1
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Ward RE, Joe WB, Jha S, Sherpa MG. Point-of-Care Ultrasound for High-Risk Pregnancy Screening in Rural Nepal. J Am Coll Radiol 2024:S1546-1440(24)00119-4. [PMID: 38302047 DOI: 10.1016/j.jacr.2024.01.013] [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] [Received: 12/26/2023] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Rebecca E Ward
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.
| | - Winston B Joe
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
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2
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Jha S, List JA. Economics of Scale-Lessons for Radiologists. J Am Coll Radiol 2023:S1546-1440(23)00935-3. [PMID: 37977249 DOI: 10.1016/j.jacr.2023.11.012] [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] [Received: 09/20/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Saurabh Jha
- Associate Professor of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - John A List
- Kenneth C. Griffin Distinguished Service Professor of Economics, University of Chicago, Chicago, Illinois.
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3
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Abstract
In this Viewpoint a radiologist surveys the ascent of artificial intelligence (AI) in imaging and what the future likely holds for AI in this discipline.
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Affiliation(s)
- Saurabh Jha
- Department of Radiology, University of Pennsylvania, Philadelphia
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4
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Ranjan R, Nath S, Jha S, Narasimha VL. Single parent adoption in India: Mental health and legal perspectives and the way forward. J Postgrad Med 2023; 69:215-220. [PMID: 37357486 PMCID: PMC10846805 DOI: 10.4103/jpgm.jpgm_718_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/08/2023] [Accepted: 02/01/2023] [Indexed: 06/27/2023] Open
Abstract
Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed.
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Affiliation(s)
- R Ranjan
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - S Nath
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - S Jha
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - VL Narasimha
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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5
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Dantzer B, Mabry KE, Bernhardt JR, Cox RM, Francis CD, Ghalambor CK, Hoke KL, Jha S, Ketterson E, Levis NA, McCain KM, Patricelli GL, Paull SH, Pinter-Wollman N, Safran RJ, Schwartz TS, Throop HL, Zaman L, Martin LB. Understanding Organisms Using Ecological Observatory Networks. Integr Org Biol 2023; 5:obad036. [PMID: 37867910 PMCID: PMC10586040 DOI: 10.1093/iob/obad036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/07/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Human activities are rapidly changing ecosystems around the world. These changes have widespread implications for the preservation of biodiversity, agricultural productivity, prevalence of zoonotic diseases, and sociopolitical conflict. To understand and improve the predictive capacity for these and other biological phenomena, some scientists are now relying on observatory networks, which are often composed of systems of sensors, teams of field researchers, and databases of abiotic and biotic measurements across multiple temporal and spatial scales. One well-known example is NEON, the US-based National Ecological Observatory Network. Although NEON and similar networks have informed studies of population, community, and ecosystem ecology for years, they have been minimally used by organismal biologists. NEON provides organismal biologists, in particular those interested in NEON's focal taxa, with an unprecedented opportunity to study phenomena such as range expansions, disease epidemics, invasive species colonization, macrophysiology, and other biological processes that fundamentally involve organismal variation. Here, we use NEON as an exemplar of the promise of observatory networks for understanding the causes and consequences of morphological, behavioral, molecular, and physiological variation among individual organisms.
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Affiliation(s)
- B Dantzer
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109,USA
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109,USA
| | - K E Mabry
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109,USA
- Department of Biology, New Mexico State University, Las Cruces, NM 88003,USA
| | - J R Bernhardt
- Department of Biology, New Mexico State University, Las Cruces, NM 88003,USA
- Department of Integrative Biology, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - R M Cox
- Department of Biology, University of Virginia, Charlottesville, VA 22940,USA
- Department of Biological Sciences, California Polytechnic State University, San Luis Obispo, CA 93407,USA
| | - C D Francis
- Department of Biological Sciences, California Polytechnic State University, San Luis Obispo, CA 93407,USA
- Department of Biology, Centre for Biodiversity Dynamics (CBD), Norwegian University of Science and Technology (NTNU), N‐7491 Trondheim, Norway
| | - C K Ghalambor
- Department of Biology, Centre for Biodiversity Dynamics (CBD), Norwegian University of Science and Technology (NTNU), N‐7491 Trondheim, Norway
- Department of Biology, Colorado State University, Fort Collins, CO 80523, USA
| | - K L Hoke
- Department of Biology, Colorado State University, Fort Collins, CO 80523, USA
| | - S Jha
- Department of Integrative Biology, University of Texas at Austin, Austin, TX 78712,USA
| | - E Ketterson
- Department of Biology, Indiana University, 1001 E. Third Street, Bloomington, IN 47405,USA
| | - N A Levis
- Department of Biology, Indiana University, 1001 E. Third Street, Bloomington, IN 47405,USA
| | - K M McCain
- Global Health and Infectious Disease Research Center, College of Public Health, University of South Florida, Tampa, FL 33612,USA
| | - G L Patricelli
- Department of Evolution and Ecology, University of California, Davis, CA 95616,USA
| | - S H Paull
- Battelle, National Ecological Observatory Network, 1685 38th Street, Boulder, CO 80301, USA
| | - N Pinter-Wollman
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, 621 Charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - R J Safran
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder 80309,USA
| | - T S Schwartz
- Department of Biological Sciences, Auburn University, Auburn, AL 36849, USA
| | - H L Throop
- School of Earth and Space Exploration and School of Life Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - L Zaman
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109,USA
- Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI 48109, USA
| | - L B Martin
- Global Health and Infectious Disease Research Center and Center for Genomics, College of Public Health, University of South Florida, Tampa, FL 33612,USA
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6
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Angelopoulos V, Zhang XJ, Artemyev AV, Mourenas D, Tsai E, Wilkins C, Runov A, Liu J, Turner DL, Li W, Khurana K, Wirz RE, Sergeev VA, Meng X, Wu J, Hartinger MD, Raita T, Shen Y, An X, Shi X, Bashir MF, Shen X, Gan L, Qin M, Capannolo L, Ma Q, Russell CL, Masongsong EV, Caron R, He I, Iglesias L, Jha S, King J, Kumar S, Le K, Mao J, McDermott A, Nguyen K, Norris A, Palla A, Roosnovo A, Tam J, Xie E, Yap RC, Ye S, Young C, Adair LA, Shaffer C, Chung M, Cruce P, Lawson M, Leneman D, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Frederick DM, Gilbert A, Hesford B, Krieger R, Lian K, McKinney E, Miller JP, Pedersen C, Qu Z, Rozario R, Rubly M, Seaton R, Subramanian A, Sundin SR, Tan A, Thomlinson D, Turner W, Wing G, Wong C, Zarifian A. Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective. Space Sci Rev 2023; 219:37. [PMID: 37448777 PMCID: PMC10335998 DOI: 10.1007/s11214-023-00984-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.
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Affiliation(s)
- V. Angelopoulos
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X.-J. Zhang
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: University of Texas at Dallas, Richardson, TX 75080 USA
| | - A. V. Artemyev
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | | | - E. Tsai
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - C. Wilkins
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Runov
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - J. Liu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - D. L. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland USA
| | - W. Li
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - K. Khurana
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. E. Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331 USA
| | - V. A. Sergeev
- University of St. Petersburg, St. Petersburg, Russia
| | - X. Meng
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Wu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. D. Hartinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Space Science Institute, Boulder, CO 80301 USA
| | - T. Raita
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland
| | - Y. Shen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. An
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shi
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. F. Bashir
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shen
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Gan
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - M. Qin
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Capannolo
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - Q. Ma
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - C. L. Russell
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - E. V. Masongsong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. Caron
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - I. He
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Iglesias
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
| | - S. Jha
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - J. King
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Kumar
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy and Astrophysics, The University of Chicago, Chicago, IL 60637 USA
| | - K. Le
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - J. Mao
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Raybeam, Inc., Mountain View, CA 94041 USA
| | - A. McDermott
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Nguyen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - A. Norris
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Palla
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Reliable Robotics Corporation, Mountain View, CA 94043 USA
| | - A. Roosnovo
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Los Alamos National Laboratory, Los Alamos, NM 87545 USA
| | - J. Tam
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - E. Xie
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. C. Yap
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - S. Ye
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - C. Young
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - L. A. Adair
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: KSAT, Inc., Denver, CO 80231 USA
| | - C. Shaffer
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - M. Chung
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - P. Cruce
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Apple, Cupertino, CA 95014 USA
| | - M. Lawson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - D. Leneman
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. Allen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Zipline International, South San Francisco, CA 94080 USA
| | - M. Anderson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Lucid Motors, Newark, CA 94560 USA
| | - M. Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J. Artinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: College of Engineering and Computer Science, California State University, Fullerton, Fullerton, CA 92831 USA
| | - J. Asher
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - D. Branchevsky
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - M. Cliffe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Colton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - C. Costello
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Heliogen, Pasadena, CA 91103 USA
| | - D. