwee Shareholder of: GSK, Employee of: GSK, Qinggong Fu Shareholder of: GSK, Employee of: GSK, Lorraine Harper Speakers bureau: Viopharm (2021), Roche (2017), Consultant of: GSK (2021), Viopharm (2021), Grant/research support from: Viopharm (researcher initiated project), MSD (researcher initiated project), Krishnarajah Nirantharakumar Consultant of: Boehringer Ingelheim (Consultancy on real world evidence), Grant/research support from: AstraZeneca, Vifor and Boehringer Ingelheim (Investigator led grants), Ruchika Goel: None declared, Rupert Jakes Shareholder of: GSK, Employee of: GSK
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Zhou P, Li Z, Snowling S, Goel R, Zhang Q. Multi-step ahead prediction of hourly influent characteristics for wastewater treatment plants: a case study from North America. Environ Monit Assess 2022; 194:389. [PMID: 35445887 DOI: 10.1007/s10661-022-09957-y] [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: 11/08/2021] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
Prediction of influent characteristics, before any treatment takes place, is of great importance to the operation and management of wastewater treatment plants (WWTPs). In this study, four machine-learning models, including multilayer perceptron (MLP), long short-term memory network (LSTM), K-nearest neighbour (KNN), and random forest (RF), are introduced to utilize real-time wastewater data from three WWTPs in North America (i.e., Tres Rios, Woodward, and one confidential plant) for predicting hourly influent characteristics. Input variables are selected using an autocorrelation analysis and a variable importance measure from RF. Both univariate and multivariate analyses are investigated to improve model accuracy. The performances of one- and multiple-step-ahead models are compared. With a short prediction horizon, all the models derived from both univariate and multivariate analyses show excellent performance. It was found that the performance deterioration as the prediction horizon expands could be mitigated significantly by including extra variables, such as meteorological variables. This work can provide valuable support for the high-temporal-resolution prediction of wastewater influent characteristics for WWTPs. The proposed models can also bridge the gap between data and decision-making in the wastewater sector.
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Affiliation(s)
- Pengxiao Zhou
- Department of Civil Engineering, McMaster University, Hamilton, ON, L8S 4L7, Canada
| | - Zhong Li
- Department of Civil Engineering, McMaster University, Hamilton, ON, L8S 4L7, Canada.
| | - Spencer Snowling
- Hatch Ltd., Sheridan Science & Technology Park, 2800 Speakman Drive, Mississauga, ON, L5K 2R7, Canada
| | - Rajeev Goel
- Hatch Ltd., Sheridan Science & Technology Park, 2800 Speakman Drive, Mississauga, ON, L5K 2R7, Canada
| | - Qianqian Zhang
- Department of Civil Engineering, McMaster University, Hamilton, ON, L8S 4L7, Canada
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Bansal SR, Wadhawan S, Goel R. mRMR-PSO: A Hybrid Feature Selection Technique with a Multiobjective Approach for Sign Language Recognition. Arab J Sci Eng 2022. [DOI: 10.1007/s13369-021-06456-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Goel R, Ojha H, Choudhary V, Sharma D, Nair A, Sharma N, Pathak M, Shivkumar H, Sharma R, Kaushik V, Singhal R. Medical management of ionizing radiation-induced skin injury. Radiat Prot Environ 2022. [DOI: 10.4103/rpe.rpe_4_21] [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] Open
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Li Y, Wu J, Liu Y, Chen F, Guan J, Shao Y, Wang J, Zhang L, Goel R, Sun X, Wang Q, Zhang R, Song H, Liu B. The effect of sludge retention time (SRT) on the Nitrifier typical kinetics at ambient temperature under the low ammonia density. Water Sci Technol 2022; 85:617-632. [PMID: 35100143 DOI: 10.2166/wst.2021.624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sludge retention time (SRT) regulation is one of the essential management techniques for refined control of the main-sidestream treatment process under the low ammonia density. It is indispensable to understand the effect of SRTs changes on the Nitrifier kinetics to obtain the functional separation of the Nitrifier and the refined control of the nitrification process. In this study, Nitrifier was cultured with conditions of 35 ± 0.5 °C, pH 7.5 ± 0.2, DO 5.0 ± 0.5 mg-O/L, and SRTs were controlled for 40 d, 20 d, 10 d, and 5 d. The net growth rate (μm), decay rate (b), specific growth rate (μ), the yield of the Nitrifier (YA), temperature parameter (TA), and inhibition coefficient (KI) have been measured and extended with the SRT decreases. Instead, the half-saturation coefficient (KS) decreased. In addition, the limited value of pH inhibition occurs (pHUL), and the pH of keeping 5% maximum reaction rate (pHLL) was in a relatively stable state. The trade of kinetics may be induced by the change of species structure of Nitrifier. The Nitrosomonas proportion was increased, and the Nitrospira was contrary with the SRT decreasing. It is a match for the functional separation of Nitrifier when SRTs was 20 d at ambient temperature under the low ammonia density. The kinetics of ammonia-oxidizing organisms (AOO) and nitrite-oxidizing organisms (NOO) in Nitrifier under different SRT conditions should be measured respectively to the refined control of the partial nitrification process in future study.
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Affiliation(s)
- Yifan Li
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail: ; These authors contributed equally to this work and should be considered co-first authors
| | - Jinzhu Wu
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail: ; These authors contributed equally to this work and should be considered co-first authors
| | - Yongjie Liu
- Shandong Institute for Product Quality Inspection, Jinan, 250102, China
| | - Feiyong Chen
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
| | - Jie Guan
- Shandong Institute for Product Quality Inspection, Jinan, 250102, China
| | - Yuanyuan Shao
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
| | - Jing Wang
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
| | - Lijie Zhang
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions, Inc., 407 King Street West, Hamilton, Ontario, Canada
| | - Xiuqin Sun
- Nuclear Engineering Lihua Technology Engineering Co. Ltd, Beijing, China
| | - Quanyong Wang
- Shandong Branch of China Urban Construction Research Institute, No. 1299, Xinluo Street, Jinan, China
| | - Ruina Zhang
- Shanghai Environmental & Sanitary Engineering Design Institute Co., Ltd, No.11, 345 Lane, Shilong RD, Shanghai, China
| | - Hengyu Song
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
| | - Bing Liu
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan 250101, China E-mail:
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Piccolo N, Goel R, Snowling S, Kim Y. Modeling the anaerobic digestion of wastewater sludge under sulfate-rich conditions. Water Environ Res 2021; 93:2084-2096. [PMID: 33991363 DOI: 10.1002/wer.1583] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
Anaerobic digestion (AD) is a biological treatment process to stabilize organic solids and produce biogas. If present, sulfate is reduced to sulfide by anaerobic sulfate-reducing bacteria and the sulfide can be toxic to anaerobic microorganisms. Here, the effect of high initial sulfate concentration on AD of wastewater sludge was investigated using lab-scale batch experiments. Additionally, a systematic mathematical modeling approach was applied for insight into the experimental results. Cumulative biogas and methane production decreased with increasing initial sulfate doses (0-3.300 mg S L-1 ). The correlation between the sulfate dose and methane production was consistent with theoretical predictions and model results, indicating no toxic effect of sulfide on methane production. The carbon dioxide content in the biogas decreased linearly with the increasing sulfate dose, which is consistent with the model-predicted behavior of the bicarbonate and hydrogen sulfide buffering system. The examined high sulfate concentrations resulted in no clear negative effects on the COD removal or VSS destruction of the wastewater sludge, indicating negligible inhibition by sulfide toxicity. Even considering the possibility of ferrous sulfide precipitation and the low model estimates of residual sulfide concentration the residual sulfide concentration was higher than reported concentrations that trigger process inhibition. PRACTITIONER POINTS: The effect of sulfate loading on anaerobic digestion of waste activated sludge was characterized. The stoichiometry of sulfate reduction allows accurate prediction of CH4 loss. High sulfate levels (up to 3300 mg/L as S) did not affect COD/VSS removal. Sulfide formation increases effluent COD; often misinterpreted as sulfide toxicity. Correcting COD for sulfide's contributions is crucial for results interpretation.
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Affiliation(s)
- Nicholas Piccolo
- Department of Civil Engineering, McMaster University, Hamilton, ON, Canada
| | - Rajeev Goel
- Digital Water Solutions, Hatch, Oakville, ON, Canada
| | | | - Younggy Kim
- Department of Civil Engineering, McMaster University, Hamilton, ON, Canada
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Thondoo M, Goel R, Tatah L, Naraynen N, Woodcock J, Nieuwenhuijsen M. The Built Environment and Health in Low- and Middle-Income Countries: a Review on Quantitative Health Impact Assessments. Curr Environ Health Rep 2021; 9:90-103. [PMID: 34514535 DOI: 10.1007/s40572-021-00324-6] [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] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Features and attributes of the built environment (BE) impact positively and negatively on health, especially in cities facing unprecedented urban population growth and mass motorization. A common approach to assess the health impacts of built environment is health impact assessment (HIA), but it is rarely used in low- and middle-income countries (LMICs) where urbanization rates are fastest. This article reviews selected HIA case studies from LMICs and reports the methods and tools used to support further implementation of quantitative HIAs in cities of LMICs. RECENT FINDINGS In total, 24 studies were reviewed across Algeria, Brazil, China, India, Iran, Kenya, Thailand, Turkey, and Mauritius. HIAs examine specific pathways through which the built environment acts: air pollution, noise, physical activity, and traffic injury. Few HIAs of BE addressed more than one exposure pathway at a time, and most studies focused on air pollution across the sectors of transport and energy. A wide number of tools were used to conduct exposure assessment, and different models were applied to assess health impacts of different exposures. Those HIAs rely on availability of local concentration data and often use models that have set exposure-response functions (ERFs). ERFs were not adapted to local populations except for HIAs conducted in China. HIAs of BE are being successfully conducted in LMICs with a variety of tools and datasets. Scaling and expanding quantitative health impact modeling in LMICs will require further study on data availability, adapted models/tools, low technical capacity, and low policy demand for evidence from modeling studies. As case studies with successful use of evidence from modeling emerge, the uptake of health impact modeling of BE is likely to increase in favor of people and planet.
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Affiliation(s)
- M Thondoo
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park, Dr. Aiguader, 88, 08003, Barcelona, Spain
| | - R Goel
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - L Tatah
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - N Naraynen
- Department of Economics, International Business School, Xi'an Jiaotong-Liverpool University, Suzhou, Jiangsu Province, China
| | - J Woodcock
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mark Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park, Dr. Aiguader, 88, 08003, Barcelona, Spain. .,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. .,Department of Biomedicine, University Pompeu Fabra (UPF), 08005, Barcelona, Spain. .,Department of Environmental Epidemiology, Municipal Institute of Medical Research, IMIM-Hospital del Mar), 08003, Barcelona, Spain. .,Department of Epidemiology and Public Health, CIBER Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain.
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Nicolas J, Cao D, Claessen B, Sartori S, Roumeliotis A, Goel R, Chandiramani R, Stefanini G, Turfah A, Chen S, Dangas G, Baber U, Sharma S, Kini A, Mehran R. Intersection of the Academic Research Consortium – high bleeding risk criteria in patients undergoing PCI for acute coronary syndromes: insights from a high-volume single centre registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2494] [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
Introduction
Patients presenting for percutaneous coronary intervention (PCI) with acute coronary syndromes (ACS) often have overlapping bleeding and ischaemic risk factors that offset the long-term success of PCI and limit the post stenting therapeutic options. Aiming at improving outcomes following PCI, the Academic Research Consortium (ARC) recently published a set of major and minor criteria that identify, a priori, patients at high bleeding risk (HBR). Indeed, knowledge of these risk factors will help in optimization of pre-procedural therapy and minimization of post intervention complications. Nonetheless, the actual prevalence of these criteria among patients undergoing PCI for ACS is not well known.
Purpose
To determine the intersection and distribution of ARC-HBR major and minor criteria in a real-world ACS population presenting for PCI.
Methods
In this analysis, we included all patients who presented with ACS to a high-volume PCI centre from 2012 to 2017 and underwent PCI with 2nd generation drug-eluting stent (DES) implantation. Patients were then classified as HBR if they met ≥1 major or ≥2 minor criteria according to the ARC-HBR definition. Baseline clinical and procedural characteristics were extracted from each patient electronic health records. The most common exclusive intersections of ARC-HBR major and minor criteria were quantitatively visualized using an Upset Plot.
Results
Only 44.6% (n=2,717) of ACS patients (n=6,097) fulfilled the ARC-HBR definition. There were significant differences in baseline clinical characteristics between HBR and non-HBR groups: age (71.4±11.5 vs. 60.9±10.3 years, p<0.001), females (40.7% vs. 25.5%, p<0.001), cerebrovascular disease (19.5% vs. 3.9%, p<0.001), and diabetes (55.4% vs. 42.1%, p<0.001). The prevalence of active smoking, a major risk factor for bleeding, was higher in the non-HBR group (20.6% vs. 9.9%, p<0.001). The most frequent major and minor criteria were severe anemia (n=1,072) and age ≥75 (n=1,264), respectively. The top five criteria intersections were: severe anemia (n=215), age ≥75 and moderate chronic kidney disease (CKD) (n=145); moderate CKD and mild anemia (n=142); age ≥75 and mild anemia (n=140); age ≥75, moderate CKD, and mild anemia (n=130) (Figure 1).
Conclusion
Among patients who have undergone PCI for ACS, a significant proportion of individuals fulfilled the ARC-HBR definition. Severe anemia was the most prevalent major criteria. Different combinations of minor criteria, mainly age ≥75, moderate CKD and mild anemia, represented the most common intersections.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Nicolas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D Cao
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - B Claessen
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sartori
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Roumeliotis
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Goel
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Chandiramani
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Stefanini
- UOS of Milan and Humanitas Clinical and Research Center, Cardiology, Milan, Italy
| | - A Turfah
- UOS of Milan and Humanitas Clinical and Research Center, Cardiology, Milan, Italy
| | - S Chen
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - U Baber
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sharma
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Kini
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
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Chandiramani R, Cao D, Claessen B, Sartori S, Nicolas J, Roumeliotis A, Goel R, Chiarito M, Power D, Camaj A, Dangas G, Baber U, Sharma S, Kini A, Mehran R. Are the minor high bleeding risk criteria of the academic research consortium truly minor? Insights from a high-volume tertiary care pci centre. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2511] [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
The Academic Research Consortium (ARC) has recently published a consensus-based definition to identify patients at high bleeding risk (HBR), reflected by a BARC 3 or 5 bleeding rate of ≥4% at 1 year after percutaneous coronary intervention (PCI). The HBR criteria included in the definition are divided into minor and major categories, with patients deemed to be at HBR if they fulfill at least one major or two minor criteria. As a result, patients who present with only one minor criterion are categorized as non-HBR.
Purpose
To compare the differences in baseline characteristics and 1-year bleeding and ischaemic outcomes between non-HBR patients undergoing PCI that present with only one minor HBR criterion versus those that do not fulfill any HBR criteria.
Methods
The study population consisted of all consecutive patients who underwent PCI with stent implantation in a single high-volume centre from January 2014 to December 2017. Patients were classified as non-HBR if they did not fulfill at least one major or two minor ARC-HBR criteria. The outcomes of interest were major bleeding (composite of peri-procedural and post-discharge bleeding), all-cause death, and myocardial infarction (MI) at 1 year. The Kaplan-Meier method was used for time-to-event analyses, with comparative risks being assessed using Cox regression.
Results
Of the 9,623 patients included in the analysis, 5,345 were classified as non-HBR. Within the non-HBR patients, 2,078 (38.9%) presented with only one minor HBR criterion and 3,267 (61.1%) presented with no HBR criteria. Non-HBR patients with one minor criterion were more often female, significantly older, with a higher burden of comorbidities such as diabetes mellitus, hypertension and hyperlipidaemia, and more likely to have multivessel disease as well as a history of prior MI and revascularisation, while non-HBR patients with no criteria were more likely to be smokers and have a higher BMI. Distribution of the minor HBR criteria within the group presenting with one minor criterion are illustrated in the figure. Non-HBR patients with only one minor criterion had a numerically higher rate of major bleeding compared to non-HBR patients with no criteria (3.6% vs. 2.9%, p=0.09). While the rate of all-cause death was significantly higher in the group with only one minor criterion (1.2% vs. 0.4%, p=0.004), there was no difference in the rate of MI between the two groups (2.1% vs. 1.9%, p=0.83). Hazard ratios comparing the two groups are presented in the figure.
Conclusions
Non-HBR patients presenting with only one minor criterion had a numerically higher rate of post-PCI bleeding and significantly higher mortality compared to those without any criteria. Nonetheless, the major bleeding rates of both groups at 1 year were less than the 4% cutoff to qualify as HBR according to the ARC definition, thereby supporting their inclusion as “minor” criteria in the recent ARC-HBR definition.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Chandiramani
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D Cao
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - B Claessen
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sartori
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - J Nicolas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Roumeliotis
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Goel
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - M Chiarito
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D Power
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Camaj
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - U Baber
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sharma
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Kini
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
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Roumeliotis A, Mehran R, Claessen B, Sartori S, Cao D, Chandiramani R, Nicolas J, Goel R, Reisman A, Baber U, Sweeny J, Barman N, Dangas G, Sharma S, Kini A. Impact of high-density lipoprotein levels in males and females undergoing percutaneous coronary intervention with drug eluting stents. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Low levels of high-density lipoprotein (HDL) have been associated with adverse cardiovascular events in multiple epidemiological studies. Evidence regarding the role of HDL in males and females with established coronary artery disease undergoing percutaneous coronary intervention (PCI) with drug eluting stents (DES) is scarce.
Purpose
We sought to investigate the impact of low HDL levels on 1-year cardiovascular outcomes in males and females undergoing PCI with DES.
Methods
We screened all patients undergoing PCI in our center from 2012 to 2017. Exclusion criteria were: unavailable baseline HDL measurement, age <18 years, presentation with ST-segment elevation myocardial infarction (MI) or shock, coexisting neoplastic disease and treatment without a stent or with a bare metal stent. The final population was divided by gender and further stratified to the high or low HDL group according to baseline HDL levels. Cut-offs were 40mg/dL in males and 50mg/dL in females, per the most recent ACC/AHA guideline recommendations. The primary endpoint of the analysis was major adverse cardiovascular events (MACE) at 1 year, defined as death, MI or target vessel revascularization (TVR). To account for potential clinical and anatomical confounders the outcomes were also adjusted for age, Caucasian ethnicity, hypertension, diabetes mellitus (DM), body mass index, smoking, prior MI, multi-vessel disease and type B2/C lesions.
Results
Out of the 10,843 patients included, 7,718 (71.2%) were male and 3,125 (28.8%) were female. Low HDL was noted in 58.5% of males and 63.8% of females. Patients with low HDL were younger and had a higher prevalence of DM, prior MI, smoking and multi-vessel disease. When comparing low to high HDL groups in terms of 1-year MACE a borderline significant difference was shown in males (7.4% vs. 6.0%; p-value=0.08) but not in females (7.7% vs 8.1%; p-value=0.90) [Panel A]. The numerically higher incidence of MACE in males with low HDL was primarily driven by TVR (5.4% vs 3.7%; p-value=0.005) while the rates of Death (1.4% vs. 1.3%; p=0.96) and MI (2.0% vs. 1.8%; p-value=0.89) were similar between the two groups. After adjustment the male low HDL subgroup remained at a higher risk for 1-year TVR but not 1-year MACE compared to the male high HDL subgroup [Panel B]. No difference for any individual component of MACE was shown between low and high HDL subgroups in females [Panel C].
Conclusion(s)
High HDL levels were associated with a lower incidence of TVR and borderline reduction of MACE in male but not female patients undergoing PCI with DES. No difference was demonstrated in terms of death or MI between the high and low HDL subgroups at 1-year follow-up.
Impact of HDL levels according to gender
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Roumeliotis
- Mount Sinai Hospital, New York, United States of America
| | - R Mehran
- Mount Sinai Hospital, New York, United States of America
| | - B Claessen
- Mount Sinai Hospital, New York, United States of America
| | - S Sartori
- Mount Sinai Hospital, New York, United States of America
| | - D Cao
- Mount Sinai Hospital, New York, United States of America
| | - R Chandiramani
- Mount Sinai Hospital, New York, United States of America
| | - J Nicolas
- Mount Sinai Hospital, New York, United States of America
| | - R Goel
- Mount Sinai Hospital, New York, United States of America
| | - A Reisman
- Mount Sinai Hospital, New York, United States of America
| | - U Baber
- Mount Sinai Hospital, New York, United States of America
| | - J Sweeny
- Mount Sinai Hospital, New York, United States of America
| | - N Barman
- Mount Sinai Hospital, New York, United States of America
| | - G Dangas
- Mount Sinai Hospital, New York, United States of America
| | - S Sharma
- Mount Sinai Hospital, New York, United States of America
| | - A Kini
- Mount Sinai Hospital, New York, United States of America
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Nicolas J, Cao D, Claessen B, Sartori S, Chandiramani R, Roumeliotis A, Goel R, Camaj A, Beerkens F, Turfah A, Dangas G, Baber U, Sharma S, Kini A, Mehran R. Long-term outcomes in high-bleeding risk patients undergoing PCI for acute coronary syndromes: results from a large single-center pci registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Current clinical guidelines recommend prolonged dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndromes (ACS). However, an extended DAPT duration in high-bleeding risk (HBR) patients amplifies the risk of post procedural complications. Hence, clinicians often face the dilemma of prolonging DAPT duration to prevent recurrent ischaemic events at the expense of increasing the incidence of bleeding in high-risk patients. The actual incidence of ischaemic and bleeding events in this particular population is not well elucidated.
Purpose
To evaluate one-year ischemic and bleeding outcomes following PCI for ACS in a real-world HBR population as defined by the Academic Research Consortium (ARC) consensus document.
Methods
We included all patients who presented with ACS to a high-volume single PCI centre from 2012 to 2017 and underwent PCI with 2nd generation drug-eluting stent implantation. Patients were classified as HBR if they met ≥1 major or ≥2 minor criteria according to the recent ARC-HBR consensus. The outcomes of interest were major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction (MI), and target lesion revascularization (TLR), and major bleeding events, including both peri-procedural and post-discharge bleeding. All outcomes were assessed at 1-year follow-up. The Kaplan-Meier method was used for time-to-event analyses.
Results
Out of 6,097 ACS patients included in this analysis, 2,717 (44.6%) fulfilled the ARC-HBR definition. Compared to non-HBR group, HBR patients were more frequently female, older, more likely to have cardiovascular risk factors (e.g., diabetes, hypertension, and hyperlipidemia) and complex coronary artery disease (e.g., multi-vessel disease, bifurcation lesions, and calcification). The 1-year incidence of MACE was significantly higher in HBR patients (16.3% vs. 8.1%, HR 2.16, 95% CI [1.81–2.59], p<0.001) (Figure 1A). This finding was driven by higher rates of all-cause death and MI (Figure 1B). The 1-year incidence of major bleeding was also significantly higher in HBR patients compared to non-HBR (11.1% vs. 3.1%, HR: 3.92, 95% CI 3.10–4.95; p<0.001).
Conclusions
HBR patients undergoing PCI for ACS are not only subject to bleeding complications but are also at an increased risk for ischemic events and all-cause mortality.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Nicolas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - D Cao
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - B Claessen
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sartori
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Chandiramani
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Roumeliotis
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Goel
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Camaj
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - F Beerkens
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Turfah
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - U Baber
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - S Sharma
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - A Kini
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
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Chiarito M, Cao D, Nicolas J, Roumeliotis A, Power D, Chandiramani R, Goel R, Claessen B, Ferrante G, Stefanini G, Mehran R, Dangas G. Radial versus femoral access for coronary angiography and interventions: a systematic review and meta-analysis of randomized trials. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2454] [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
The presence of any benefits associated with radial or femoral access among patients undergoing coronary angiography and percutaneous coronary interventions (PCI) is still debated.
Purpose
Our aim is to provide a comprehensive quantitative appraisal of the effects of access site on the risks of stroke, myocardial infarction, and major bleeding in patients undergoing coronary angiography with or without PCI.
Methods
In January 2020, we searched PubMed, Embase, and meeting abstracts for randomized trials comparing radial versus femoral access for coronary angiography with or without subsequent PCI. Odds ratios (OR) were used as metric of choice for treatment effects with random-effects models. Co-primary efficacy endpoints were stroke and myocardial infarction. Primary safety endpoint was major bleeding. Secondary endpoints were all cause mortality and vascular complications. Heterogeneity was assessed with the I-squared index. This study is registered with PROSPERO.
Results
We identified 31 trials, including 30,414 patients. Risks of stroke (OR 1.11, 95% CI 0.76–1.64, I2=0%) and myocardial infarction (OR 0.90, 95% CI 0.79–1.03, I2=0%) were comparable between radial and femoral access. Radial access was associated with a reduction for the risk of major bleeding as compared to femoral access (OR 0.53, 95% CI 0.42–0.67, I2=3.3%) with a number needed to treat of 92. Findings were consistent regardless clinical features and procedure performed, with the only exception of an increased benefit of the radial access in patients with chronic coronary syndrome (p forinteraction=0.005). The risk for all-cause mortality (OR 0.73, 95% CI 0.61–0.89, I2=0%) and vascular complication (OR 0.32, 95% CI 0.23–0.44, I2=16.7%) was significantly lower in the radial compared to femoral access group.
Conclusions
In patients undergoing coronary angiography with or without PCI, radial compared to femoral access did not reduce the risk of stroke and myocardial infarction, with no impact on the effect estimates of clinical presentation, age, gender, or subsequent PCI. Whereas, radial access is associated with a significant risk reduction of major bleeding as compared to femoral access. The benefit favoring radial access is of important clinical relevance in view of the relatively low number needed to treat to prevent a major bleeding and the significant impact on mortality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Chiarito
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - D Cao
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - J Nicolas
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - A Roumeliotis
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - D Power
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - R Chandiramani
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - R Goel
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - B.E Claessen
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - G Ferrante
- Istituto Clinico Humanitas, Milan, Italy
| | | | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
| | - G Dangas
- Icahn School of Medicine at Mount Sinai, New York City, United States of America
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Goel R, Kaur I, Mahajan K, Chatterjee M. PMU8 The Increasing Burden of NON-Communicable Diseases in India. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kulshrestha S, Chawla R, Singh S, Yadav P, Sharma N, Goel R, Ojha H, Kumar V, Adhikari J. Protection of sildenafil citrate hydrogel against radiation-induced skin wounds. Burns 2020; 46:1157-1169. [DOI: 10.1016/j.burns.2019.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/18/2019] [Accepted: 11/23/2019] [Indexed: 12/23/2022]
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Sun M, Liu B, Yanagawa K, Ha NT, Goel R, Terashima M, Yasui H. Effects of low pH conditions on decay of methanogenic biomass. Water Res 2020; 179:115883. [PMID: 32402863 DOI: 10.1016/j.watres.2020.115883] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 12/18/2019] [Revised: 04/24/2020] [Accepted: 04/25/2020] [Indexed: 06/11/2023]
Abstract
Acidic failure is relatively common in anaerobic digesters that receive readily biodegradable food wastes at high loading. Under low pH conditions, the activity of methanogenic biomass decreases resulting in complete failure of the digestion process. In this experimental study, we demonstrated that one of the causes for the digester failure under low pH conditions is due to accelerated decay of methanogenic biomass. When enriched acetate degrading methanogens were exposed to a low pH environment (pH = 5.1 with phosphoric acid) in a batch experiment without external substrate, the specific decay rate was observed to increase as much as 10 times of that at pH 7.0. The specific decay rate for formate degrader was also found to increase under low pH conditions whilst the fermentative microorganisms in the cultures appeared to be tolerant to low pH conditions. A Propidium Mono-Azide-quantitative Polymerase Chain Reaction (PMA-qPCR) analysis revealed that the archaeal biomass dominated by methanogens dropped by 71-79% from the initial concentration after 6 days of the acidic batch experiment whilst the bacterial biomass dominating acidogens decreased by only 25%. The decrease in the number of living cells in the batch experiments at different pH was monitored with time to determine a correlation between decay rate and incubation pH.
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Affiliation(s)
- Meng Sun
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, Japan
| | - Bing Liu
- School of Municipal and Environmental Engineering, Shandong Jianzhu University, Fengming Rd., Lingang Development Zone, Jinan, China
| | - Katsunori Yanagawa
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, Japan
| | - Nguyen Thi Ha
- Faculty of Environmental Science, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Viet Nam
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions, Inc., 407 King St. W., Hamilton, Ontario, Canada
| | - Mitsuharu Terashima
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, Japan.
| | - Hidenari Yasui
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, Japan
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Liu B, Li Y, Wu J, Shao Y, Chen F, Wu JH, Goel R, Terashima M, Yasui H. Evaluating nitrite oxidizing organism survival under different nitrite concentrations. Water Sci Technol 2020; 82:273-280. [PMID: 32941169 DOI: 10.2166/wst.2020.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this study is to explore the optimal pre-treatment procedures and statistics methods for live/dead bacterial staining using nitrite oxidizing organism (NOO) as the research aim. This staining method was developed and widely utilized to evaluate activated bacterial survival situation, because it is direct and convenience to count live and dead bacteria amount by colour distinguishes (green/red) from pictures taken by microscope. The living cell (green colour) percentage and initial bacterial chemical oxygen demand (COD) could be used for accurate reaction rate calculation at the beginning of tests. While according to the physiological principles, the detection target was limited as the organism has a complete cell shape, that was applicable for the initial phase for decay stage (live cell → particulate dead cell), but it is impossible to evaluate the decayed soluble COD from particulate dead cell during whole reaction. To model the decay stage scientifically, a two-step decay model was developed to cater to the live/dead bacterial staining analysis of biological nitrite oxidizer under inhibition condition of high nitrite concentrations at 35 °C. As results of optimal pre-treatment, a three level ultrasonic wave with 45 seconds was explored, as a reasonable observed picture number, 30 sets with 95% confident interval for datasets statistics was summarized. A set of nitrite oxidizer inhibition test (total COD and oxygen uptake rates) under high nitrite concentrations was simulated using the above model and obtained experimental schemes. Additionally, the disintegration enhancement from particulate dead cell to soluble COD by nitrite was inspected and modelled on the basis of experimental datasets.
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Affiliation(s)
- Bing Liu
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan, 250101, China E-mail: ; Faculty of Environmental Engineering, University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, 808-0135, Japan
| | - Yifan Li
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan, 250101, China E-mail:
| | - Jinzhu Wu
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan, 250101, China E-mail:
| | - Yuanyuan Shao
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan, 250101, China E-mail:
| | - Feiyong Chen
- Resources and Environment Innovation Institute, School of Municipal and Environmental Engineering, Shandong Jianzhu University, Jinan, 250101, China E-mail:
| | - Jer-Horng Wu
- Department of Environmental Engineering, National Cheng Kung University, No. 1 University Road, East District, Taiwan City 701, Taiwan
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions Inc., Suite 1601, 1 James Street South, Hamilton, Ontario L8P4R5, Canada
| | - Mitsuharu Terashima
- Faculty of Environmental Engineering, University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, 808-0135, Japan
| | - Hidenari Yasui
- Faculty of Environmental Engineering, University of Kitakyushu, 1-1, Hibikino, Wakamatsu, Kitakyushu, 808-0135, Japan
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Nair A, Goel R, Chebbi P, Mathew A, Ganapati A, Rebekah G, Yadav B, Prakash JAJ, Danda D, Mathew J. AB0596 PREDICTORS, LONG TERM CLINICAL AND TREATMENT OUTCOMES IN SOUTH ASIAN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOSITIS: A SINGLE CENTER STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Idiopathic inflammatory myositis (IIM) are a heterogeneous group of immune-mediated disorders with varied presentations and multiple organ involvement. Data on long term outcome among South Asian patients with IIM is sparse.Objectives:To study the long term clinical outcome, treatment responses and factors predicting outcome among adult patients with IIMMethods:Patients diagnosed as ‘Idiopathic Inflammatory Myositis’ under the department of Clinical Immunology and Rheumatology at CMC, Vellore, India were screened retrospectively. Patients aged 18 years and above, satisfying Bohan and Peter criteria, having follow up of one year or more with atleast two outpatient or inpatient visits between January 2010 and April 2019 were included in this study. Those patients with connective tissue disease associated myositis were not included. Details on muscle weakness, extramuscular involvement, muscle enzymes and treatment administered were recorded at baseline, 3, 6, 12, 18, 24 months and yearly thereafter. After assessing their cumulative response, categorization of patients into complete and partial responders was done. Complete responders were defined as patients with persistent muscle power of more than 4/5 and/or MMT 8 more than 76/80, complete resolution of skin, articular and lung involvement (if any) as well as muscle enzymes less than twice the upper limit of normal without any documented flares during the entire follow up period. Patients not satisfying the said criterias were grouped as Partial responders. Disease free survival duration was also analyzed.Results:Out of 310 patients of IIM identified, 187 (60.3%) patients satisfied the inclusion criteria. Women were 2.2 times more than men and mean age at symptom onset was 35.7±12.6 years. Dermatomyositis was the predominant myositis subtype seen. All patients were put on steroids with the mean dose being 45.9 ± 18.6 mg/day. At baseline, the key immunosuppressants used were methotrexate in 44.9% and mycophenolate in 37.6% patients. The median follow up duration was 48 (25-80) months. An associated malignancy was diagnosed in 3.2% after a median duration of 24.5 months. Five patients expired after a median duration of 80 months from diagnosis. Normal muscle power was attained in 76.1% patients and 88.6% were vocational by the last follow up visit. Steroids were discontinued in 56.7% patients after a median duration of 24 months (p=0.0002). Discontinuation of the immunosuppressant was feasible in 10.2% patients after a median duration of 44 months. Assessment of the cumulative responses revealed a relapsing and remitting course in 45.9%. Outcome predictors in univariate analysis were Jo-1 status, presence of arthritis, interstitial lung disease and pericardial effusion at baseline. On multivariate analysis, absence of pericardial effusion (p=0.011) and interstitial lung disease (p=0.067) at baseline were found to be predictors of complete response. Disease free survival probability estimated at 5 years and 10 years was 91.6% and 72.4% respectively. Estimating the probability gender wise, males achieved disease free status earlier than females.Conclusion:A favorable clinical and functional outcome was seen in a significant proportion of these patients with IIM on long term follow up. Pericardial effusion and ILD were identified as predictors of poor clinical outcome.References:[1]Taborda AL, Azevedo P, Isenberg DA. Retrospective analysis of the outcome of patients with idiopathic inflammatory myopathy: a long-term follow-up study. Clin Exp Rheumatol. 2014 Apr; 32(2):188–93.Acknowledgments:NilDisclosure of Interests:None declared
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Ganapati A, K J, Nair A, Mathew A, Goel R, Mathew J, Prakash JAJ, Nair SC, Danda D. THU0523 CLINICAL UTILITY OF TESTING CONVENTIONAL AND NON-CONVENTIONAL ANTI-PHOSPHOLIPID ANTIBODIES IN SUSPECTED OBSTETRIC ANTI-PHOSPHOLIPID SYNDROME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Anti-phospholipid syndrome (APS) is an important cause for recurrent pregnancy losses (RPL). Conventional APS antibodies (aPLs) like lupus anti-coagulant (LA), anti-cardiolipin(ACL) and anti-beta 2 glycoprotein I (anti-β2 GP I) are not present in significant number of obstetric APS(OAPS) patients, leading to a state described as “ sero-negative” OAPS (SNOAPS). Recent literature shows non-conventional aPLs like Anti phosphatidylserine-prothrombin complex (Anti-PSPT) and Anti-Annexin V (Anti-Ann V) can be positive in up to 50% of SNOAPS patientsObjectives:Testing the performance of conventional and non-conventional aPLs in suspected OAPS patients (obstetric events as defined in the Sydney classification criteria for APS)Methods:We performed a retrospective chart review of 101 patients who underwent combined testing for non-conventional aPLs for suspected OAPS from May 2016 to November 2019 at our department. Patients were categorized into OAPS cases (n=50, median age 31 years) and controls (n=51, median age 30 years) based on their fulfillment of clinical definition of OAPS events defined by Sydney criteria. Conventional aPLs were tested by methods adapted in Sydney criteria and Anti PSPT /Anti Ann V were tested by commercial ELISA. The sample size(n=101) has 95% confidence interval with a margin of error of 10% for the objective of the study.Results:36 cases (72%) were ‘sero-positive’ & 14 cases (28%) were truly ‘sero-negative’ for conventional aPLs. 5 (35.7%) of the SNOAPS patients were positive for Ant-PSPT and/or Anti AnnV antibodies. Performance of the various aPLs in suspected OAPS is displayed in Table 1 & Figure 1.Table 1showing the performance of the various conventional and non-conventional APLs in suspected obstetric APS casesAntibodySensitivitySpecificityLikelihood Ratio(+)Likelihood Ratio (-)Positive Predictive ValueNegative Predictive ValueAccuracyYouden’s IndexLA50%94.1 %8.50.589.3%65.7%72.3%44.1%ACL32%98%16.30.794.1%59.5 %65.3%30 %anti β2 GP I IgM38.4%91.4 %4.50.783.3%57.1 %63.5%29.8%anti β2 GP I IgG24%96.1 %6.10.885.7%56.3%60.4%20.1%Anti PSPT28%96.1 %7.10.787.5%57.6 %62.4%24.1%Anti AnnV28%98 %14.30.793.3%58.1%63.4%26%Conventional APLs72%88.2%6.10.385.7%76.3 %79.8%60.2%Non-conventional APLS38%94.1%6.40.786.4%60.7 %66.3%32.1%All APLs82%86.3%6.000.2085.4%83 %84.2%68.3%Figure 1showing the comparative diagnostic performance of Conventional aPL testing vs Combined testing along with non-conventional aPLs in suspected obstetric APS scenarioConclusion:In a delicate situation like RPL, performance of non-conventional aPLs on their own, though not as sensitive as conventional aPLs, still demonstrate better specificity. Non-conventional APLs can newly identify 1/3rd of SNOAPS as APS. The real value of testing Anti PSPT & Anti Ann V in RPL, is combined testing with conventional aPLs wherein they improve the sensitivity and accuracy of diagnosis of OAPS by 10% & 4.4 % respectively, with only 1.9% drop in specificity. Non-conventional aPLs should be tested in SNOAPS.Disclosure of Interests:None declared
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Affiliation(s)
- N Arora
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
| | - P Bhat
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
| | - R Goel
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
| | - A K Pannu
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
| | - P Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
| | - V Suri
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, 4th Floor, F block, PGIMER, Chandigarh 160012, India
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Maini R, Goel R. Evolutionary ant colony algorithm using firefly-based transition for solving vehicle routing problems. IJCSE 2020. [DOI: 10.1504/ijcse.2020.10022039] [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: 11/21/2022]
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Hyde AJ, Nassabein R, AlShareef A, Armstrong D, Babak S, Berry S, Bossé D, Chen E, Colwell B, Essery C, Goel R, Goodwin R, Gray S, Hammad N, Jeyakuymar A, Jonker D, Karanicolas P, Lamond N, Letourneau R, Michael J, Patil N, Powell E, Ramjeesingh R, Saliba W, Singh R, Snow S, Stuckless T, Tadros S, Tehfé M, Thana M, Thirlwell M, Vickers M, Virik K, Welch S, Asmis T. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2018. Curr Oncol 2019; 26:e665-e681. [PMID: 31708660 PMCID: PMC6821113 DOI: 10.3747/co.26.5193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/06/2023] Open
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference was held in Halifax, Nova Scotia, 20-22 September 2018. Experts in radiation oncology, medical oncology, surgical oncology, and pathology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of pancreatic cancer, pancreatic neuroendocrine tumours, hepatocellular cancer, and rectal and colon cancer, including ■ surgical management of pancreatic adenocarcinoma,■ adjuvant and metastatic systemic therapy options in pancreatic adenocarcinoma,■ the role of radiotherapy in the management of pancreatic adenocarcinoma,■ systemic therapy in pancreatic neuroendocrine tumours,■ updates in systemic therapy for patients with advanced hepatocellular carcinoma,■ optimum duration of adjuvant systemic therapy for colorectal cancer, and■ sequence of therapy in oligometastatic colorectal cancer.
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Affiliation(s)
- A J Hyde
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - R Nassabein
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - A AlShareef
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - D Armstrong
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - S Babak
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Berry
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - D Bossé
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - E Chen
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - B Colwell
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - C Essery
- New Brunswick-Saint John Regional Hospital, Saint John (Gray, Michael)
| | - R Goel
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - R Goodwin
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Gray
- British Columbia-Penticton Regional Hospital, Penticton (Essery)
| | - N Hammad
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - A Jeyakuymar
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - D Jonker
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - P Karanicolas
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - N Lamond
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - R Letourneau
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - J Michael
- British Columbia-Penticton Regional Hospital, Penticton (Essery)
| | - N Patil
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - E Powell
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - R Ramjeesingh
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - W Saliba
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - R Singh
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - S Snow
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - T Stuckless
- Newfoundland and Labrador-Dr. H. Bliss Murphy Cancer Centre, St. John's (Armstrong, Powell, Stuckless)
| | - S Tadros
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - M Tehfé
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - M Thana
- Nova Scotia-Queen Elizabeth ii Health Sciences Centre, Dalhousie University, Halifax (Colwell, Jeyakumar, Lamond, Patil, Ramjeesingh, Singh, Saliba, Snow, Thana)
| | - M Thirlwell
- Quebec-McGill University Health Centre, Montreal (Thirlwell); Centre Hospitalier de l'Université de Montréal, Montreal (Letourneau, Nassabein, Tehfé)
| | - M Vickers
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - K Virik
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - S Welch
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
| | - T Asmis
- Ontario-The Ottawa Hospital Cancer Centre, Ottawa (AlShareef, Asmis, Bossé, Goel, Goodwin, Hyde, Jonker, Tadros, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Hammad, Virik); Princess Margaret Cancer Centre, Toronto (Chen); Markham Stouffville Hospital, Markham (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry, Karanicolas); London Health Sciences Centre, London (Welch)
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Chandiramani R, Chen H, Cao D, Claessen B, Blum M, Goel R, Sartori S, Aquino M, Guedeney P, Effron M, Keller S, Baker B, Pocock S, Baber U, Mehran R. P1760Incidence and effects of stroke, MI and bleeding on mortality among patients with ACS undergoing PCI: a comparative analysis from the PROMETHEUS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Stroke represents a potentially calamitous complication among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) even though its rates are relatively low. Data on the distribution of stroke occurrence over time and its overlap with myocardial infarction (MI) and bleeding after PCI is scarce.
Purpose
We sought to compare the occurrence and impacts of stroke, MI and bleeding on subsequent mortality in ACS patients undergoing PCI in contemporary clinical practice.
Methods
A total of 19,914 ACS patients who underwent PCI in the PROMETHEUS multi-center observational study were analyzed. We calculated the cumulative stroke incidence at 30 days and 1 year using Kaplan Meier (KM) method. We also compared the distribution of stroke, myocardial infarction (MI) and bleeding across time and evaluated the overlap between their occurrences. Predictors of 1 year stroke occurrence were identified through multivariable Cox-regression and stroke, MI and bleeding were entered as time-updated covariates to estimate their individual effects on subsequent mortality.
Results
Of the total number of patients, 244 patients (1.5%) had a stroke within 1 year. 48 of these patients also experienced an MI while another 48 patients experienced a bleeding event. Furthermore, 14 of these overlapping patients experienced a stroke, MI and bleeding event, all within the 1-year follow-up. Patients who sustained a stroke were more likely to have a prior history of cerebrovascular disease, peripheral artery disease, MI and heart failure compared to those who did not have a stroke. Mortality risk was significantly higher among those with stroke versus those without stroke (adjusted HR 4.84, p<0.0001). However, the association attenuated over time with a much larger effect in the first 30 days of its occurrence (adjusted HR 17.7, p<0.0001) versus beyond 30 days (adjusted HR 1.22; 95% CI: 0.6–2.46, p=0.58). Although the effects of MI and bleeding on subsequent mortality within 30 days of occurrence were significantly lower than stroke (adjusted HR 6.22, p<0.0001; adjusted HR 7.30, p<0.0001, respectively), their effects were more sustained on mortality beyond 30 days (adjusted HR 2.89, p<0.0001; adjusted HR 3.05, p<0.0001, respectively).
Conclusion
When compared with MI and bleeding, stroke had a substantially stronger impact on mortality that attenuated rapidly over time among ACS patients undergoing PCI. Optimization of modifiable risk factors and medication adherence are essential parts of management of stroke following PCI for ACS.
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Affiliation(s)
- R Chandiramani
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - H Chen
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - D Cao
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - B Claessen
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - M Blum
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - R Goel
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - S Sartori
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - M Aquino
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - P Guedeney
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - M Effron
- Eli Lilly and Company, Indianapolis, United States of America
| | - S Keller
- Eli Lilly and Company, Indianapolis, United States of America
| | - B Baker
- Daiichi-Sankyo, Inc, Parsippany, United States of America
| | - S Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - U Baber
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
| | - R Mehran
- The Zena and Michael A. Wiener Cardiovascular Institute, New York, United States of America
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Singh L, Dubey R, Singh S, Goel R, Nair S, Singh PK. Measuring quality of antenatal care: a secondary analysis of national survey data from India. BJOG 2019; 126 Suppl 4:7-13. [DOI: 10.1111/1471-0528.15825] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/27/2022]
Affiliation(s)
- L Singh
- ICMR – National Institute of Medical StatisticsNew Delhi India
| | - R Dubey
- ICMR – National Institute of Medical StatisticsNew Delhi India
| | - S Singh
- Division of Reproductive Biology, Maternal and Child Health Indian Council of Medical Research (ICMR) New Delhi India
| | - R Goel
- Division of Reproductive Biology, Maternal and Child Health Indian Council of Medical Research (ICMR) New Delhi India
| | - S Nair
- ICMR – National Institute of Medical StatisticsNew Delhi India
| | - PK Singh
- Division of Preventive Oncology, ICMR – National Institute of Cancer Prevention and ResearchNoida India
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Goel R, Maini R. Evolutionary Ant Colony Algorithm Using Firefly Based Transition for Solving Vehicle Routing Problems. International Journal of Swarm Intelligence Research 2019. [DOI: 10.4018/ijsir.2019070103] [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: 11/09/2022]
Abstract
Vehicle routing problems are a classical NP-hard optimization problem. In this article we propose an evolutionary optimization algorithm which adapts the advantages of ant colony optimization and firefly optimization to solve vehicle routing problem and its variants. Firefly optimization (FA) based transition rules and a novel pheromone shaking rule is proposed to escape local optima. Whereas the multi-modal nature of FA explores the search space, pheromone shaking avoids the stagnation of pheromones on the exploited paths. This is expected to improve working of an ant colony system (ACS). Performance of the proposed algorithm is compared with the performance of some of other currently available meta-heuristic approaches for solving vehicle routing problems (VRP) by applying it to certain standard benchmark datasets. Results show that the proposed approach is consistent and its convergence rate is faster. The results also demonstrate the superiority of the proposed approach over some of the other existing FA-based approaches for solving such type of discrete optimization problems.
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Affiliation(s)
- Rajeev Goel
- Ambala College of Engg. and Applied Research, Ambala, India
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Ghosh D, Hermonat E, Mhaskar P, Snowling S, Goel R. Hybrid Modeling Approach Integrating First-Principles Models with Subspace Identification. Ind Eng Chem Res 2019. [DOI: 10.1021/acs.iecr.9b00900] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Debanjan Ghosh
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario L8S 4L7, Canada
| | - Emma Hermonat
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario L8S 4L7, Canada
| | - Prashant Mhaskar
- Department of Chemical Engineering, McMaster University, Hamilton, Ontario L8S 4L7, Canada
| | - Spencer Snowling
- Hydromantis Environmental Software Solutions, Inc. 407 King Street West, Hamilton Ontario L8P 1B5, Canada
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions, Inc. 407 King Street West, Hamilton Ontario L8P 1B5, Canada
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Goel R, Rosenberg MJ, Cohen HS, Bloomberg JJ, Mulavara AP. Calibrating balance perturbation using electrical stimulation of the vestibular system. J Neurosci Methods 2018; 311:193-199. [PMID: 30339880 DOI: 10.1016/j.jneumeth.2018.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 03/27/2018] [Revised: 09/19/2018] [Accepted: 10/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Supra-threshold galvanic vestibular stimulation (GVS) can be used to challenge the balance control system by disrupting vestibular inputs. The goal of this study was to propose an objective method to assess variability across subjects in the minimum safe GVS level that causes maximum balance degradation. New method: Thirteen healthy young subjects stood on a compliant foam surface with their eyes closed and tried to maintain a stable upright stance. Variables related to the stability of the trunk and whole body were quantified to characterize the relationship between postural responses and GVS at amplitudes from 0 to 4.5 mA in 0.5 mA increments. The relationship between decrements in postural responses and GVS was linear up to a minimum GVS level (called KNEE). An increase in the stimulation level above that did not lead to any further degradation of balance performance. The KNEE was determined by iteratively performing linear fits to the performance measure at different stimulation levels. RESULTS There were individual differences in KNEE; it was in the range of 1-2.5 mA across subjects. GVS caused an average performance decrement of 27-99% across six variables at the KNEE level compared to a no-stimulus condition. Comparison to existing methods: We propose a method to consistently attain the maximum level of impairment across subjects using the minimum current intensity, to minimize all types of adverse effects usually observed at high intensities. CONCLUSIONS Individual differences in the disruption of posture control in response to GVS have important implications for testing and training paradigms.
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Affiliation(s)
- R Goel
- University of Houston, Houston, TX, United States
| | - M J Rosenberg
- Baylor College of Medicine, Houston, TX, United States
| | - H S Cohen
- Baylor College of Medicine, Houston, TX, United States
| | - J J Bloomberg
- NASA Johnson Space Center, Houston, TX, United States
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McGee S, AlGhareeb W, Ahmad C, Armstrong D, Babak S, Berry S, Biagi J, Booth C, Bossé D, Champion P, Colwell B, Finn N, Goel R, Gray S, Green J, Harb M, Hyde A, Jeyakumar A, Jonker D, Kanagaratnam S, Kavan P, MacMillan A, Muinuddin A, Patil N, Porter G, Powell E, Ramjeesingh R, Raza M, Rorke S, Seal M, Servidio-Italiano F, Siddiqui J, Simms J, Smithson L, Snow S, St-Hilaire E, Stuckless T, Tate A, Tehfe M, Thirlwell M, Tsvetkova E, Valdes M, Vickers M, Virik K, Welch S, Marginean C, Asmis T. Eastern Canadian Colorectal Cancer Consensus Conference 2017. Curr Oncol 2018; 25:262-274. [PMID: 30111967 PMCID: PMC6092057 DOI: 10.3747/co.25.4083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2017 was held in St. John's, Newfoundland and Labrador, 28-30 September. Experts in radiation oncology, medical oncology, surgical oncology, and cancer genetics who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of gastric, rectal, and colon cancer, including ■ identification and management of hereditary gastric and colorectal cancer (crc);■ palliative systemic therapy for metastatic gastric cancer;■ optimum duration of preoperative radiation in rectal cancer-that is, short- compared with long-course radiation;■ management options for peritoneal carcinomatosis in crc;■ implications of tumour location for treatment and prognosis in crc; and■ new molecular markers in crc.
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Affiliation(s)
- S.F. McGee
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - W. AlGhareeb
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C.H. Ahmad
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - D. Armstrong
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - S. Babak
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Berry
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - J. Biagi
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C. Booth
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - D. Bossé
- Dana–Farber Cancer Institute, Boston, MA, U.S.A
| | - P. Champion
- Prince Edward Island—Prince Edward Island Cancer Treatment Centre, Charlottetown
| | - B. Colwell
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - N. Finn
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - R. Goel
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Gray
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - J. Green
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Harb
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - A. Hyde
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - A. Jeyakumar
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - D. Jonker
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Kanagaratnam
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - P. Kavan
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - A. MacMillan
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - A. Muinuddin
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - N. Patil
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - G. Porter
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - E. Powell
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - R. Ramjeesingh
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - M. Raza
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - S. Rorke
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Seal
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - F. Servidio-Italiano
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - J. Siddiqui
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - J. Simms
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - L. Smithson
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - S. Snow
- Nova Scotia—qeii Health Sciences Centre, Dalhousie University, Halifax
| | - E. St-Hilaire
- New Brunswick—Saint John Regional Hospital, Saint John (Gray); Centre hospitalier universitaire Dr-Georges-L.-Dumont, Moncton (Finn, St-Hilaire); Dr. Everett Chalmers Hospital, Fredericton (Raza); Moncton City Hospital (Harb)
| | - T. Stuckless
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - A. Tate
- Newfoundland and Labrador— Dr. H. Bliss Murphy Cancer Centre, St. John’s (Ahmad, Armstrong, Powell, Rorke, Seal, Siddiqui, Stuckless); Faculty of Medicine, Memorial University of Newfoundland, St. John’s (Green, Seal, Siddiqui, Tate); Faculty of Surgery, Memorial University of Newfoundland, St. John’s (Kanagaratnam); Eastern Health Authority, St. John’s (MacMillan); Labrador–Grenfell Regional Health Authority, Happy Valley–Goose Bay (Simms, Smithson)
| | - M. Tehfe
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - M. Thirlwell
- Quebec—McGill University Health Centre, Montreal (Kavan, Thirlwell); Centre hospitalier de l’Université de Montréal, Montreal (Tehfé)
| | - E. Tsvetkova
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - M. Valdes
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - M. Vickers
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - K. Virik
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - S. Welch
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - C. Marginean
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
| | - T. Asmis
- Ontario—The Ottawa Hospital Cancer Centre, Ottawa (AlGhareeb, Asmis, Goel, Hyde, Jonker, Marginean, McGee, Vickers); Queen’s University and Cancer Centre of Southeastern Ontario, Kingston (Biagi, Booth, Virik); Princess Margaret Cancer Centre, Toronto (Dawson); St. Michael’s Hospital, Toronto (Babak); Sunnybrook Odette Cancer Centre, University of Toronto, Toronto (Berry); Cancer Centre of Southeastern Ontario, Kingston (Mahmud); Queensway Health Centre, Toronto (Muinuddin); Colorectal Cancer Canada, North York (Servidio-Italiano); Grand River Regional Cancer Centre, Kitchener (Tsvetkova, Valdes); London Health Sciences Centre, London (Welch)
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Liu B, Terashima M, Quan NT, Ha NT, Van Chieu L, Goel R, Yasui H. High nitrite concentration accelerates nitrite oxidising organism's death. Water Sci Technol 2018; 77:2812-2822. [PMID: 30065133 DOI: 10.2166/wst.2018.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
High nitrite is a known operation parameter to inhibit the biological oxidation of nitrite to nitrate. The phenomenon is traditionally expressed using a Monod-type equation with non-competitive inhibition, in which the reaction associated with the biomass growth is reduced when high nitrite is present. On the other hand, very high nitrite is also known to slay nitrifiers. To clarify the difference between the growth inhibition and the poisoning, cell counting for living microorganisms in the nitrite oxidiser-enriched activated sludge was conducted in batch conditions under various nitrite concentrations together with measurements of biomass chemical oxygen demand (COD) concentration and oxygen uptake rate. The experiments demonstrated that these measureable parameters were all decayed when nitrite concentration exceeded 100-500 mgN/L at pH 7.0 in the system, indicating that nitrite poisoning took place. Biomass growth was recognised in lower range of nitrite which was expressed with growth inhibition only. Based on the response, a kinetic model for the biological nitrite oxidation was developed with a modification of IWA ASM1. The model was further utilised to calculate a possibility to wash out nitrite oxidiser in the aeration tank where a part of the return activated sludge was exposed to high nitrite liquor in a side-stream partial nitritation reactor.
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Affiliation(s)
- Bing Liu
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
| | - Mitsuharu Terashima
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
| | - Nguyen Truong Quan
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Nguyen Thi Ha
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Le Van Chieu
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions, Inc., 407 King Street West, Hamilton, Ontario, Canada
| | - Hidenari Yasui
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
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Liu B, Terashima M, Quan NT, Ha NT, Van Chieu L, Goel R, Yasui H. Determination of optimal dose of allylthiourea (ATU) for the batch respirometric test of activated sludge. Water Sci Technol 2018; 77:2876-2885. [PMID: 30065140 DOI: 10.2166/wst.2018.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Allylthiourea is a known specific inhibitor for ammonium oxidiser to suppress its oxygen uptake, and is commonly used for various kinds of batch respirometric tests to detect heterotrophic respiration in activated sludge. However, when high heterotrophs were present in the sample, it appeared the inhibitor was noticeably degraded and reached below the inhibition threshold after a couple of days, which resulted in overestimation of the heterotrophic respiration. The biological decomposition of the inhibitor was expressed with a Monod-type rate expression having a half-saturation coefficient of 980 mg-COD/L and maximum specific growth rate of 1.0 d-1. The developed kinetic model, including the growth and decay of the heterotrophs and nitrifiers, indicated that the ATU with about 90 mg-ATU/L which was initially dosed to the system would reach below the inhibition threshold of 1.0 mg-ATU/L after 10 days when 750 mg-COD/L of heterotrophs were present. From the kinetic model, an empirical formula to calculate a safe minimum ATU dose for the batch respirometric test was elaborated. The model also provided a modified experimental procedure to accurately estimate the initial heterotrophic biomass concentration in the sample and its specific decay rate based on IWA Activated Sludge Models.
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Affiliation(s)
- Bing Liu
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
| | - Mitsuharu Terashima
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
| | - Nguyen Truong Quan
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Nguyen Thi Ha
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Le Van Chieu
- Department of Environmental Technology, VNU University of Science, 334 Nguyen Trai, Thanh Xuan, Hanoi, Vietnam
| | - Rajeev Goel
- Hydromantis Environmental Software Solutions, Inc., 407 King Street West, Hamilton, Ontario, Canada
| | - Hidenari Yasui
- Faculty of Environmental Engineering, The University of Kitakyushu, 1-1, Hibikino Wakamatsu, Kitakyushu, Japan E-mail:
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DeSimone R, Makhani S, Goel R, Reich-Slotky R, Vasovic L, Hsu Y, Maliarova E, Ancharski M, Hsu J, van Besien K, Cushing M. CD34 selection quality is influenced by graft platelet count, time from collection to selection, and regisry versus in-house graft collections. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.079] [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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Goel R, Fleischman AN, Tan T, Sterbis E, Huang R, Higuera C, Parvizi J, Rothman RH. Venous thromboembolic prophylaxis after simultaneous bilateral total knee arthroplasty: aspirin versus warfarin. Bone Joint J 2018; 100-B:68-75. [PMID: 29292343 PMCID: PMC6424442 DOI: 10.1302/0301-620x.100b1.bjj-2017-0587.r1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/10/2017] [Indexed: 11/10/2022]
Abstract
Aims The aims of this study were to compare the efficacy of two agents,
aspirin and warfarin, for the prevention of venous thromboembolism
(VTE) after simultaneous bilateral total knee arthroplasty (SBTKA),
and to elucidate the risk of VTE conferred by this procedure compared
with unilateral TKA (UTKA). Patients and Methods A retrospective, multi-institutional study was conducted on 18
951 patients, 3685 who underwent SBTKA and 15 266 who underwent
UTKA, using aspirin or warfarin as VTE prophylaxis. Each patient
was assigned an individualised baseline VTE risk score based on
a system using the Nationwide Inpatient Sample. Symptomatic VTE,
including pulmonary embolism (PE) and deep vein thrombosis (DVT),
were identified in the first 90 days post-operatively. Statistical
analyses were performed with logistic regression accounting for
baseline VTE risk. Results The adjusted incidence of PE following SBTKA was 1.0% (95% confidence
interval (CI) 0.86 to 1.2) with aspirin and 2.2% (95% CI 2.0 to
2.4) with warfarin. Similarly, the adjusted incidence of VTE following
SBTKA was 1.6% (95% CI 1.1 to 2.3) with aspirin and 2.5% (95% CI
1.9 to 3.3) with warfarin. The risk of PE and VTE were reduced by
66% (odds ratio (OR) 0.44, 95% CI 0.25 to 0.78) and 38% (OR 0.62,
95% CI 0.38 to 1.0), respectively, using aspirin. In addition, the risk
of PE was 204% higher for patients undergoing SBTKA relative to
those undergoing UTKA. For each ten-point increase in baseline VTE
risk, the risk of PE increased by 25.5% for patients undergoing
SBTKA compared with 10.5% for those undergoing UTKA. Patients with
a history of myocardial infarction or peripheral vascular disease had
the greatest increase in risk from undergoing SBTKA instead of UTKA. Conclusion Aspirin is more effective than warfarin for the prevention of
VTE following SBTKA, and serves as the more appropriate agent for
VTE prophylaxis for patients in all risk categories. Furthermore,
patients undergoing SBTKA are at a substantially increased risk
of VTE, even more so for those with significant underlying risk
factors. Patients should be informed about the risks associated
with undergoing SBTKA. Cite this article: Bone Joint J 2018;100-B(1
Supple A):68–75.
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Affiliation(s)
- R Goel
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - A N Fleischman
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - T Tan
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - E Sterbis
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - R Huang
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - C Higuera
- Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - J Parvizi
- Rothman Institute, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
| | - R H Rothman
- Rothman Institute at Thomas Jefferson University, 125 South 9th Street, Suite 1000, Philadelphia, PA 19107, USA
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Gotfrit J, Vickers M, Sud S, Asmis T, Cripps C, Goel R, Hsu T, Jonker D, Goodwin R. Real-life treatment of metastatic colorectal cancer with regorafenib: a single-centre review. ACTA ACUST UNITED AC 2017; 24:234-239. [PMID: 28874891 DOI: 10.3747/co.24.3562] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Various tyrosine kinase signalling pathways affect the development and progression of colorectal cancer (crc). In clinical trials, regorafenib has been associated with a survival benefit in metastatic crc (mcrc). We assessed the safety and efficacy of regorafenib in real-world patients. METHODS In a retrospective review of patients with mcrc treated with regorafenib at our institution from 2013 to 2015, patient demographics, treatment, and survival data were collected. Progression-free survival (pfs) and overall survival (os) were estimated using the Kaplan-Meier method. RESULTS In total, 48 patients were offered regorafenib, and 35 (73%) started treatment. Of the patients who started regorafenib, 57% were men. Median age in the cohort was 61 years, and all patients had a performance status in the range 0-2. Time from diagnosis of mcrc to regorafenib treatment was more than 18 months in 71% of patients. Starting dose was 160 mg in 54% of the patients, 120 mg in 40%, and 80 mg in 6%. Dose reductions occurred in 34% of the patients, and interruptions, in 29%. Best response was progressive disease (60%) and stable disease (17%); response in the rest of the patients was unknown. The most common adverse events on regorafenib (any grade) were fatigue (57%), hyperbilirubinemia (43%), thrombocytopenia (37%), anorexia (31%), and hypertension (31%). The most common grade 3 or 4 adverse events were fatigue (29%), hypophosphatemia (17%), weight loss (11%), and hyperbilirubinemia (9%). Common reasons for discontinuing regorafenib included progressive disease (51%) and toxicity (26%). In patients treated with regorafenib, pfs was 2.4 months (95% confidence interval: 1.8 to 3.3 months) and os was 5.6 months (95% confidence interval: 3.7 to 8.9 months). No factors were associated with survival in univariate or multivariate analysis. CONCLUSIONS In a real-world setting, regorafenib is associated with survival similar to that reported in the randomized controlled trials, but at the expense of toxicity leading to discontinuation in many patients. Future studies of regorafenib should focus on identifying the patients most likely to benefit and on minimizing toxicity.
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Affiliation(s)
- J Gotfrit
- The Ottawa Hospital Research Institute and
| | - M Vickers
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - S Sud
- The Ottawa Hospital Research Institute and
| | - T Asmis
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - C Cripps
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - R Goel
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - T Hsu
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - D Jonker
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
| | - R Goodwin
- The Ottawa Hospital Research Institute and.,Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON
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Pasricha S, Sharma D, Ojha H, Gahlot P, Pathak M, Basu M, Chawla R, Singhal S, Singh A, Goel R, Kukreti S, Shukla S. Luminescence, circular dichroism and
in silico
studies of binding interaction of synthesized naphthylchalcone derivatives with bovine serum albumin. LUMINESCENCE 2017; 32:1252-1262. [DOI: 10.1002/bio.3319] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/07/2016] [Accepted: 02/22/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Sharda Pasricha
- Department of Chemistry Sri Venkateswara College, University of Delhi Delhi India
| | - Deepti Sharma
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Himanshu Ojha
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Pragya Gahlot
- Department of Chemistry Sri Venkateswara College, University of Delhi Delhi India
| | | | - Mitra Basu
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Raman Chawla
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Sugandha Singhal
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Anju Singh
- Nucleic Acid Research Laboratory, Department of Chemistry University of Delhi Delhi India
| | - Rajeev Goel
- Division of CBRN Defence Institute of Nuclear Medicine and Allied Sciences Delhi India
| | - Shrikant Kukreti
- Nucleic Acid Research Laboratory, Department of Chemistry University of Delhi Delhi India
| | - Shefali Shukla
- Department of Chemistry Sri Venkateswara College, University of Delhi Delhi India
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Goel R, Nagpal S, Kamal S, Kumar S, Mishra B, Loomba PS. Study of microbial growth on silicone tubes after transcanalicular laser-assisted dacryocystorhinostomy and correlation with patency. Nepal J Ophthalmol 2017; 8:119-127. [PMID: 28478465 DOI: 10.3126/nepjoph.v8i2.16992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Intubation in primary transcanalicular laser assisted dacryocystorhinostomy (TCLADCR) is performed to increase the success rates. However, the associated inflammation and infection can have adverse effects. OBJECTIVE To study the microbial infection and drug susceptibility of extubated silicone tubes and final anatomical patency in patients undergoing TCLADCR. MATERIALS AND METHODS A non-randomised prospective interventional study was conducted in a tertiary care eye centre. The study included twenty consecutive adult patients with primary nasolacrimal duct obstruction. They underwent TCLADCR with bicanalicular silicone intubation. The stents were removed at 2 months and subjected to culture sensitivity, followed by administration of appropriate antimicrobial agents. Main outcome measures studied were the microbial spectrum on the cultured tubes, their sensitivity profile and its correlation with final anatomical patency. RESULTS A positive culture was obtained in 100% cases, comprising of normal commensals and pathogenic organisms. Of the total 24 isolates, 16 (66.6%) Gram positive bacteria (75% Staphylococcus aureus) and 8 (33.3%) Gram negative bacteria (commonest E.coli) were found, with 4 tubes having more than one isolate. No fungal growth was seen. Ninety percent success rate was achieved at one year following appropriate antimicrobial therapy except in 2 patients with gram negative isolates who had failed to take the prescribed antibiotics following sensitivity reports. There was no correlation between multiple infections and success rate. However, by using the Fisher exact test, a positive correlation was obtained between appropriate antibiotic treatment and the final anatomical patency (p less than 0.05). CONCLUSION Silicone intubation predisposes to microbial growth, which if neglected, can lead to failure of TCLADCR.
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Sharma N, Ojha H, Pathak DP, Goel R, Sharma RK. Ex-vivo complexation, skin permeation, interaction and cytodermal toxicity studies of p-tertbutylcalix[4]arene nanoemulsion for radiation decontamination. Life Sci 2017; 168:65-76. [DOI: 10.1016/j.lfs.2016.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/23/2016] [Accepted: 11/08/2016] [Indexed: 01/27/2023]
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39
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Tanwar A, Chawla R, Ansari MM, Neha, Thakur P, Chakotiya AS, Goel R, Ojha H, Asif M, Basu M, Arora R, Khan HA. In vivo anti-arthritic efficacy of Camellia sinensis (L.) in collagen induced arthritis model. Biomed Pharmacother 2016; 87:92-101. [PMID: 28049097 DOI: 10.1016/j.biopha.2016.12.089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 10/24/2016] [Revised: 12/12/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA), an autoimmune inflammatory disorder with synovial hyperplasia, destruction of cartilage, bone damage is often associated with risk of infections. Such risk could be attributed towards usage of immunosuppressive agents. Thus, the present study was undertaken to evaluate the anti-arthritic efficacy of aquo-alcoholic extract of Camellia sinensis (L.). MATERIAL AND METHODS Dried leaves of Camellia sinensis (L.) or Cs were filtered and extracted in 1:1 aqueous: ethanol by Soxhlet apparatus followed by lyophilization and spray drying to develop amorphous powder. Four different oral doses (50, 100, 200, 400mg/kg/body wt.) of aquo-alcoholic extract were evaluated for anti-edematogenic effect in collagen induced arthritis model. The selected anti-arthritic doses of Cs were evaluated for the oxidative stress markers like Glutathione [5-5'dithio-bis-2-nitrobenzoicacid (DTNB)], Superoxide dismutase [Epinephrine], Catalase [Hydrogen peroxide], Lipid peroxidation [Thiobarbituric acid reactive substance (TBARS)], Nitric oxide [Griess reagents:Nitrobluetetrazolium], Articular elastase [N-methoxysuccinyl-Ala-Ala-Pro- Val p-nitroanilide] in joints followed by haematological evaluation including RBC, WBC, Haemoglobin, platelets and haematocrit. To validate these biochemical changes, the radiological and histopathological (Haematoxylin & Eosin) evaluation was also conducted. RESULTS The selected anti-arthritic dose of Cs i.e. 400mg/kg/body wt. (∼60% anti-arthritic efficacy on 35th day) could be attributed towards significant (p<0.05) increase in the levels of enzymatic (Superoxide dismutase and Catalase) and non-enzymatic (Glutathione) antioxidants by 34%, 59% and 50% respectively. Simultaneously, the significant (p<0.05) reduction of lipid peroxides, nitrite radical and elastase activity by 32%, 45% & 32% respectively as compare to control indicated overall decrease in oxidative stress. Haematological evaluation revealed restoration of RBC, WBC and platelets level in treatment group. The confirmatory analysis utilizing radiological and histological assessment showed alleviation of joint deformity, tissue swelling, pannus formation and neutrophils infiltration in treatment group as compared to collagen induced arthritis. CONCLUSION The analysis showed that Cs can play an effective role in reduction of oxidative stress by modulating levels of antioxidants, reducing levels of free radicals while restoring normal haematopoietic cascade as observed in collagen induced arthritis model. Thus, the cumulative dose impact of 400mg/kg body wt., over a period of 14days also found extremely effective in terms of safeguarding their structural conformity against such auto-immune disorder.
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Affiliation(s)
- Ankit Tanwar
- Heavy Metal and Clinical Toxicology Laboratory, Department of Medical Elementology and Toxicology, Hamdard University, Hamdard Nagar, New Delhi, 110062, India; Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Raman Chawla
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Md Meraj Ansari
- Heavy Metal and Clinical Toxicology Laboratory, Department of Medical Elementology and Toxicology, Hamdard University, Hamdard Nagar, New Delhi, 110062, India
| | - Neha
- Heavy Metal and Clinical Toxicology Laboratory, Department of Medical Elementology and Toxicology, Hamdard University, Hamdard Nagar, New Delhi, 110062, India
| | - Pallavi Thakur
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Ankita Singh Chakotiya
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Rajeev Goel
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Himanshu Ojha
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - M Asif
- Faculty of Medicine (U), Hamdard University, Hamdard Nagar, New Delhi, 110062, India
| | - Mitra Basu
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Rajesh Arora
- Office of DG (LS), Defence Research and Development Organisation, DRDO Bhawan, Delhi, India
| | - Haider Ali Khan
- Heavy Metal and Clinical Toxicology Laboratory, Department of Medical Elementology and Toxicology, Hamdard University, Hamdard Nagar, New Delhi, 110062, India.
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40
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Bossé D, Ng T, Ahmad C, Alfakeeh A, Alruzug I, Biagi J, Brierley J, Chaudhury P, Cleary S, Colwell B, Cripps C, Dawson LA, Dorreen M, Ferland E, Galiatsatos P, Girard S, Gray S, Halwani F, Kopek N, Mahmud A, Martel G, Robillard L, Samson B, Seal M, Siddiqui J, Sideris L, Snow S, Thirwell M, Vickers M, Goodwin R, Goel R, Hsu T, Tsvetkova E, Ward B, Asmis T. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016. ACTA ACUST UNITED AC 2016; 23:e605-e614. [PMID: 28050151 DOI: 10.3747/co.23.3394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents.
