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Abbasi R, Ackermann M, Adams J, Agarwalla SK, Aguilar JA, Ahlers M, Alameddine JM, Amin NM, Andeen K, Anton G, Argüelles C, Ashida Y, Athanasiadou S, Axani SN, Bai X, Balagopal VA, Baricevic M, Barwick SW, Basu V, Bay R, Beatty JJ, Becker Tjus J, Beise J, Bellenghi C, Benning C, BenZvi S, Berley D, Bernardini E, Besson DZ, Blaufuss E, Blot S, Bontempo F, Book JY, Boscolo Meneguolo C, Böser S, Botner O, Böttcher J, Bourbeau E, Braun J, Brinson B, Brostean-Kaiser J, Burley RT, Busse RS, Butterfield D, Campana MA, Carloni K, Carnie-Bronca EG, Chattopadhyay S, Chau N, Chen C, Chen Z, Chirkin D, Choi S, Clark BA, Classen L, Coleman A, Collin GH, Connolly A, Conrad JM, Coppin P, Correa P, Cowen DF, Dave P, De Clercq C, DeLaunay JJ, Delgado D, Deng S, Deoskar K, Desai A, Desiati P, de Vries KD, de Wasseige G, DeYoung T, Diaz A, Díaz-Vélez JC, Dittmer M, Domi A, Dujmovic H, DuVernois MA, Ehrhardt T, Eller P, Ellinger E, El Mentawi S, Elsässer D, Engel R, Erpenbeck H, Evans J, Evenson PA, Fan KL, Fang K, Farrag K, Fazely AR, Feigl N, Fiedlschuster S, Fienberg AT, Finley C, Fischer L, Fox D, Franckowiak A, Fritz A, Fürst P, Gallagher J, Ganster E, Garcia A, Gerhardt L, Ghadimi A, Glaser C, Glauch T, Glüsenkamp T, Goehlke N, Gonzalez JG, Goswami S, Grant D, Gray SJ, Gries O, Griffin S, Griswold S, Groth KM, Günther C, Gutjahr P, Haack C, Hallgren A, Halliday R, Halve L, Halzen F, Hamdaoui H, Ha Minh M, Hanson K, Hardin J, Harnisch AA, Hatch P, Haungs A, Helbing K, Hellrung J, Henningsen F, Heuermann L, Heyer N, Hickford S, Hidvegi A, Hill C, Hill GC, Hoffman KD, Hori S, Hoshina K, Hou W, Huber T, Hultqvist K, Hünnefeld M, Hussain R, Hymon K, In S, Ishihara A, Jacquart M, Janik O, Jansson M, Japaridze GS, Jeong M, Jin M, Jones BJP, Kang D, Kang W, Kang X, Kappes A, Kappesser D, Kardum L, Karg T, Karl M, Karle A, Katz U, Kauer M, Kelley JL, Khatee Zathul A, Kheirandish A, Kiryluk J, Klein SR, Kochocki A, Koirala R, Kolanoski H, Kontrimas T, Köpke L, Kopper C, Koskinen DJ, Koundal P, Kovacevich M, Kowalski M, Kozynets T, Krishnamoorthi J, Kruiswijk K, Krupczak E, Kumar A, Kun E, Kurahashi N, Lad N, Lagunas Gualda C, Lamoureux M, Larson MJ, Latseva S, Lauber F, Lazar JP, Lee JW, Leonard DeHolton K, Leszczyńska A, Lincetto M, Liu QR, Liubarska M, Lohfink E, Love C, Lozano Mariscal CJ, Lucarelli F, Luszczak W, Lyu Y, Madsen J, Mahn KBM, Makino Y, Manao E, Mancina S, Marie Sainte W, Mariş IC, Marka S, Marka Z, Marsee M, Martinez-Soler I, Maruyama R, Mayhew F, McElroy T, McNally F, Mead JV, Meagher K, Mechbal S, Medina A, Meier M, Merckx Y, Merten L, Micallef J, Mitchell J, Montaruli T, Moore RW, Morii Y, Morse R, Moulai M, Mukherjee T, Naab R, Nagai R, Nakos M, Naumann U, Necker J, Negi A, Neumann M, Niederhausen H, Nisa MU, Noell A, Novikov A, Nowicki SC, Obertacke Pollmann A, O'Dell V, Oehler M, Oeyen B, Olivas A, Orsoe R, Osborn J, O'Sullivan E, Pandya H, Pankova DV, Park N, Parker GK, Paudel EN, Paul L, Pérez de Los Heros C, Peterson J, Philippen S, Pizzuto A, Plum M, Pontén A, Popovych Y, Prado Rodriguez M, Pries B, Procter-Murphy R, Przybylski GT, Raab C, Rack-Helleis J, Rawlins K, Rechav Z, Rehman A, Reichherzer P, Renzi G, Resconi E, Reusch S, Rhode W, Riedel B, Rifaie A, Roberts EJ, Robertson S, Rodan S, Roellinghoff G, Rongen M, Rott C, Ruhe T, Ruohan L, Ryckbosch D, Safa I, Saffer J, Salazar-Gallegos D, Sampathkumar P, Sanchez Herrera SE, Sandrock A, Santander M, Sarkar S, Sarkar S, Savelberg J, Savina P, Schaufel M, Schieler H, Schindler S, Schlickmann L, Schlüter B, Schlüter F, Schmeisser N, Schmidt T, Schneider J, Schröder FG, Schumacher L, Schwefer G, Sclafani S, Seckel D, Seikh M, Seunarine S, Shah R, Sharma A, Shefali S, Shimizu N, Silva M, Skrzypek B, Smithers B, Snihur R, Soedingrekso J, Søgaard A, Soldin D, Soldin P, Sommani G, Spannfellner C, Spiczak GM, Stamatikos M, Stanev T, Stezelberger T, Stürwald T, Stuttard T, Sullivan GW, Taboada I, Ter-Antonyan S, Thiesmeyer M, Thompson WG, Thwaites J, Tilav S, Tollefson K, Tönnis C, Toscano S, Tosi D, Trettin A, Tung CF, Turcotte R, Twagirayezu JP, Ty B, Unland Elorrieta MA, Upadhyay AK, Upshaw K, Valtonen-Mattila N, Vandenbroucke J, van Eijndhoven N, Vannerom D, van Santen J, Vara J, Veitch-Michaelis J, Venugopal M, Vereecken M, Verpoest S, Veske D, Vijai A, Walck C, Weaver C, Weigel P, Weindl A, Weldert J, Wen AY, Wendt C, Werthebach J, Weyrauch M, Whitehorn N, Wiebusch CH, Willey N, Williams DR, Witthaus L, Wolf A, Wolf M, Wrede G, Xu XW, Yanez JP, Yildizci E, Yoshida S, Young R, Yu F, Yu S, Zhang Z, Zhelnin P, Zilberman P, Zimmerman M. Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube. Phys Rev Lett 2024; 132:151001. [PMID: 38682982 DOI: 10.1103/physrevlett.132.151001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 05/01/2024]
Abstract
We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.
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Affiliation(s)
- R Abbasi
- Department of Physics, Loyola University Chicago, Chicago, Illinois 60660, USA
| | - M Ackermann
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - J Adams
- Department of Physics and Astronomy, University of Canterbury, Private Bag 4800, Christchurch, New Zealand
| | - S K Agarwalla
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J A Aguilar
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - M Ahlers
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - J M Alameddine
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - N M Amin
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - K Andeen
- Department of Physics, Marquette University, Milwaukee, Wisconsin 53201, USA
| | - G Anton
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - C Argüelles
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - Y Ashida
- Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah 84112, USA
| | - S Athanasiadou
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - S N Axani
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - X Bai
- Physics Department, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - V A Balagopal
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Baricevic
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S W Barwick
- Department of Physics and Astronomy, University of California, Irvine, California 92697, USA
| | - V Basu
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - R Bay
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J J Beatty
- Department of Astronomy, Ohio State University, Columbus, Ohio 43210, USA
- Department of Physics and Center for Cosmology and Astro-Particle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J Becker Tjus
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - J Beise
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - C Bellenghi
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - C Benning
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - S BenZvi
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - D Berley
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - E Bernardini
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università Degli Studi di Padova, 35122 Padova PD, Italy
| | - D Z Besson
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - E Blaufuss
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - S Blot
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - F Bontempo
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - J Y Book
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - C Boscolo Meneguolo
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università Degli Studi di Padova, 35122 Padova PD, Italy
| | - S Böser
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - O Botner
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - J Böttcher
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - E Bourbeau
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - J Braun
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B Brinson
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - J Brostean-Kaiser
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - R T Burley
- Department of Physics, University of Adelaide, Adelaide, 5005, Australia
| | - R S Busse
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - D Butterfield
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M A Campana
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - K Carloni
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - E G Carnie-Bronca
- Department of Physics, University of Adelaide, Adelaide, 5005, Australia
| | - S Chattopadhyay
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - N Chau
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - C Chen
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - Z Chen
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794-3800, USA
| | - D Chirkin
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Choi
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - B A Clark
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - L Classen
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - A Coleman
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - G H Collin
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Connolly
- Department of Astronomy, Ohio State University, Columbus, Ohio 43210, USA
- Department of Physics and Center for Cosmology and Astro-Particle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J M Conrad
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - P Coppin
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - P Correa
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - D F Cowen
- Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - P Dave
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - C De Clercq
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - J J DeLaunay
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - D Delgado
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - S Deng
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - K Deoskar
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - A Desai
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - P Desiati
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K D de Vries
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - G de Wasseige
- Centre for Cosmology, Particle Physics and Phenomenology-CP3, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - T DeYoung
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Diaz
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J C Díaz-Vélez
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Dittmer
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - A Domi
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - H Dujmovic
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M A DuVernois
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - T Ehrhardt
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - P Eller
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - E Ellinger
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - S El Mentawi
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - D Elsässer
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - R Engel
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
- Karlsruhe Institute of Technology, Institute of Experimental Particle Physics, D-76021 Karlsruhe, Germany
| | - H Erpenbeck
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Evans
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - P A Evenson
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - K L Fan
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - K Fang
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K Farrag
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - A R Fazely
- Department of Physics, Southern University, Baton Rouge, Louisiana 70813, USA
| | - N Feigl
- Institut für Physik, Humboldt-Universität zu Berlin, D-12489 Berlin, Germany
| | - S Fiedlschuster
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - A T Fienberg
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - C Finley
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - L Fischer
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - D Fox
- Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - A Franckowiak
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - A Fritz
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - P Fürst
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - J Gallagher
- Department of Astronomy, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E Ganster
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - A Garcia
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - L Gerhardt
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Ghadimi
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - C Glaser
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - T Glauch
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - T Glüsenkamp
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - N Goehlke
- Karlsruhe Institute of Technology, Institute of Experimental Particle Physics, D-76021 Karlsruhe, Germany
| | - J G Gonzalez
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - S Goswami
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - D Grant
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S J Gray
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - O Gries
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - S Griffin
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Griswold
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - K M Groth
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - C Günther
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - P Gutjahr
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - C Haack
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - A Hallgren
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - R Halliday
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - L Halve
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - F Halzen
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - H Hamdaoui
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794-3800, USA
| | - M Ha Minh
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - K Hanson
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Hardin
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A A Harnisch
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Hatch
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A Haungs
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - K Helbing
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - J Hellrung
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - F Henningsen
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - L Heuermann
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - N Heyer
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - S Hickford
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - A Hidvegi
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - C Hill
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - G C Hill
- Department of Physics, University of Adelaide, Adelaide, 5005, Australia
| | - K D Hoffman
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - S Hori
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K Hoshina
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - W Hou
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - T Huber
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - K Hultqvist
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - M Hünnefeld
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - R Hussain
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K Hymon
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - S In
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - A Ishihara
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - M Jacquart
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - O Janik
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - M Jansson
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - G S Japaridze
- CTSPS, Clark-Atlanta University, Atlanta, Georgia 30314, USA
| | - M Jeong
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - M Jin
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - B J P Jones
- Department of Physics, University of Texas at Arlington, 502 Yates St., Science Hall Rm 108, Box 19059, Arlington, Texas 76019, USA
| | - D Kang
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - W Kang
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - X Kang
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - A Kappes
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - D Kappesser
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - L Kardum
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - T Karg
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - M Karl
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - A Karle
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - U Katz
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - M Kauer
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J L Kelley
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Khatee Zathul
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Kheirandish
- Department of Physics & Astronomy, University of Nevada, Las Vegas, Nevada, 89154, USA
- Nevada Center for Astrophysics, University of Nevada, Las Vegas, Nevada 89154, USA
| | - J Kiryluk
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794-3800, USA
| | - S R Klein
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Kochocki
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Koirala
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - H Kolanoski
- Institut für Physik, Humboldt-Universität zu Berlin, D-12489 Berlin, Germany
| | - T Kontrimas
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - L Köpke
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - C Kopper
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - D J Koskinen
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - P Koundal
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - M Kovacevich
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - M Kowalski
- Institut für Physik, Humboldt-Universität zu Berlin, D-12489 Berlin, Germany
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - T Kozynets
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - J Krishnamoorthi
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K Kruiswijk
- Centre for Cosmology, Particle Physics and Phenomenology-CP3, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - E Krupczak
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Kumar
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - E Kun
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - N Kurahashi
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - N Lad
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - C Lagunas Gualda
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - M Lamoureux
- Centre for Cosmology, Particle Physics and Phenomenology-CP3, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - M J Larson
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - S Latseva
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - F Lauber
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - J P Lazar
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J W Lee
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - K Leonard DeHolton
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - A Leszczyńska
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - M Lincetto
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - Q R Liu
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Liubarska
- Department of Physics, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
| | - E Lohfink
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - C Love
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - C J Lozano Mariscal
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - F Lucarelli
- Département de physique nucléaire et corpusculaire, Université de Genève, CH-1211 Genève, Switzerland
| | - W Luszczak
- Department of Astronomy, Ohio State University, Columbus, Ohio 43210, USA
- Department of Physics and Center for Cosmology and Astro-Particle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - Y Lyu
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Madsen
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K B M Mahn
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - Y Makino
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E Manao
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - S Mancina
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
- Dipartimento di Fisica e Astronomia Galileo Galilei, Università Degli Studi di Padova, 35122 Padova PD, Italy
| | - W Marie Sainte
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - I C Mariş
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - S Marka
- Columbia Astrophysics and Nevis Laboratories, Columbia University, New York, New York 10027, USA
| | - Z Marka
- Columbia Astrophysics and Nevis Laboratories, Columbia University, New York, New York 10027, USA
| | - M Marsee
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - I Martinez-Soler
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - R Maruyama
- Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - F Mayhew
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - T McElroy
- Department of Physics, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
| | - F McNally
- Department of Physics, Mercer University, Macon, Georgia 31207-0001, USA
| | - J V Mead
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - K Meagher
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Mechbal
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - A Medina
- Department of Physics and Center for Cosmology and Astro-Particle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - M Meier
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - Y Merckx
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - L Merten
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - J Micallef
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - J Mitchell
- Department of Physics, Southern University, Baton Rouge, Louisiana 70813, USA
| | - T Montaruli
- Département de physique nucléaire et corpusculaire, Université de Genève, CH-1211 Genève, Switzerland
| | - R W Moore
- Department of Physics, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
| | - Y Morii
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - R Morse
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Moulai
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - T Mukherjee
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - R Naab
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - R Nagai
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - M Nakos
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - U Naumann
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - J Necker
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - A Negi
- Department of Physics, University of Texas at Arlington, 502 Yates St., Science Hall Rm 108, Box 19059, Arlington, Texas 76019, USA
| | - M Neumann
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - H Niederhausen
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M U Nisa
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Noell
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - A Novikov
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - S C Nowicki
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Obertacke Pollmann
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - V O'Dell
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Oehler
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - B Oeyen
- Department of Physics and Astronomy, University of Gent, B-9000 Gent, Belgium
| | - A Olivas
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - R Orsoe
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - J Osborn
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E O'Sullivan
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - H Pandya
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - D V Pankova
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - N Park
- Department of Physics, Engineering Physics, and Astronomy, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - G K Parker
- Department of Physics, University of Texas at Arlington, 502 Yates St., Science Hall Rm 108, Box 19059, Arlington, Texas 76019, USA
| | - E N Paudel
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - L Paul
- Department of Physics, Marquette University, Milwaukee, Wisconsin 53201, USA
- Physics Department, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - C Pérez de Los Heros
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - J Peterson
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Philippen
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - A Pizzuto
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Plum
- Physics Department, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - A Pontén
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - Y Popovych
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - M Prado Rodriguez
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B Pries
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Procter-Murphy
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - G T Przybylski
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Raab
- Centre for Cosmology, Particle Physics and Phenomenology-CP3, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J Rack-Helleis
- Institute of Physics, University of Mainz, Staudinger Weg 7, D-55099 Mainz, Germany
| | - K Rawlins
- Department of Physics and Astronomy, University of Alaska Anchorage, 3211 Providence Dr., Anchorage, Alaska 99508, USA
| | - Z Rechav
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Rehman
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - P Reichherzer
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - G Renzi
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - E Resconi
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - S Reusch
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - W Rhode
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - B Riedel
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Rifaie
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - E J Roberts
- Department of Physics, University of Adelaide, Adelaide, 5005, Australia
| | - S Robertson
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Rodan
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - G Roellinghoff
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - M Rongen
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - C Rott
- Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah 84112, USA
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - T Ruhe
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - L Ruohan
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - D Ryckbosch
- Department of Physics and Astronomy, University of Gent, B-9000 Gent, Belgium
| | - I Safa
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Saffer
- Karlsruhe Institute of Technology, Institute of Experimental Particle Physics, D-76021 Karlsruhe, Germany
| | - D Salazar-Gallegos
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Sampathkumar
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - S E Sanchez Herrera
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - A Sandrock
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - M Santander
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - S Sarkar
- Department of Physics, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
| | - S Sarkar
- Department of Physics, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
| | - J Savelberg
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - P Savina
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Schaufel
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - H Schieler
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - S Schindler
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - L Schlickmann
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - B Schlüter
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - F Schlüter
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - N Schmeisser
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - T Schmidt
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - J Schneider
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - F G Schröder
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - L Schumacher
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - G Schwefer
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - S Sclafani
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - D Seckel
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - M Seikh
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - S Seunarine
- Department of Physics, University of Wisconsin, River Falls, Wisconsin 54022, USA
| | - R Shah
- Department of Physics, Drexel University, 3141 Chestnut Street, Philadelphia, Pennsylvania 19104, USA
| | - A Sharma
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - S Shefali
- Karlsruhe Institute of Technology, Institute of Experimental Particle Physics, D-76021 Karlsruhe, Germany
| | - N Shimizu
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - M Silva
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - B Skrzypek
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - B Smithers
- Department of Physics, University of Texas at Arlington, 502 Yates St., Science Hall Rm 108, Box 19059, Arlington, Texas 76019, USA
| | - R Snihur
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Soedingrekso
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - A Søgaard
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - D Soldin
- Karlsruhe Institute of Technology, Institute of Experimental Particle Physics, D-76021 Karlsruhe, Germany
| | - P Soldin
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - G Sommani
- Fakultät für Physik & Astronomie, Ruhr-Universität Bochum, D-44780 Bochum, Germany
| | - C Spannfellner
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - G M Spiczak
- Department of Physics, University of Wisconsin, River Falls, Wisconsin 54022, USA
| | - M Stamatikos
- Department of Physics and Center for Cosmology and Astro-Particle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - T Stanev
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - T Stezelberger
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - T Stürwald
- Department of Physics, University of Wuppertal, D-42119 Wuppertal, Germany
| | - T Stuttard
- Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - G W Sullivan
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - I Taboada
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - S Ter-Antonyan
- Department of Physics, Southern University, Baton Rouge, Louisiana 70813, USA
| | - M Thiesmeyer
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - W G Thompson
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - J Thwaites
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Tilav
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - K Tollefson
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Tönnis
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - S Toscano
- Université Libre de Bruxelles, Science Faculty CP230, B-1050 Brussels, Belgium
| | - D Tosi
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Trettin
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - C F Tung
- School of Physics and Center for Relativistic Astrophysics, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - R Turcotte
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - J P Twagirayezu
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - B Ty
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M A Unland Elorrieta
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - A K Upadhyay
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - K Upshaw
- Department of Physics, Southern University, Baton Rouge, Louisiana 70813, USA
| | - N Valtonen-Mattila
- Department of Physics and Astronomy, Uppsala University, Box 516, S-75120 Uppsala, Sweden
| | - J Vandenbroucke
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - N van Eijndhoven
- Vrije Universiteit Brussel (VUB), Dienst ELEM, B-1050 Brussels, Belgium
| | - D Vannerom
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J van Santen
- Deutsches Elektronen-Synchrotron DESY, Platanenallee 6, 15738 Zeuthen, Germany
| | - J Vara
- Institut für Kernphysik, Westfälische Wilhelms-Universität Münster, D-48149 Münster, Germany
| | - J Veitch-Michaelis
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Venugopal
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - M Vereecken
- Centre for Cosmology, Particle Physics and Phenomenology-CP3, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - S Verpoest
- Bartol Research Institute and Department of Physics and Astronomy, University of Delaware, Newark, Delaware 19716, USA
| | - D Veske
- Columbia Astrophysics and Nevis Laboratories, Columbia University, New York, New York 10027, USA
| | - A Vijai
- Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - C Walck
- Oskar Klein Centre and Department of Physics, Stockholm University, SE-10691 Stockholm, Sweden
| | - C Weaver
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - P Weigel
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Weindl
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - J Weldert
- Department of Physics, Pennsylvania State University, University Park, Pennsylvania 16802, USA
| | - A Y Wen
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - C Wendt
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - J Werthebach
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - M Weyrauch
- Karlsruhe Institute of Technology, Institute for Astroparticle Physics, D-76021 Karlsruhe, Germany
| | - N Whitehorn
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C H Wiebusch
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - N Willey
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D R Williams
- Department of Physics and Astronomy, University of Alabama, Tuscaloosa, Alabama 35487, USA
| | - L Witthaus
- Department of Physics, TU Dortmund University, D-44221 Dortmund, Germany
| | - A Wolf
- III. Physikalisches Institut, RWTH Aachen University, D-52056 Aachen, Germany
| | - M Wolf
- Physik-department, Technische Universität München, D-85748 Garching, Germany
| | - G Wrede
- Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91058 Erlangen, Germany
| | - X W Xu
- Department of Physics, Southern University, Baton Rouge, Louisiana 70813, USA
| | - J P Yanez
- Department of Physics, University of Alberta, Edmonton, Alberta, Canada T6G 2E1
| | - E Yildizci
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Yoshida
- Department of Physics and The International Center for Hadron Astrophysics, Chiba University, Chiba 263-8522, Japan
| | - R Young
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - F Yu
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - S Yu
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - Z Zhang
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, New York 11794-3800, USA
| | - P Zhelnin
- Department of Physics and Laboratory for Particle Physics and Cosmology, Harvard University, Cambridge, Massachusetts 02138, USA
| | - P Zilberman
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - M Zimmerman
- Department of Physics and Wisconsin IceCube Particle Astrophysics Center, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
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Shah R, Finlay AY, Ali FM, Allen H, Nixon SJ, Nixon M, Otwombe K, Ingram JR, Salek MS. Measurement of the major ignored burden of multiple myeloma, pernicious anaemia and of other haematological conditions on partners and family members: A cross-sectional study. Eur J Haematol 2024. [PMID: 38577720 DOI: 10.1111/ejh.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Having a haematological condition can adversely affect the quality of life (QoL) of family members/partners of patients. It is important to measure this often ignored burden in order to implement appropriate supportive interventions. OBJECTIVE To measure current impact of haematological conditions on the QoL of family members/partners of patients, using the Family Reported Outcome Measure-16 (FROM-16). METHODS A cross-sectional study, recruited online through patient support groups, involved UK family members/partners of people with haematological conditions completing the FROM-16. RESULTS 183 family members/partners (mean age = 60.5 years, SD = 13.2; females = 62.8%) of patients (mean age = 64.1, SD = 12.8; females = 46.4%) with 12 haematological conditions completed the FROM-16. The FROM-16 mean total score was 14.0 (SD = 7.2), meaning 'a moderate effect on QoL'. The mean FROM-16 scores of family members of people with multiple myeloma (mean = 15.8, SD = 6.3, n = 99) and other haematological malignancies (mean = 13.9, SD = 7.8, n = 29) were higher than of people with pernicious anaemia (mean = 10.7, SD = 7.5, n = 47) and other non-malignant conditions (mean = 11, SD = 7.4, n = 56, p < .01). Over one third (36.1%, n = 183) of family members experienced a 'very large effect' (FROM-16 score>16) on their quality of life. CONCLUSIONS Haematological conditions, in particular those of malignant type, impact the QoL of family members/partners of patients. Healthcare professionals can now, using FROM-16, identify those most affected and should consider how to provide appropriate holistic support within routine practice.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Shah R, Finlay AY, Salek MS, Allen H, Nixon SJ, Nixon M, Otwombe K, Ali FM, Ingram JR. Responsiveness and minimal important change of the Family Reported Outcome Measure (FROM-16). J Patient Rep Outcomes 2024; 8:38. [PMID: 38530614 DOI: 10.1186/s41687-024-00703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/15/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The FROM-16 is a generic family quality of life (QoL) instrument that measures the QoL impact of patients' disease on their family members/partners. The study aimed to assess the responsiveness of FROM-16 to change and determine Minimal Important Change (MIC). METHODS Responsiveness and MIC for FROM-16 were assessed prospectively with patients and their family members recruited from outpatient departments of the University Hospital Wales and University Hospital Llandough, Cardiff, United Kingdom. Patients completed the EQ-5D-3L and a global severity question (GSQ) online at baseline and at 3-month follow-up. Family members completed FROM-16 at baseline and a Global Rating of Change (GRC) in addition to FROM-16 at follow-up. Responsiveness was assessed using the distribution-based (effect size-ES, standardized response mean -SRM) and anchor-based (area under the receiver operating characteristics curve ROC-AUC) approaches and by testing hypotheses on expected correlation strength between FROM-16 change score and patient assessment tools (GSQ and EQ-5D). Cohen's criteria were used for assessing ES. The AUC ≥ 0.7 was considered a good measure of responsiveness. MIC was calculated using anchor-based (ROC analysis and adjusted predictive modelling) and distribution methods based on standard deviation (SD) and standard error of the measurement (SEM). RESULTS Eighty-three patients with 15 different health conditions and their relatives completed baseline and follow-up questionnaires and were included in the responsiveness analysis. The mean FROM-16 change over 3 months = 1.43 (SD = 4.98). The mean patient EQ-5D change over 3 months = -0.059 (SD = 0.14). The responsiveness analysis showed that the FROM-16 was responsive to change (ES = 0.2, SRM = 0.3; p < 0.01). The ES and SRM of FROM-16 change score ranged from small (ES = 0.2; SRM = 0.3) for the distribution-based method to large (ES = 0.8, SRM = 0.85) for anchor-based methods. The AUC value was above 0.7, indicating good responsiveness. There was a significant positive correlation between the FROM-16 change scores and the patient's disease severity change scores (p < 0.001). The MIC analysis was based on data from 100 family members of 100 patients. The MIC value of 4 was suggested for FROM-16. CONCLUSIONS The results of this study confirm the longitudinal validity of FROM-16 which refers to the degree to which an instrument is able to measure change in the construct to be measured. The results yield a MIC value of 4 for FROM-16. These psychometric attributes of the FROM-16 instrument are useful in both clinical research as well as clinical practice.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M S Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - M Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Shah R, Salek MS, Finlay AY, Kay R, Nixon SJ, Otwombe K, Ali FM, Ingram JR. Mapping of Family Reported Outcome Measure (FROM-16) scores to EQ-5D: algorithm to calculate utility values. Qual Life Res 2024:10.1007/s11136-023-03590-z. [PMID: 38402530 DOI: 10.1007/s11136-023-03590-z] [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: 12/17/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Although decision scientists and health economists encourage inclusion of family member/informal carer utility in health economic evaluation, there is a lack of suitable utility measures comparable to patient utility measures such those based on the EQ-5D. This study aims to predict EQ-5D-3L utility values from Family Reported Outcome Measure (FROM-16) scores, to allow the use of FROM-16 data in health economic evaluation when EQ-5D data is not available. METHODS Data from 4228 family members/partners of patients recruited to an online cross-sectional study through 58 UK-based patient support groups, three research support platforms and Welsh social services departments were randomly divided five times into two groups, to derive and test a mapping model. Split-half cross-validation was employed, resulting in a total of ten multinomial logistic regression models. The Monte Carlo simulation procedure was used to generate predicted EQ-5D-3L responses, and utility scores were calculated and compared against observed values. Mean error and mean absolute error were calculated for all ten validation models. The final model algorithm was derived using the entire sample. RESULTS The model was highly predictive, and its repeated fitting using multinomial logistic regression demonstrated a stable model. The mean differences between predicted and observed health utility estimates ranged from 0.005 to 0.029 across the ten modelling exercises, with an average overall difference of 0.015 (a 2.2% overestimate, not of clinical importance). CONCLUSIONS The algorithm developed will enable researchers and decision scientists to calculate EQ-5D health utility estimates from FROM-16 scores, thus allowing the inclusion of the family impact of disease in health economic evaluation of medical interventions when EQ-5D data is not available.
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Affiliation(s)
- R Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK.
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - R Kay
- RK Statistics, Bakewell, UK
| | - S J Nixon
- Multiple Sclerosis Society, Cardiff, UK
| | - K Otwombe
- Statistics and Data Management Centre, Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - F M Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Vasani A, Mistry S, Shah R. Exponential Rise of Fungal Infection Reported in Rajkot Civil Hospital in Covid Pandemic Era: A Retrospective Study. Indian J Otolaryngol Head Neck Surg 2024; 76:1-4. [PMID: 38440567 PMCID: PMC10908927 DOI: 10.1007/s12070-023-03743-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/27/2023] [Indexed: 03/06/2024] Open
Abstract
Mucormycosis is a rare but serious angio-invasive infection caused by a group of fungi called mucormycetes. Mucormycosis is an aggressive, life-threatening infection requiring prompt diagnosis and early treatment. Wide spread use of steroid and higher antibiotics may cause immune irregulation in post covid patients. A hallmark of mucormycosis infection is the presence of extensive angioinvasion with resultant vessel thrombosis and tissue necrosis. We reported exponential rising cases of fungal infection in covid pandemic era. Here we published epidemiological data of 773 fungal infected cases operated in ENT department of PDU Medical college, Rajkot in 2021. We have documented patients demographic data with comorbidity, paranasal sinuses with orbital, palatal and cerebral involvement, evaluation method, surgical and post surgical management protocol which we followed in our institute to treat all cases. We got promising result in terms of survival and less morbidity. Early presentation, less comorbidity, proper evaluation and immediate debridement with systemic antifungal coverage for adequate duration proved to be mainstay treatment of fungal infection in covid pandemic era.
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Vasani A, Mistry S, Parmar S, Shah R. Ansel Mucormycosis Staging and Outcome Evaluation Score: Our Experience in Soaring Stage of Mucormycosis. Indian J Otolaryngol Head Neck Surg 2024; 76:118-122. [PMID: 38440620 PMCID: PMC10909059 DOI: 10.1007/s12070-023-04103-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/24/2023] [Indexed: 03/06/2024] Open
Abstract
To propose Mucormycosis staging and Outcome evaluation score. (i) To provide method of conveying clinical experience to others without ambiguity. (ii) To facilitate an estimation of prognosis. (iii) To provide useful information for treatment decision. Retrospective observational study. Tertiary care center, Rajkot. 556 confirmed operated case of mucormycosis. It was a single center observational study of 556 confirmed cases of mucormycosis. In suspected cases of fungal infection, clinical symptoms were noted along with covid history and comorbid condition. Clinical findings were noted after nasal endoscopy. Rest neurological examination was done to rule out CNS involvement. Representative sample from nasal mucosa sent for microbiological examination. MRI PNS with Brain and Orbit was advised. After surgery, specimen was sent for histopathological confirmation. We reported most common age group was 51-60 years. 52% cases presented early with only nasal involvement and 1.8% cases with late cerebral involvement presentation. From recorded all above findings we have described this diseases progression in 4 components limited to nasal, orbital, palate and/or skull base, cerebral involvement. It is bases on anatomical progression on clinical and radiological findings. Considering all four components, staging system is designed that includes stage I to stage Vb. Outcome evaluation score designed to consider factors like patient's age, comorbidity, stage of disease while presentation, IV antifungal coverage and patient's psychological condition. Our clinical and radiological diagnostic staging and outcome evaluation score may helpful for others for early and better management of mucormycosis.
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Shah R, Ibis B, Kashyap M, Boussiotis VA. The role of ROS in tumor infiltrating immune cells and cancer immunotherapy. Metabolism 2024; 151:155747. [PMID: 38042522 PMCID: PMC10872310 DOI: 10.1016/j.metabol.2023.155747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 12/04/2023]
Abstract
Reactive oxygen species (ROS) are a group of short-lived highly reactive molecules formed intracellularly from molecular oxygen. ROS can alter biochemical, transcriptional, and epigenetic programs and have an indispensable role in cellular function. In immune cells, ROS are mediators of specialized functions such as phagocytosis, antigen presentation, activation, cytolysis, and differentiation. ROS have a fundamental role in the tumor microenvironment (TME) where they are produced by immune cell-intrinsic and -extrinsic mechanisms. ROS can act as a double-edged sword with short exposures leading to activation in various innate and adaptative immune cells, and prolonged exposures, unopposed by redox balancing antioxidants leading to exhaustion, immunosuppression, and unresponsiveness to cancer immunotherapy. Due to its plasticity and impact on the anti-tumor function of immune cells, attempts are currently in process to harness ROS biology with the purpose to improve contemporary strategies of cancer immunotherapy. Here, we provide a short overview how ROS and various antioxidant systems impact on the function of innate and adaptive immune system cells with emphasis on the TME and immune-based therapies for cancer.
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Affiliation(s)
- Rushil Shah
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America
| | - Betul Ibis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America
| | - Monisha Kashyap
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America
| | - Vassiliki A Boussiotis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America; Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States of America.
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Assis F, Tandri H, Shah R, Batich C, Karmarkar P, Gonuguntla A, Dill M, Uzunoglu EC, Catanzaro JN. Effects of Intraluminal Content on Esophageal Lesion Formation During Radiofrequency Catheter Ablation: Preliminary Data. Circ Arrhythm Electrophysiol 2023; 16:672-674. [PMID: 37970703 DOI: 10.1161/circep.123.012404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Affiliation(s)
- Fabrizio Assis
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD (F. A., P.K., A.G.)
| | - Harikrishna Tandri
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (H.T.)
| | - Rushil Shah
- Division of Cardiology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA (R.S.)
| | - Christopher Batich
- Department of Materials Science and Engineering, J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville (C.B., M.D.)
| | - Parag Karmarkar
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD (F. A., P.K., A.G.)
| | - Akhilesh Gonuguntla
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD (F. A., P.K., A.G.)
| | - Michele Dill
- Department of Materials Science and Engineering, J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville (C.B., M.D.)
| | - Ekin C Uzunoglu
- Department of Medicine, Division of Cardiology, University of Florida Health Science Center, Jacksonville (E.C.U.)
| | - John N Catanzaro
- Department of Cardiovascular Sciences, East Carolina University, Greenville, NC (J.N.C.)
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9
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Boltz AJ, Memmini AK, Brett BL, Snedden TR, Yengo-Kahn AM, Chandran A, Conway DP, Shah R, Pasquina PF, McAllister TW, McCrea MA, Master CL, Broglio SP. Intersection of Race and Socioeconomic Status on Concussion Recovery among NCAA Student-Athletes: A CARE Consortium Study. Med Sci Sports Exerc 2023; 55:2180-2193. [PMID: 37486776 DOI: 10.1249/mss.0000000000003258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
PURPOSE The objectives of this study are to 1) describe collegiate student-athlete (SA) race and household income and 2) evaluate time to normal academic performance (i.e., return to learn (RTL)), initiation of the return to play (iRTP) protocol, RTP protocol duration, and time to unrestricted RTP (URTP) after sustaining sport-related concussion (SRC). METHODS Data were collected between 2014 and 2020 by the Concussion Assessment, Research, and Education Consortium. Baseline data were used to characterize participant demographics ( N = 22,819) and post-SRC outcomes ( n = 5485 SRC) in time to RTL ( n = 1724) and RTP outcomes ( n = 2646) by race. Descriptive statistics and nonparametric tests examined differences across race by demographic and injury characteristics. Kaplan-Meier curves estimated median days to RTL, iRTP protocol, RTP protocol completion, and URTP by race and covariate measures. Multivariable Cox proportional hazards regression assessed the effect of race on risk of RTL and RTP recovery time points. RESULTS SA largely identified as White (75%) followed by Black (14%), multiracial (7%), and Asian (3%). More than half (53%) of all SA reported a household income of >$120,000, whereas 41% of Black SA reported a household income <$60,000. Race was not associated with relative risk of RTL or iRTP but was associated with RTP protocol completion and URTP. Non-Black/non-White SA were 17% less likely (adjusted hazard ratio = 0.83; 95% confidence interval = 0.71, 0.97) to complete the RTP protocol, and Black SA were 17% more likely (adjusted hazard ratio = 1.17; 95% confidence interval = 1.05, 1.31) to reach the URTP time point compared with White SA. CONCLUSIONS The present findings suggest collegiate SA enrolled in the Concussion Assessment, Research, and Education Consortium are primarily White and come from household incomes well above the US median. Race was not associated with RTL or iRTP but was associated with RTP protocol duration and total time to URTP. Clinicians should be conscientious of how their implicit or preconceived biases may influence SRC management among National Collegiate Athletic Association SA.
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Affiliation(s)
- Adrian J Boltz
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI
| | - Allyssa K Memmini
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM
| | - Benjamin L Brett
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI
| | - Traci R Snedden
- School of Nursing, University of Wisconsin-Madison, Madison, WI
| | | | - Avinash Chandran
- Datalys Center for Sports Injury Research and Prevention, Indianapolis, IN
| | - Darryl P Conway
- Department of Athletics, University of Michigan, Ann Arbor, MI
| | - Rushil Shah
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI
| | - Paul F Pasquina
- Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Michael A McCrea
- Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI
| | - Christina L Master
- Perelman School of Medicine at the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI
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Rice EN, Lan RH, Nunes JC, Shah R, Clark K, Periyakoil VS, Chen JH, Lin B, Echols M, Awad C, Idris MY, Cruz ER, Poullos PD, Lewis EF, Brown‐Johnson C, Igwe J, Shen S, Palaniappan L, Stefanick ML, Ritter V, Pemu P, Rodriguez F, Deb B, Pundi K, Wang PJ. Who Are We Missing? Reporting of Transgender and Gender-Expansive Populations in Clinical Trials. J Am Heart Assoc 2023; 12:e030209. [PMID: 37947088 PMCID: PMC10727288 DOI: 10.1161/jaha.123.030209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/31/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Eli N. Rice
- Stanford University School of MedicineStanfordCAUSA
| | - Roy H. Lan
- Stanford University School of MedicineStanfordCAUSA
| | | | - Rushil Shah
- Stanford University School of MedicineStanfordCAUSA
| | - Kira Clark
- Stanford University School of MedicineStanfordCAUSA
| | | | | | - Bryant Lin
- Stanford University School of MedicineStanfordCAUSA
| | | | | | | | | | | | | | | | - Joseph Igwe
- Stanford University School of MedicineStanfordCAUSA
| | - Sa Shen
- Stanford University School of MedicineStanfordCAUSA
| | | | | | | | | | | | - Brototo Deb
- Georgetown University School of MedicineWashingtonDCUSA
| | | | - Paul J. Wang
- Stanford University School of MedicineStanfordCAUSA
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11
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Lan RH, Rice EN, Nunes JC, Shah R, Igwe J, Clark K, Periyakoil VS, Chen JH, Lin B, Awad C, Idris M, Cruz ER, Lewis EF, Johnson CB, Wang PJ. Disabilities Reporting in Cardiac Clinical Trials: How Are We Doing? J Am Heart Assoc 2023; 12:e029726. [PMID: 37949834 PMCID: PMC10727282 DOI: 10.1161/jaha.123.029726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/24/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Roy H. Lan
- Stanford University School of MedicineStanfordCAUSA
| | - Eli N. Rice
- Stanford University School of MedicineStanfordCAUSA
| | | | - Rushil Shah
- Stanford University School of MedicineStanfordCAUSA
| | | | - Kira Clark
- Stanford University School of MedicineStanfordCAUSA
| | | | | | - Bryant Lin
- Stanford University School of MedicineStanfordCAUSA
| | | | | | | | | | | | - Paul J. Wang
- Stanford University School of MedicineStanfordCAUSA
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12
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Asher S, Shah R, Ings S, Horder J, Newrick F, Nesr G, Kesse Adu R, Streetly M, Trompeter S, Lee L, Wisniowski B, Mahmood S, Xu K, Papanikalaou X, McMillan A, Popat R, Yong K, Sive J, Kyriakou C, Rabin N. Haematopoietic stem cell mobilisation followed by high-dose chemotherapy and autologous stem cell transplantation for patients with sickle cell disease and myeloma. Br J Haematol 2023; 202:1224-1227. [PMID: 37488061 DOI: 10.1111/bjh.18990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/12/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Affiliation(s)
- S Asher
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Shah
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - S Ings
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - J Horder
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - F Newrick
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - G Nesr
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Kesse Adu
- Department of Haematology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - M Streetly
- Department of Haematology, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - S Trompeter
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - L Lee
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - B Wisniowski
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - S Mahmood
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - K Xu
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - X Papanikalaou
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - A McMillan
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - R Popat
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - K Yong
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - J Sive
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - C Kyriakou
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
| | - N Rabin
- Department of Haematology, University College Hospital London NHS Foundation Trust, London, UK
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13
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Gasperetti A, Assis F, Tripathi H, Suzuki M, Gonuguntla A, Shah R, Sampognaro J, Schiavone M, Karmarkar P, Tandri H. Determinants of acute irreversible electroporation lesion characteristics after pulsed field ablation: the role of voltage, contact, and adipose interference. Europace 2023; 25:euad257. [PMID: 37649337 PMCID: PMC10485186 DOI: 10.1093/europace/euad257] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
AIMS Pulsed field ablation (PFA) is a non-thermal ablative approach in which cardiomyocyte death is obtained through irreversible electroporation (IRE). Data correlating the biophysical characteristics of IRE and lesion characteristics are limited. The aim of this study was to assess the effect of different procedural parameters [voltage, number of cycles (NoCs), and contact] on lesion characteristics in a vegetal and animal model for IRE. METHODS AND RESULTS Two hundred and four Russet potatoes were used. Pulsed field ablation lesions were delivered on 3 cm cored potato specimens using a multi-electrode circular catheter with its dedicated IRE generator. Different voltage (from 300 to 1200 V) and NoC (from 1 to 5×) protocols were used. The impact of 0.5 and 1 mm catheter-to-specimen distances was tested. A swine animal model was then used to validate the results observed in the vegetable model. The association between voltage, the NoCs, distance, and lesion depth was assessed through linear regression. An almost perfect linear association between lesion depth and voltage was observed (R2 = 0.95; P < 0.001). A similarly linear relationship was observed between the NoCs and the lesion depth (R2 = 0.73; P < 0.001). Compared with controls at full contact, a significant dampening on lesion depth was observed at 0.5 mm distance (1000 V 2×: 2.11 ± 0.12 vs. 0.36 ± 0.04, P < 0.001; 2.63 ± 0.10 vs. 0.43 ± 0.08, P < 0.001). No lesions were observed at 1.0 mm distance. CONCLUSION In a vegetal and animal model for IRE assessment, PFA lesion characteristics were found to be strongly dependent on voltage settings and the NoCs, with a quasi-linear relationship. The lack of catheter contact was associated with a dampening in lesion depth.
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Affiliation(s)
- Alessio Gasperetti
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Fabrizio Assis
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Hemantkumar Tripathi
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Masahito Suzuki
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Akhilesh Gonuguntla
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Rushil Shah
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - James Sampognaro
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
| | - Marco Schiavone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milano, Italy
| | - Parag Karmarkar
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Harikrishna Tandri
- Division of Cardiology, School of Medicine, Johns Hopkins University, 600 N. Wolfe St. Blalock 545, Baltimore, MD 21287, USA
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14
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Yeo AT, Shah R, Aliazis K, Pal R, Xu T, Zhang P, Rawal S, Rose CM, Varn FS, Appleman VA, Yoon J, Varma H, Gygi SP, Verhaak RG, Boussiotis VA, Charest A. Driver Mutations Dictate the Immunologic Landscape and Response to Checkpoint Immunotherapy of Glioblastoma. Cancer Immunol Res 2023; 11:629-645. [PMID: 36881002 PMCID: PMC10155040 DOI: 10.1158/2326-6066.cir-22-0655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/20/2022] [Accepted: 03/03/2023] [Indexed: 03/08/2023]
Abstract
The composition of the tumor immune microenvironment (TIME) is considered a key determinant of patients' response to immunotherapy. The mechanisms underlying TIME formation and development over time are poorly understood. Glioblastoma (GBM) is a lethal primary brain cancer for which there are no curative treatments. GBMs are immunologically heterogeneous and impervious to checkpoint blockade immunotherapies. Utilizing clinically relevant genetic mouse models of GBM, we identified distinct immune landscapes associated with expression of EGFR wild-type and mutant EGFRvIII cancer driver mutations. Over time, accumulation of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) was more pronounced in EGFRvIII-driven GBMs and was correlated with resistance to PD-1 and CTLA-4 combination checkpoint blockade immunotherapy. We determined that GBM-secreted CXCL1/2/3 and PMN-MDSC-expressed CXCR2 formed an axis regulating output of PMN-MDSCs from the bone marrow leading to systemic increase in these cells in the spleen and GBM tumor-draining lymph nodes. Pharmacologic targeting of this axis induced a systemic decrease in the numbers of PMN-MDSC, facilitated responses to PD-1 and CTLA-4 combination checkpoint blocking immunotherapy, and prolonged survival in mice bearing EGFRvIII-driven GBM. Our results uncover a relationship between cancer driver mutations, TIME composition, and sensitivity to checkpoint blockade in GBM and support the stratification of patients with GBM for checkpoint blockade therapy based on integrated genotypic and immunologic profiles.
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Affiliation(s)
- Alan T. Yeo
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Sackler School of Graduate Studies, Tufts University School of Medicine, Boston, Massachusetts
| | - Rushil Shah
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Konstantinos Aliazis
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Rinku Pal
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Tuoye Xu
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Piyan Zhang
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Shruti Rawal
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Frederick S. Varn
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut
| | - Vicky A. Appleman
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Joon Yoon
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hemant Varma
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Steven P. Gygi
- Department of Cell Biology, Harvard Medical School, Boston, Massachusetts
| | - Roel G.W. Verhaak
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut
| | - Vassiliki A. Boussiotis
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Al Charest
- Cancer Research Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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15
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Daniello L, Elshiaty M, Lusky F, Blasi M, Schneider M, Bozorgmehr F, Shah R, Kazdal D, Angeles A, Liersch S, Eichhorn F, Allgäuer M, Janke F, Bischoff H, Thomas M, Sültmann H, Stenzinger A, Christopoulos P. 67P Blood cell gene expression and clinical characteristics in advanced non-small cell lung cancer with immune-related adverse events. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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16
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Soulat K, Shah A, Damse S, Thiyagarajah P, Shah R. 195P Efficacy of mobile health intervention on quality of life and symptom burden in lung cancer. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00448-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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17
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Shah R, Barrett TJ, Colcelli A, Oručević F, Trombettoni A, Krüger P. Probing the Degree of Coherence through the Full 1D to 3D Crossover. Phys Rev Lett 2023; 130:123401. [PMID: 37027886 DOI: 10.1103/physrevlett.130.123401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 08/03/2022] [Accepted: 01/09/2023] [Indexed: 06/19/2023]
Abstract
We experimentally study a gas of quantum degenerate ^{87}Rb atoms throughout the full dimensional crossover, from a one-dimensional (1D) system exhibiting phase fluctuations consistent with 1D theory to a three-dimensional (3D) phase-coherent system, thereby smoothly interpolating between these distinct, well-understood regimes. Using a hybrid trapping architecture combining an atom chip with a printed circuit board, we continuously adjust the system's dimensionality over a wide range while measuring the phase fluctuations through the power spectrum of density ripples in time-of-flight expansion. Our measurements confirm that the chemical potential μ controls the departure of the system from 3D and that the fluctuations are dependent on both μ and the temperature T. Through a rigorous study we quantitatively observe how inside the crossover the dependence on T gradually disappears as the system becomes 3D. Throughout the entire crossover the fluctuations are shown to be determined by the relative occupation of 1D axial collective excitations.
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Affiliation(s)
- R Shah
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - T J Barrett
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - A Colcelli
- SISSA and INFN, Sezione di Trieste, Via Bonomea 265, I-34136 Trieste, Italy
| | - F Oručević
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - A Trombettoni
- SISSA and INFN, Sezione di Trieste, Via Bonomea 265, I-34136 Trieste, Italy
- Department of Physics, University of Trieste, Strada Costiera 11, I-34151 Trieste, Italy
| | - P Krüger
- Department of Physics and Astronomy, University of Sussex, Brighton BN1 9QH, United Kingdom
- Physikalisch-Technische Bundesanstalt, 10587 Berlin, Germany
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18
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Narasimhan B, Shah R, Assis F, Tandri HS. CLINICAL UTILITY OF CARDIAC SYMPATHETIC NEUROMODULATION IN INAPPROPRIATE SINUS TACHYCARDIA. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00649-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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19
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Lewis P, Charalel R, Andrew C, Aliaksei S, Kassin M, Dubel G, Garg T, Brooks O, Shah R, Halin N, Kleedehn M, Johnson M. Abstract No. 235 Challenges, Successes and Barriers of Structured Report Templates: A Brief Report on Survey Results. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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20
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Salvi A, Shah R, Higgins L, Menon P. Abstract No. 202 AI-Driven Regional Characterization of Peripheral Artery Disease from Maximum Intensity Projections. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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21
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Jimenez C, Stanton E, Kondra K, Nickels EM, Jacob L, Shah R, Hammoudeh JA. NUT carcinoma of the mandible in a child: case report and systematic review. Int J Oral Maxillofac Surg 2023; 52:304-312. [PMID: 35868909 DOI: 10.1016/j.ijom.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
Nuclear protein of the testis (NUT) carcinoma is a rare, undifferentiated carcinoma that is characterized by NUTM1 gene rearrangements. Patients with NUT carcinoma have an overall survival of approximately 5% at 5 years despite a multimodal treatment approach. This report illustrates the management of mandibular NUT carcinoma in a pediatric patient, complemented by a systematic review of head and neck NUT carcinoma. A 5-year-old female presented with an enlarging jaw mass that was diagnosed as BRD4-NUTM1 carcinoma and was treated with hemimandibulectomy and chemoradiation. She remains disease-free 21 months after completion of therapy. A total of 63 patient cases reported in 34 articles were identified in the review. Only 26.9% (14/52) of tumors were correctly diagnosed initially as NUT carcinoma, whereas 73.1% (38/52) were incorrectly diagnosed as another malignancy; the initial diagnosis was not reported for 11 patients. The mandibular tumor subtype was among the rarest reported (n = 1; 1.6%). Combination therapy, including surgery and chemoradiation, was the most common treatment (55.2%). The patient case presented here is a novel case of pediatric mandibular NUT carcinoma. Due to the poor overall survival of patients with NUT carcinoma, aggressive upfront resection with 2-cm margins followed by adjuvant chemoradiation is advocated.
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Affiliation(s)
- C Jimenez
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E Stanton
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - K Kondra
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - E M Nickels
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Hematology-Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - L Jacob
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - R Shah
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Hematology-Oncology, Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - J A Hammoudeh
- Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA, USA.
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22
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Manimaran P, Shah R, Trivedi P, Mehta S. Primary cutaneous neuroendocrine tumor with axillary lymph node metastasis: A clinical masquerade. J Postgrad Med 2023; 69:118-119. [PMID: 36751760 DOI: 10.4103/jpgm.jpgm_254_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- P Manimaran
- Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - R Shah
- Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - P Trivedi
- Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
| | - S Mehta
- Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India
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23
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Wang PJ, Lu Y, Mahaffey KW, Lin A, Morin DP, Sears SF, Chung MK, Russo AM, Lin B, Piccini J, Hills MT, Berube C, Pundi K, Baykaner T, Garay G, Lhamo K, Rice E, Pourshams IA, Shah R, Newswanger P, DeSutter K, Nunes JC, Albert MA, Schulman KA, Heidenreich PA, Bunch TJ, Sanders LM, Turakhia M, Verghese A, Stafford RS. Randomized Clinical Trial to Evaluate an Atrial Fibrillation Stroke Prevention Shared Decision-Making Pathway. J Am Heart Assoc 2023; 12:e028562. [PMID: 36342828 PMCID: PMC9973612 DOI: 10.1161/jaha.122.028562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Background Oral anticoagulation reduces stroke and disability in atrial fibrillation (AF) but is underused. We evaluated the effects of a novel patient-clinician shared decision-making (SDM) tool in reducing oral anticoagulation patient's decisional conflict as compared with usual care. Methods and Results We designed and evaluated a new digital decision aid in a multicenter, randomized, comparative effectiveness trial, ENHANCE-AF (Engaging Patients to Help Achieve Increased Patient Choice and Engagement for AF Stroke Prevention). The digital AF shared decision-making toolkit was developed using patient-centered design with clear health communication principles (eg, meaningful images, limited text). Available in English and Spanish, the toolkit included the following: (1) a brief animated video; (2) interactive questions with answers; (3) a quiz to check on understanding; (4) a worksheet to be used by the patient during the encounter; and (5) an online guide for clinicians. The study population included English or Spanish speakers with nonvalvular AF and a CHA2DS2-VASc stroke score ≥1 for men or ≥2 for women. Participants were randomized in a 1:1 ratio to either usual care or the shared decision-making toolkit. The primary end point was the validated 16-item Decision Conflict Scale at 1 month. Secondary outcomes included Decision Conflict Scale at 6 months and the 10-item Decision Regret Scale at 1 and 6 months as well as a weighted average of Mann-Whitney U-statistics for both the Decision Conflict Scale and the Decision Regret Scale. A total of 1001 participants were enrolled and followed at 5 different sites in the United States between December 18, 2019, and August 17, 2022. The mean patient age was 69±10 years (40% women, 16.9% Black, 4.5% Hispanic, 3.6% Asian), and 50% of participants had CHA2DS2-VASc scores ≥3 (men) or ≥4 (women). The primary end point at 1 month showed a clinically meaningful reduction in decisional conflict: a 7-point difference in median scores between the 2 arms (16.4 versus 9.4; Mann-Whitney U-statistics=0.550; P=0.007). For the secondary end point of 1-month Decision Regret Scale, the difference in median scores between arms was 5 points in the direction of less decisional regret (P=0.078). The treatment effects lessened over time: at 6 months the difference in medians was 4.7 points for Decision Conflict Scale (P=0.060) and 0 points for Decision Regret Scale (P=0.35). Conclusions Implementation of a novel shared decision-making toolkit (afibguide.com; afibguide.com/clinician) achieved significantly lower decisional conflict compared with usual care in patients with AF. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04096781.
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Affiliation(s)
- Paul J. Wang
- Stanford University Department of MedicinePalo AltoCA
| | - Ying Lu
- Stanford University Department of Biomedical Data ScienceStanfordCA
| | - Kenneth W. Mahaffey
- Stanford Center for Clinical Research Stanford University Department of MedicineStanfordCA
| | - Amy Lin
- Stanford University Department of Biomedical Data ScienceStanfordCA
| | | | - Samuel F. Sears
- East Carolina University Department of PsychologyGreenvilleNC
| | - Mina K. Chung
- Cleveland Clinic Foundation Department of MedicineClevelandOH
| | | | - Bryant Lin
- Stanford University Department of MedicinePalo AltoCA
| | | | | | | | - Krishna Pundi
- Stanford University Department of MedicinePalo AltoCA
| | - Tina Baykaner
- Stanford University Department of MedicinePalo AltoCA
| | - Gotzone Garay
- Stanford University Department of MedicinePalo AltoCA
| | - Karma Lhamo
- Stanford Center for Clinical Research Stanford University Department of MedicineStanfordCA
| | - Eli Rice
- Stanford Center for Clinical Research Stanford University Department of MedicineStanfordCA
| | | | - Rushil Shah
- Stanford University Department of MedicinePalo AltoCA
| | - Paul Newswanger
- Stanford Center for Clinical Research Stanford University Department of MedicineStanfordCA
| | | | | | - Michelle A. Albert
- University of California San Francisco Department of MedicineSan FranciscoCA
| | | | - Paul A. Heidenreich
- Stanford University Department of MedicinePalo AltoCA
- Palo Alto Veterans Administration Health Care Department of MedicinePalo AltoCA
| | - T. Jared Bunch
- University of Utah Department of MedicineSalt Lake CityUT
| | | | - Mintu Turakhia
- Stanford University Department of MedicinePalo AltoCA
- iRhythm TechnologiesSan FranciscoCA
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24
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Shah R, Sharma A, Assis F, De Vasconcellos HD, Alugubelli N, Pandey P, Akhtar T, Gasperetti A, Zhou S, Halperin H, Zimmerman SL, Tandri H, Kolandaivelu A. Quality assessment of cardiac magnetic resonance myocardial scar imaging prior to ventricular arrhythmia ablation. Int J Cardiovasc Imaging 2023; 39:411-421. [PMID: 36331683 PMCID: PMC9870828 DOI: 10.1007/s10554-022-02734-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
High-resolution scar characterization using late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is useful for guiding ventricular arrhythmia (VA) treatment. However, imaging study quality may be degraded by breath-holding difficulties, arrhythmias, and implantable cardioverter-defibrillators (ICDs). We evaluated the effect of image quality on left ventricle (LV) base to apex scar interpretation in pre-VA ablation LGE-CMR. 43 consecutive patients referred for VA ablation underwent gradient-recalled-echo LGE-CMR. In ICD patients (n = 24), wide-bandwidth inversion-recovery suppressed ICD artifacts. In non-ICD patients, single-shot steady-state free-precession LGE-CMR could also be performed to reduce respiratory motion/arrhythmia artifacts. Study quality was assessed for adequate/limited scar interpretation due to cardiac/respiratory motion artifacts, ICD-related artifacts, and image contrast. 28% of non-ICD patients had studies where image quality limited scar interpretation in at least one image compared to 71% of ICD patient studies (p = 0.012). A median of five image slices had limited quality per ICD patient study, compared to 0 images per non-ICD patient study. Poorer quality in ICD patients was largely due to motion-related artifacts (54% ICD vs 6% non-ICD studies, p = 0.001) as well as ICD-related image artifacts (25% of studies). In VA ablation patients with ICDs, conventional CMR protocols frequently have image slices with limited scar interpretation, which can limit whole-heart scar assessment. Motion artifacts contribute to suboptimal image quality, particularly in ICD patients. Improved methods for motion and ICD artifact suppression may better delineate high-resolution LGE scar features of interest for guiding VA ablation.
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Affiliation(s)
- Rushil Shah
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Apurva Sharma
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Fabrizio Assis
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Henrique Doria De Vasconcellos
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Navya Alugubelli
- Division of Cardiology, Department of Medicine, Creighton University, Omaha, NE USA
| | - Pallavi Pandey
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Tauseef Akhtar
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Alessio Gasperetti
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Shijie Zhou
- Department of Chemical, Paper and Biomedical Engineering, Miami University, Oxford, OH USA ,Department of Electrical and Chemical Engineering, Miami University, Oxford, OH USA
| | - Henry Halperin
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Stefan L. Zimmerman
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Harikrishna Tandri
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Aravindan Kolandaivelu
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Carnegie 528, 600 N. Wolfe St, Baltimore, MD 21287 USA
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25
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Gessner C, Griesinger F, Shah R, Talbot T, Venkateshan S, Vadanahalli Shankar A, Seluzhytsky A, Marsden D. 119TiP An observational study to assess the effectiveness and safety of cemiplimab in patients with advanced non-small cell lung cancer (NSCLC) in routine clinical practice within Europe (CEMI-LUNG). Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Homicsko K, Zygoura P, Tissot S, Norkin M, Popat S, Curioni-Fontecedro A, O'Brien M, Pope T, Shah R, Kammler R, Finn S, Coukos G, Dafni U, Peters S, Stahel R. 11P Association of VISTA-expressing CD66b-positive neutrophils, with response and survival benefit from pembrolizumab in advanced malignant pleural mesothelioma. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Yenyuwadee S, Aliazis K, Wang Q, Christofides A, Shah R, Patsoukis N, Boussiotis VA. Immune cellular components and signaling pathways in the tumor microenvironment. Semin Cancer Biol 2022; 86:187-201. [PMID: 35985559 PMCID: PMC10735089 DOI: 10.1016/j.semcancer.2022.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022]
Abstract
During the past decade there has been a revolution in cancer therapeutics by the emergence of antibody-based and cell-based immunotherapies that modulate immune responses against tumors. These new therapies have extended and improved the therapeutic efficacy of chemo-radiotherapy and have offered treatment options to patients who are no longer responding to these classic anti-cancer treatments. Unfortunately, tumor eradication and long-lasting responses are observed in a small fraction of patients, whereas the majority of patients respond only transiently. These outcomes indicate that the maximum potential of immunotherapy has not been reached due to incomplete knowledge of the cellular and molecular mechanisms that guide the development of successful anti-tumor immunity and its failure. In this review, we discuss recent discoveries about the immune cellular composition of the tumor microenvironment (TME) and the role of key signaling mechanisms that compromise the function of immune cells leading to cancer immune escape.
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Affiliation(s)
- Sasitorn Yenyuwadee
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Konstantinos Aliazis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Qi Wang
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Anthos Christofides
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Rushil Shah
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Nikolaos Patsoukis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School; Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA 02215, USA.
| | - Vassiliki A Boussiotis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center; Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School; Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA 02215, USA.
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Shah R, Shah PP, Nahar P, Patidar S, Patidar S, Jain R. Spatial Relationship of Maxillary Posterior Teeth with Maxillary Sinus Floor in Sagittal, Coronal and Axial Planes by Using Cone-Beam Computed Tomography in a Subpopulation of Central India. Mymensingh Med J 2022; 31:1162-1169. [PMID: 36189567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Inadvertent perforation of the root apex during endodontic procedure in maxillary posterior teeth may unnecessarily invite the complications of sinusitis or inflammatory responses. This becomes even more important when performing endodontic surgical procedures. Thus, it is mandatory to have the precise knowledge of anatomic structures which are in close proximity to the apex of roots and its variations among different geographic area. This retrospective observational study was performed in the Central India to assess the spatial relationships between the maxillary second pre-molar (sPM), maxillary first molar (M1), maxillary second molar (M2) with the maxillary sinus floor using cone beam computed tomography (CBCT) in all three axial, sagittal and coronal sections from year 2016 to 2021. Three hundred and sixty teeth were examined through sixty full volumes CBCT scans of the patients in between year 2016-2021 in Indore, (MP, India). The Distances (D) between the examined roots and the sinus floor, were evaluated using CBCT in all three sections, and grouped in 7 classes. To simplify, Class 1 and 2 were grouped as Negative Configuration where apices are protruding into sinus floor, Class 3 as Zero and Class 4-7 as Positive configuration. The data were analyzed statistically using SPSS system. The prevalence of class 1 and 2 (negative configuration) was the highest for the Palatal of M1 (16.67%) followed by Distobuccal of M1 (13.34%). The prevalence of class 3 that is Zero configuration was the highest for the Mesiobuccal of M2 (63.33%). The results suggested all the three teeth roots showed closed proximity with sinus floor, closest relationship with the sinus floor was seen in palatal of M1 in this study.
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Affiliation(s)
- R Shah
- Dr Ruchi Shah, Reader, Department of Conservative Dentistry and Endodontics, KM Shah Dental College and Hospital, Sumandeep Vidhyapeeth, Vadodara, Gujarat, India; E-mail:
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Lusky F, Schindler H, Elshiaty M, Gaissmaier L, Daniello L, Bozorgmehr F, Kuon J, Shah R, Schneider M, Eichhorn F, Trudzinski F, Angeles A, Janke F, Kirchner M, Kazdal D, Stenzinger A, Sültmann H, Thomas M, Christopoulos P. EP08.01-031 Blood Gene Expression Changes in Metastatic Lung Cancer under second-line Immunotherapy according to Clinical Response. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Nathan P, Grob J, Dummer R, Ascierto P, Ribas A, Robert C, Schadendorf D, Flaherty K, Tawbi H, Hauschild A, Mandala M, Shah R, Banerjee H, Sarkar R, Lau M, Long G. 819P Efficacy of dabrafenib (D) trametinib (T) plus spartalizumab (S) by baseline site of metastases in patients (pts) with previously untreated BRAF V600-mutant unresectable or metastatic melanoma: Post hoc analysis of phase III COMBI-i trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Shah R, Memmini AK, Brett BL, McCrea MA, McAllister TW, Broglio SP. Socioeconomic Status Of NCAA Student-athletes: Findings From The NCAA-DoD Care Consortium. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878328.51192.8e] [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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Shah R. 1641TiP Adjuvant nivolumab with chemotherapy in pleural mesothelioma: The NICITA trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Broglio SP, Memmini AK, Brett B, Shah R, Shea HD, McAllister TW, McCrea MA. Distribution Of Parent Occupations Among Ncaa Student-athletes: Findings From The Ncaa-dod Care Consortium. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878336.17489.ba] [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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Memmini AK, Shah R, Brett BL, McCrea MA, McAllister TW, Broglio SP. Differences In Socioeconomic Status Based On Race And Ethnicity Among Collegiate Student-athletes. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878324.55206.a5] [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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Shah R, Rahman S, Pywell M, Ibanez J. 107 A Rare Presentation of a Giant, Multi-Compartmental Lipoma of the Hand Causing Median Nerve Compression. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.115] [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: 11/05/2022]
Abstract
Abstract
Lipomas are the commonest benign tumour, made up exclusively of adipose tissue, and can arise anywhere in the body. However, giant lipomas of the hand, defined as greater than 5cm in diameter, are rare. They have the potential to invade and cause a multitude of symptoms due to the compression and proximity of underlying structures.
We describe a case of a 64-year-old woman who presents with a swelling of the left thenar eminence, associated with numbness and tingling in all fingers.
MRI and nerve conduction studies confirmed the diagnosis of a lipoma causing median nerve compression. The patient underwent elective surgical excision using a volar approach, with good postoperative recovery. The excised lesion, measuring 12x7x2.4cm, is the largest giant lipoma of the hand reported in literature, and the first to demonstrate invasion from the mid palmar space into both the dorsal sub-aponeurotic space and carpal tunnel.
Space occupying lesions, such as giant lipomas of the hand, are a rare but important secondary cause of compression neuropathies of the upper extremity and must be suspected when these neuropathies present with atypical symptomatology. Any patient presenting with a soft-tissue lesion of the hand demonstrating rapid growth, pain or large size must be thoroughly investigated to rule out malignancy. MRI forms an essential part of the workup in such cases due to its high diagnostic accuracy. Malignant transformation of giant lipomas of the hand is extremely rare, and such lesions can be removed by en bloc marginal resection with excellent postoperative results.
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Affiliation(s)
- R Shah
- Guys’ and St Thomas NHS foundation Trust , London , United Kingdom
| | - S Rahman
- Guys’ and St Thomas NHS Foundation Trust , London , United Kingdom
| | - M Pywell
- Guys’ and St Thomas NHS Foundation Trust , London , United Kingdom
| | - J Ibanez
- Guys’ and St Thomas NHS Foundation Trust , London , United Kingdom
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Yenyuwadee S, Sanchez-Trincado Lopez JL, Shah R, Rosato PC, Boussiotis VA. The evolving role of tissue-resident memory T cells in infections and cancer. Sci Adv 2022; 8:eabo5871. [PMID: 35977028 PMCID: PMC9385156 DOI: 10.1126/sciadv.abo5871] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/05/2022] [Indexed: 06/12/2023]
Abstract
Resident memory T cells (TRM) form a distinct type of T memory cells that stably resides in tissues. TRM form an integral part of the immune sensing network and have the ability to control local immune homeostasis and participate in immune responses mediated by pathogens, cancer, and possibly autoantigens during autoimmunity. TRM express residence gene signatures, functional properties of both memory and effector cells, and remarkable plasticity. TRM have a well-established role in pathogen immunity, whereas their role in antitumor immune responses and immunotherapy is currently evolving. As TRM form the most abundant T memory cell population in nonlymphoid tissues, they are attractive targets for therapeutic exploitation. Here, we provide a concise review of the development and physiological role of CD8+ TRM, their involvement in diseases, and their potential therapeutic exploitation.
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Affiliation(s)
- Sasitorn Yenyuwadee
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jose Luis Sanchez-Trincado Lopez
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Laboratory of Immunomedicine, School of Medicine, Complutense University of Madrid, Ave Complutense S/N, 28040 Madrid, Spain
| | - Rushil Shah
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Cornell University, Ithaca, NY 14850 , USA
| | - Pamela C. Rosato
- The Geisel School of Medicine at Dartmouth, Lebanon, NH 03755, USA
| | - Vassiliki A. Boussiotis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Shah R, Kiely A, McKirdy S. 709 Two-Layer Biodegradable Temporizing Matrix Reconstruction of Abdominal Wall Dermatofibrosarcoma Protuberans. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.149] [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: 11/05/2022]
Abstract
Abstract
Dermatofibrosarcoma protuberans (DFSP) is a rare, locally invasive dermal sarcoma. The management is generally surgical, with wide local excision (WLE) forming the mainstay of treatment. Large abdominal wall defects are most aesthetically reconstructed using pedicled or free flaps; however, these require tumour-free surgical margins, and can cause donor site morbidity. We describe an alternative, aesthetic, and low-morbidity technique for abdominal wall reconstruction following WLE of DFSP, using 2 layers of a novel synthetic dermal matrix (NovoSorb® BTM).
25-year-old women presented with a large DFSP involving the right anterior-abdominal wall. After WLE with 3cm margins, BTM was implanted to the large sub-fascial abdominal wall defect. At 6 weeks, after histological confirmation of tumour-free margins, a second layer of BTM was applied to improve the significant contour deformity of the wound bed. After complete integration by 7 weeks, a split-thickness skin graft was harvested from the right thigh and fixed to the new dermis.
At 14-days postoperatively, the skin graft had fully taken, and donor site healed. By 8 weeks, the scar had started to mature with no obvious contour defect or contracture. Overall, the patient was satisfied with the functional and aesthetic outcome.
To our knowledge, a two-layer reconstruction using an artificial dermal matrix has never been described for abdominal wall reconstruction. We found that double-layer BTM is able to restore the inherent thickness and pliability of skin in complex abdominal wall reconstruction following WLE of DFSP and offers improved durability and cosmesis compared to skin grafting or indeed single layer skin substitutes alone.
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Affiliation(s)
- R Shah
- Royal Preston Hospital , Preston , United Kingdom
| | - A Kiely
- Royal Preston Hospital , Preston , United Kingdom
| | - S McKirdy
- Royal Preston Hospital , Preston , United Kingdom
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Parmekar S, Shah R, Gokulakrishnan G, Gowda S, Castillo D, Iniguez S, Gallegos J, Sisson A, Thammasitboon S, Pammi M. Components of interprofessional education programs in neonatal medicine: A focused BEME review: BEME Guide No. 73. Med Teach 2022; 44:823-835. [PMID: 35319316 DOI: 10.1080/0142159x.2022.2053086] [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] [Indexed: 06/14/2023]
Abstract
BACKGROUND Care delivery in neonatology is dependent on an interprofessional team. Collaborative learning and education amongst professionals can lead to successful management of critically ill patients. This focused BEME review synthesized the components, outcomes, and impact of such interprofessional education (IPE) programs in neonatal medicine. METHODS The authors systematically searched four online databases and hand-searched MedEdPublish up to 10 September 2020. Two authors independently screened titles, abstracts, full-texts, performed data extraction and risk of bias assessment related to study methodology and reporting. Discrepancies were resolved by a third author. We reported our findings based on BEME guidance and the STORIES (STructured apprOach to the Reporting in health education of Evidence Synthesis) statement. RESULTS We included 17 studies on IPE in neonatal medicine. Most studies were from North America with varying learners, objectives, instruction, and observed outcomes. Learners represented nurses, respiratory therapists, neonatal nurse practitioners, patient care technicians, parents, early interventionists, physicians, and medical trainees amongst others. Risk of bias assessment in reporting revealed poor reporting of resources and instructor training. Bias assessment for study methodology noted moderate quality evidence with validity evidence as the weakest domain. IPE instruction strategies included simulation with debriefing, didactics, and online instruction. Most studies reported level 1 Kirkpatrick outcomes (76%) and few reported level 3 or 4 outcomes (23%). Challenges include buy-in from leadership and the negative influence of hierarchy amongst learners. CONCLUSIONS This review highlights IPE program components within neonatal medicine and exemplary practices including a multimodal instructional approach, asynchronous instruction, an emphasis on teamwork, and elimination of hierarchy amongst learners. We identified a lack of reporting on program development and instructor training. Future work should address long term knowledge and skill retention and impact on patient outcomes and organizations.
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Affiliation(s)
- S Parmekar
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - R Shah
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - G Gokulakrishnan
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - S Gowda
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - D Castillo
- Texas Children's Hospital, Houston, TX, USA
| | - S Iniguez
- Texas Children's Hospital, Houston, TX, USA
| | - J Gallegos
- Texas Children's Hospital, Houston, TX, USA
| | - A Sisson
- The Texas Medical Center Library, Houston, TX, USA
| | - S Thammasitboon
- Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Center for Research, Innovation and Scholarship in medical Education, Texas Children's Hospital, Houston, TX, USA
| | - M Pammi
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Livingstone J, Raveh Y, Souki F, Shatz V, Shah R, Ibrahim T, Shuman M, Beduschi T, Vianna R, Alvarez R, Nicolau-Raducu R. Multivisceral Transplant in a Patient With Portopulmonary Hypertension: A Case Report. Transplant Proc 2022; 54:1664-1670. [PMID: 35914967 DOI: 10.1016/j.transproceed.2022.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022]
Abstract
Portopulmonary hypertension, a type of pulmonary arterial hypertension in the setting of cirrhotic or noncirrhotic portal hypertension, is associated with elevated morbidity and mortality during and after transplantation. Uncontrolled portopulmonary hypertension may prevent or delay listing for transplant candidates, and the prognosis without treatment and ultimately transplant is extremely poor. We present a 29-year-old White woman, who had a post-liver transplant at infancy due to biliary atresia. Later on, she developed extensive portal vein thrombosis and portopulmonary hypertension and underwent a multivisceral transplant (liver, stomach, pancreaticoduodenal complex, and small and large intestine). Preoperative mean pulmonary artery pressure was <30 mm Hg with a pulmonary vascular resistance of <300 dynes.s/cm5 on oral sildenafil and intravenous epoprostenol. Intraoperatively, management required comprehensive transfusion protocols, a careful balance between correcting blood loss and preventing thrombosis. Intravenous epoprostenol, sildenafil, milrinone, and inhaled nitric oxide were used to reduce elevated mean pulmonary artery pressure and right ventricular strain associated with vascular clamping, reperfusion, and massive fluid shifts. Nitric oxide and epoprostenol use unleashed antiplatelet effects on a patient already susceptible to coagulopathy. A multimodal and multidisciplinary approach continued throughout the surgery and in the postoperative period, which led to a successful outcome.
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Affiliation(s)
- J Livingstone
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - Y Raveh
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - F Souki
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - V Shatz
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - R Shah
- Miami Transplant Institute, University of Miami/Jackson Memorial Hospital, Miami, Florida; Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - T Ibrahim
- Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - M Shuman
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - T Beduschi
- Miami Transplant Institute, University of Miami/Jackson Memorial Hospital, Miami, Florida; Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - R Vianna
- Miami Transplant Institute, University of Miami/Jackson Memorial Hospital, Miami, Florida; Department of Surgery, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - R Alvarez
- Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida
| | - R Nicolau-Raducu
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida.
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Fong J, Bernacki K, Pham D, Shah R, Tan Y, Oetomo D. Exploring the Utility of Crutch Force Sensors to Predict User Intent in Assistive Lower Limb Exoskeletons. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176137 DOI: 10.1109/icorr55369.2022.9896511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The adoption of assistive lower limb exoskeletons in built environments is reliant on the further development of these devices to handle the varied conditions experienced in everyday life. The required development includes more varied and flexible gait patterns, but also appropriate user interfaces to enable fluid gait. This work explores the properties of an algorithm used to predict user intent based on sensors onboard a user-balanced robotic exoskeleton system. Specifically, classification algorithms built with different input data sets are compared - with varying detail of the interaction forces between the crutches and the ground, and the duration of the data sample used to make the prediction. Data were collected with one able-bodied participant using an exoskeleton, training three independent classifiers corresponding to different exoskeleton states. The results indicate the value of including information about the interaction forces between the crutches and the ground in improving prediction accuracy, with increasing prediction window also generally resulting in an increase in prediction accuracy. Whilst no categorical recommendation can be made with respect to either parameter, these results provide a baseline which can be used in conjunction deliberate consideration of the costs associated with implementation.
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, 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Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Abstract
Methotrexate leading to hypercalcaemia is a rarely reported adverse event. We present three elderly patients with inflammatory arthritis who developed hypercalcemia probably due to methotrexate-induced granulomatous pneumonitis. All patients presented with worsening non-productive cough with dyspnea, nausea, loss of appetite, and confusion. Their clinical and radiologic features were consistent with methotrexate-induced pneumonitis. On evaluation, all patients concurrently had hypercalcemia with normal 25OH D3, and low PTH with markedly elevated levels of 1,25OH D3 seen in two patients. In all three patients, hypercalcemia and pneumonia responded to hydration, corticosteroids, and methotrexate withdrawal. There was no relapse of symptoms on long term follow-up. In these three patients with inflammatory arthritis, methotrexate-induced pneumonitis led to symptomatic hypercalcemia. Unless hypercalcemia is looked for and treated in this setting, the morbidity can be high.
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Affiliation(s)
- R Samant
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - S Yadav
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - A Khune
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
| | - R Shah
- Department of Rheumatology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India
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Mroue J, Saouma S, Lafferty J, Ali H, Mehta V, El-Khoury M, Weinberg M, Kowalski M, Epstein L, Akhrass P, Parikh V, Shah R, Yacoub H. 472 Proximity Of Coronary Arteries To Tricuspid Annulus As Determined By Computed Tomography. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Phyo AZZ, Ryan J, Gonzalez-Chica D, Stocks N, Woods R, Murray A, Reid C, Nelson M, Tonkin A, Storey E, Gasevic D, Orchard, Shah R, Freak-Poli R. 1005 HEALTH-RELATED QUALITY OF LIFE AND FUTURE RISK OF HEALTH OUTCOMES AMONG OLDER ADULTS LIVING IN AUSTRALIA AND THE UNITED STATES. Age Ageing 2022. [DOI: 10.1093/ageing/afac124.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Poor health-related quality of life (HRQoL) is associated with higher morbidity and mortality in patient populations. However, whether HRQoL is associated with health outcomes among community-dwelling older people requires further investigation. This study aimed to examine whether HRQoL predicts cognitive decline, dementia, cardiovascular disease (CVD), and mortality in community-dwelling older people living in Australia and the United States.
Method
A cohort of 19,106 individuals from the ASPirin in Reducing Events in the Elderly (ASPREE) study, aged 65–98 years, initially free of dementia or CVD, and who completed the HRQoL 12-item short form (SF-12, version-2) at baseline (2010–2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were generated using standardized norm-based method.
Results
Over a median of 4.7 years, there were 2,412 cognitive declines, 574 dementia, 922 incident CVD events, and 1,052 deaths. Using Cox proportional-hazard regression adjusted for a range of covariates, every 10-unit increase in PCS was associated with a 6% lower risk of cognitive decline, a 14% lower risk of incident CVD, and 17% lower risk of all-cause mortality, but was not associated with incident dementia. In contrast, higher MCS was only associated with a 12% and 15% lower risk of cognitive decline and dementia, respectively. Findings did not differ by sex.
Conclusion
Our study provides some of the first evidence that HRQoL can be used in combination with clinical data to identify the future risks of health outcomes among older individuals living in the community. Our findings support the decision of the Australian Commission on Safety and Quality in Health Care to incorporate the SF-12 into the annual Patient-Reported Outcome Measures (PROMs assessment.
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Affiliation(s)
| | - J Ryan
- Monash University , Australia
| | | | - N Stocks
- The University of Adelaide , Australia
| | - R Woods
- Monash University , Australia
| | - A Murray
- Berman Center for Outcomes and Clinical Research , Minneapolis, Minnesota, USA
| | - C Reid
- Monash University , Australia
- Curtin University , Australia
| | - M Nelson
- Monash University , Australia
- University of Tasmania , Australia
| | | | | | - D Gasevic
- Monash University , Australia
- University of Edinburgh , UK
| | - Orchard
- Monash University , Australia
| | - R Shah
- Rush University Medical Center , Chicago, Illinois, USA
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Shah R, Christofides A, Aksoylar HI, Pal R, Boussiotis VA, Patsoukis N. Loss of the nuclear receptor PPARγ primes CD8+ T cells for exhaustion. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.55.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Peroxisome proliferator activated receptors (PPARs) are transcription factors that belong to nuclear hormone superfamily, with three distinct types identified: PPARapha (PPARα), PPARgamma (PPARγ), and PPARbeta/delta (PPARβ/δ). The role of PPARγ in the immune system has been mainly studied in macrophages, where it is known to mediate M2 polarization. Synthetic ligands for activating PPARγ ameliorate disease outcomes in various models of inflammation and autoimmunity. Here, we investigated how PPARγ affects antigen-specific effector and memory responses of CD8+ T cells using OT-I TCR transgenic mice and OT-I mice with T cell-specific PPARγ deletion. During CD8+ T effector differentiation in vitro by IL-2 culture following stimulation with cognate antigen, PPARγ deletion resulted in a rapid and enhanced T effector cell expansion and activation. However, PPARγ deficient OTI cells were more prone to exhaustion. This effect coincided with decreased mitochondrial fitness and spare respiratory capacity, high ROS levels and a significant increase in oxidized lipids. During generation of T effector cells in vivo, PPARγ deletion resulted in similar outcomes. At the memory phase there were no numerical differences in the T memory subsets in vivo, but upon rechallenge in vitro, PPARγ-deficient antigen-specific T cells had impaired capacity for effector differentiation. Our findings uncover a new role of PPARγ in CD8+ T responses and indicate that PPARγ has an indispensable role in regulating metabolism-mediated cues that imprint T cell differentiation and long-term effector capacity.
Supported by RO1CA212605, RO1CA229784-01, RO1CA238263 (to VAB)
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Affiliation(s)
- Rushil Shah
- 1Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School
- 2Cornell Univ
| | - Anthos Christofides
- 3Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School
| | | | - Rinku Pal
- 3Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School
| | | | - Nikolaos Patsoukis
- 3Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School
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Bhattarai R, Acharya S, Shah R. P.47 Spinal anaesthesia for caesarean section in high altitude and low altitude: a comparative cross-sectional study. Int J Obstet Anesth 2022. [DOI: 10.1016/j.ijoa.2022.103343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shah R, Dodd M, Allen E, Viner R, Bonell C. Is being a victim of bullying or cyberbullying in secondary school associated with subsequent risk-taking behavior in adolescence? A longitudinal study in secondary schools. J Adolesc 2022; 94:611-627. [PMID: 35484876 DOI: 10.1002/jad.12050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Neurobiological and social changes in adolescence can make victims of bullying more susceptible to subsequent impulsive behavior. With the high prevalence of bullying in schools and rise in cyberbullying in the United Kingdom, it is important that the health impacts of bullying victimization, including on risk-taking, are understood. Our study aims to investigate whether bullying/cyberbullying victimization is associated with subsequent health risk-taking behavior in adolescence. Risk-taking behavior includes electronic cigarette and cigarette smoking, alcohol consumption, illicit drug use, early sexual debut, weapon carrying, damaging property, and setting fire. METHODS A secondary quantitative analysis of data from 3337, English, secondary school students in the control arm of the INCLUSIVE trial, constituting an observational cohort. Bullying victimization was measured at baseline (age 11/12 years) using the gatehouse bullying scale and a separate question on cyberbullying victimization. Logistic regression was used to test for an association between bullying/cyberbullying victimization at baseline and risk-taking behavior at 36 months, adjusting for baseline risk-taking behavior and other potential confounders, and accounting for school clustering. RESULTS There was strong evidence (p ≤ .02) for a positive dose-responsive association between being bullied at baseline and nearly all risk-taking behavior at follow-up. Although there was no evidence for an association between being bullied at baseline and weapon carrying (p = .102), there was evidence for a positive association between being cyberbullied at baseline and weapon carrying (p = .036). CONCLUSIONS It is plausible that bullying/cyberbullying victimization increases the likelihood of subsequent risk-taking behavior in adolescence. Policy options should focus on implementing evidence-based antibullying school interventions.
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Affiliation(s)
- R Shah
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - M Dodd
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - E Allen
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - R Viner
- Institute of Child Health, University College London, London, UK
| | - C Bonell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Calabrese D, Singer J, Hays S, Leard L, Golden J, Kolaitis N, Kleinhenz M, Shah R, Venado A, Kukreja J, Belperio J, Weigt S, Greenland J, Looney M. Bronchoalveolar Lavage MICB is Associated with Severe Primary Graft Dysfunction, Prolonged Mechanical Ventilation, and Low Post-Transplant FEV1 in Lung Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Seijo L, Smith P, Greenland J, Gao Y, Kolaitis N, Venado A, Hays S, Thakur N, Kukreja J, Leard L, Golden J, Shah R, Kleinhenz M, Perez A, Trinh B, Betancourt L, Medikonda N, Calabrese D, Blanc P, Katz P, Singer J. Worsening in the Lung Transplant-Valued Life Activities Scale is Associated with Mortality in Lung Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Nguyen A, Trinh B, Deuse T, Singer J, Hays S, Venado A, Leard L, Shah R, Kleinhenz M, Kolaitis N, Calabrese D, Greenland J, Golden J, Brzezinski M, Kukreja J. Short-Term Outcomes of Lung Transplantation for COVID-19 ARDS: A Single Center Experience. J Heart Lung Transplant 2022. [PMCID: PMC8988588 DOI: 10.1016/j.healun.2022.01.1217] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose The outcomes of lung transplant (LTx) for COVID-19 related lung disease are continuing to be examined. This study describes our experience in the first 7 cases. Methods This study included all patients received double LTx (DLTx) for COVID-19 acute respiratory distress syndrome (ARDS) between November 2020 and October 2021. Patient pre-LTx and perioperative characteristics as well as post-LTx outcomes are presented. Results Seven patients underwent DLTx for COVID-19 ARDS. All required mechanical ventilation (MV) pre-LTx. Six patients were male (85%), 5 Hispanic (71%), with a median age of 48 (IQR 40-53) and median body mass index of 23.6 (IQR 21.7-25.6). Six patients (85%) were on veno-venous extracorporeal membrane oxygenation (VV-ECMO) pre-LTx (one conversion from VV to veno-arterial (VA)). Median duration of MV and ECMO pre-LTx was 140 days (IQR 82-165) and 71.5 days (IQR 58-149), respectively. Two patients developed acute kidney injury pre-LTx requiring continuous renal replacement therapy (CRRT). Median time from listing to transplant was 17 days (IQR 10-24). ECMO was discontinued in all but 1 patient post-LTx. Median length of stay in the hospital post-LTx was 30 days (IQR 15-57). All were discharged from the hospital (43% to rehabilitation facility). Two patients on pre-LTx CRRT remained hemodialysis dependent and had multi-drug resistant (MDR) bacterial infections post-LTx. One readmission occurred for presumed rejection, aspiration and infection with MDR Klebsiella now requiring oxygen. All surgical pathology showed diffuse interstitial fibrosis consistent with the fibrotic sequelae of alveolar damage due to COVID-19. At 3-month follow-up, 6 patients (85%) did not need supplemental oxygen and had good pulmonary function. Conclusion Lung transplantation for COVID-ARDS is feasible. However, pre-transplant multi-system involvement may be associated with a protracted post-LTx stay and MDR infection. Further studies are needed to assess the long-term outcomes in this cohort.
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