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Affiliation(s)
- D Bossé
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - T Ng
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - C Ahmad
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - A Alfakeeh
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - I Alruzug
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - J Biagi
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - J Brierley
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - P Chaudhury
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Cleary
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Colwell
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - C Cripps
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - L A Dawson
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - M Dorreen
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - E Ferland
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - P Galiatsatos
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Girard
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Gray
- New Brunswick: Saint John Regional Hospital, Saint John (Gray)
| | - F Halwani
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - N Kopek
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - A Mahmud
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - G Martel
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - L Robillard
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Samson
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - M Seal
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - J Siddiqui
- Newfoundland and Labrador: Dr. H. Bliss Murphy Cancer Centre, St. John's (Ahmad, Seal, Siddiqui)
| | - L Sideris
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - S Snow
- Nova Scotia: QEII Health Sciences Centre, Halifax (Colwell, Dorreen, Snow)
| | - M Thirwell
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - M Vickers
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - R Goodwin
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - R Goel
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - T Hsu
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - E Tsvetkova
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
| | - B Ward
- Quebec: Hôpital Charles-LeMoyne Cancer Centre, Greenfield Park (Samson); McGill University Health Centre, Montreal (Alfakeeh, Alruzug, Chaudhury, Kopek, Thirlwell, Ward); Sir Mortimer B. Davis Jewish General Hospital (Galiatsatos); Centre Hospitalier Pierre-Boucher (Ferland); Centre Hospitalier Universitaire de Montréal (Girard, Sideris)
| | - T Asmis
- Ontario: The Ottawa Hospital Cancer Centre, Ottawa (Asmis, Bossé, Cripps, Goel, Goodwin, Halwani, Hsu, Martel, Ng, Robillard, Vickers); Queen's University and Cancer Centre of Southeastern Ontario, Kingston (Biagi); Princess Margaret Cancer Centre, Toronto (Brierley, Cleary, Dawson); Juravinski Cancer Centre, Hamilton (Tsvetkova); Cancer Centre of Southeastern Ontario, Kingston (Mahmud)
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Tanwar A, Chawla R, Chakotiya AS, Thakur P, Goel R, Basu M, Arora R, Khan HA. Effect of Holarrhena antidysentrica (Ha) and Andrographis paniculata (Ap) on the biofilm formation and cell membrane integrity of opportunistic pathogen Salmonella typhimurium. Microb Pathog 2016; 101:76-82. [DOI: 10.1016/j.micpath.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 11/02/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
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Goel R, Goel M, O'Donnell M, Al-Khaffaf H. Assessment of carotid plaque morphology in symptomatic carotid artery disease on ultrasound for predicting the increased ischaemic stroke risk – A systematic review. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.493] [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]
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Goel R, Mitri E, Tedesco K, Zheng D, Mansbach J, Sullivan A, Espinola J, Camargo C. 215 Confirmation of Racial/Ethnic Disparities in the Management of Severe Bronchiolitis. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.229] [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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Thakur P, Chawla R, Narula A, Goel R, Arora R, Sharma RK. In vitro bactericidal activity of Berberis aristata extract against clinical isolates of carbapenem-resistant Escherichia coli. J Complement Integr Med 2016; 13:229-237. [PMID: 27101558 DOI: 10.1515/jcim-2015-0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Berberis aristata is known to contain a variety of phenolic compounds, flavonoids such as quercetin attributing towards its holistic capability of mitigating multidrug resistance. METHODS B. aristata stem bark extract was prepared and characterized using phytochemical and bioactivity-based fingerprinting. Anti-oxidant and anti-lipid peroxidation profiling was also done in conjunction with in vitro anti-microbial efficacy testing against the test microorganism i. e., New Delhi Metallo-β-lactamase-1 (NDM-1) Escherichia coli. RESULTS Aquo-alcoholic (1:1) extract of B. aristata (PTRC-2111-A), containing 3.0±0.02 µg of QUERCETIN/mg of dried extract, exhibited [flavonoid/polyphenol: F/P (quercetin %) ~ 0.16(0.06 %)]. The bioactivity fingerprint profile of PTRC-2111-A included IC50 ratio [DPPH/NOS]=0.064 as functional standardized value having IC50 (DPPH Scavenging)=16±0.5 µg/mL and IC50 (Nitric Oxide Scavenging)=250±0.5 µg/mL respectively. The reducing ability and anti-lipid peroxidation equivalent (extract: standard) of PTRC-2111-A with respect to standard was estimated to be 3.44 (ascorbic acid) and 0.78 (quercetin) respectively. In vitro anti-microbial activity evaluated against sts-09 multidrug-resistant strain of carbapenem-resistant E. coli was found to be 25 µg/mL. CONCLUSIONS B. aristata was found to contain a number of phytoconstituents, which acts in a synergistic manner to provide significant bactericidal potential against carbapenem-resistant E. coli.
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Thakur P, Chawla R, Goel R, Narula A, Arora R, Sharma RK. Augmenting the potency of third-line antibiotics with Berberis aristata : In vitro synergistic activity against carbapenem-resistant Escherichia coli. J Glob Antimicrob Resist 2016; 6:10-16. [DOI: 10.1016/j.jgar.2016.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 01/20/2016] [Accepted: 01/30/2016] [Indexed: 01/22/2023] Open
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Tsvetkova E, Sud S, Aucoin N, Biagi J, Burkes R, Samson B, Brule S, Cripps C, Colwell B, Falkson C, Dorreen M, Goel R, Halwani F, Marginean C, Maroun J, Michaud N, Tehfe M, Thirlwell M, Vickers M, Asmis T. Corrigendum: Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014. ACTA ACUST UNITED AC 2016; 23:e435. [PMID: 27536192 DOI: 10.3747/co.23.3283] [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: 11/15/2022]
Abstract
[This corrects the article DOI: 10.3747/co.22.2603.].
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Affiliation(s)
- E Tsvetkova
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - S Sud
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - N Aucoin
- Hôpital de la Cité-de-la-Santé de Laval, Laval, QC
| | - J Biagi
- Queen's University, Kingston, Toronto, ON
| | - R Burkes
- Mount Sinai Hospital, Toronto, ON
| | - B Samson
- Monteregie Cancer Centre, Charles-LeMoyne Hospital, Longueil, QC
| | - S Brule
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - C Cripps
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | | | - C Falkson
- Queen's University, Kingston, Toronto, ON
| | | | - R Goel
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - F Halwani
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - C Marginean
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - J Maroun
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - N Michaud
- Centre de Santé et de Services sociaux de Sept Îles, Sept-Îles, Montreal, QC
| | - M Tehfe
- Centre hospitalier de l'Université de Montréal, Montreal, QC
| | - M Thirlwell
- McGill University Health Centre, Montreal, QC
| | - M Vickers
- The Ottawa Hospital Cancer Centre, Ottawa, ON
| | - T Asmis
- The Ottawa Hospital Cancer Centre, Ottawa, ON
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Goel R, Tyagi N. Potential Contribution of Antioxidant Mechanism in the Defensive Effect of Lycopene Against Partial Sciatic Nerve Ligation Induced Behavioral, Biochemical and Histopathological Modification in Wistar Rats. Drug Res (Stuttg) 2016; 66:633-638. [DOI: 10.1055/s-0042-112364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- R. Goel
- I.T.S College of Pharmacy, Ghaziabad, Uttar Pradesh, India
| | - N. Tyagi
- I.T.S College of Pharmacy, Ghaziabad, Uttar Pradesh, India
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Chakotiya AS, Chawla R, Thakur P, Tanwar A, Narula A, Grover SS, Goel R, Arora R, Sharma RK. In vitro bactericidal activity of promising nutraceuticals for targeting multidrug resistant Pseudomonas aeruginosa. Nutrition 2016; 32:890-7. [PMID: 27083519 DOI: 10.1016/j.nut.2016.01.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/20/2016] [Accepted: 01/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We evaluated the bactericidal activity of nutraceuticals against multidrug resistant Pseudomonas aeruginosa. The nutritionally valued herbs were screened on the basis of a matrix modeling approach and molecular docking based validation analysis. METHODS The database of 38 herbs developed earlier using fuzzy logic based scoring analysis was subjected to molecular docking based validation. The molecular docking (Hex 6.12) analyses of predominant phytoligands (∼10 per herb) against exoenzyme S of P. aeruginosa filtered potent herbs were selected. The preauthenticated bacterial inoculum (10(8) CFU/mL) was added to the sterile nutrient broth impregnated with standardized aqueous-alcoholic herbal extracts (1-1600 μg/mL). After overnight incubation at 37°C, antibacterial activity was evaluated in terms of minimum inhibitory and minimum bactericidal concentrations. RESULTS Five herbs were selected on the basis of fuzzy set scoring, an herbal informatics model, and validation analysis based on energy of docking (i.e., Evalue of 380) phytoligands with maximum scoring obtained by Glycyrrhiza glabra. Among the 5 nutraceuticals, G. glabra showed maximum bactericidal activity significantly (P < 0.05) higher than Amikacin, a standard antibiotic, which was in consonance with in silico bioprospection. Zingiber officinale, despite a low Evalue, showed considerably higher inhibition attributed to its higher flavonoid content as compared to other herbs. CONCLUSION G. glabra (licorice), a flavoring agent; Z. officinale (ginger), a condiment; and Mentha piperita (mint), a fragrance component, showed significant therapeutic potential against multidrug resistant strains of P. aeruginosa.
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Affiliation(s)
- Ankita Singh Chakotiya
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Raman Chawla
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Pallavi Thakur
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Ankit Tanwar
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Alka Narula
- Department of Biotechnology, Jamia Hamdard, Delhi, India
| | - Shyam Sunder Grover
- Department of Microbiology, National Centre for Disease Control, Delhi, India
| | - Rajeev Goel
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Rajesh Arora
- Office of DG (LS), Defence Research and Development Organisation, DRDO Bhawan, Delhi, India
| | - Rakesh Kumar Sharma
- Division of Chemical, Biological, Radiological and Nuclear Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
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Gupta N, Mandal S, Mathew J, Pulukool S, Goel R, Mathew A, Nair A, Sebastian T, Danda D. AB0414 Mycophenolate Mofetil and Deflazacort in Neuropsychiatric Lupus: A Retrospective Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5461] [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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Thakur P, Chawla R, Narula A, Goel R, Arora R, Sharma RK. Anti-hemolytic, hemagglutination inhibition and bacterial membrane disruptive properties of selected herbal extracts attenuate virulence of Carbapenem Resistant Escherichia coli. Microb Pathog 2016; 95:133-141. [PMID: 27057673 DOI: 10.1016/j.micpath.2016.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 04/01/2016] [Indexed: 11/19/2022]
Abstract
Expression of a multitude of virulence factors by multi-drug resistant microbial strains, e.g., Carbapenem Resistant Escherichia coli (Family: Enterobacteriaceae; Class: Gammaproteobacteria), is responsible for resistance against beta-lactam antibiotics. Hemolysin production and induction of hemagglutination by bacterial surface receptors inflicts direct cytotoxicity by destroying host phagocytic and epithelial cells. We have previously reported that Berberis aristata, Camellia sinensis, Cyperus rotundus Holarrhena antidysenterica and Andrographis paniculata are promising herbal leads for targeting Carbapenem resistant Escherichia coli. These herbal leads were analyzed for their anti-hemolytic potential by employing spectrophotometric assay of hemoglobin liberation. Anti-hemagglutination potential of the extracts was assessed by employing qualitative assay of visible RBC aggregate formation. Camellia sinensis (PTRC-31911-A) exhibited anti-hemolytic potential of 73.97 ± 0.03%, followed by Holarrhena antidysenterica (PTRC-8111-A) i.e., 68.32 ± 0.05%, Berberis aristata (PTRC-2111-A) i.e., 60.26 ± 0.05% and Cyperus rotundus (PTRC-31811-A) i.e., 53.76 ± 0.03%. Comprehensive, visual analysis of hemagglutination inhibition revealed that only Berberis aristata (PTRC-2111-A) and Camellia sinensis (PTRC-31911-A) exhibited anti-hemagglutination activity. However, Andrographis paniculata (PTRC-11611-A) exhibited none of the inhibitory activities. Furthermore, the pair wise correlation analysis of the tested activities with quantitative phytochemical descriptors revealed that an increased content of alkaloid; flavonoids; polyphenols, and decreased content of saponins supported both the activities. Additionally, flow cytometry revealed that cell membrane structures of CRE were damaged by extracts of Berberis aristata (PTRC-2111-A) and Camellia sinensis (PTRC-31911-A) at their respective Minimum Inhibitory Concentrations, thereby confirming noteworthy antibacterial potential of both these extracts targeting bacterial membrane; hemolysin and bacterial hemagglutination.
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Affiliation(s)
- Pallavi Thakur
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Raman Chawla
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
| | - Alka Narula
- Department of Biotechnology, Jamia Hamdard, Delhi, India
| | - Rajeev Goel
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - Rajesh Arora
- Directorate General-Life Sciences, Defence Research and Development Organisation, DRDO Bhawan, Delhi, India
| | - Rakesh Kumar Sharma
- Division of CBRN Defence, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
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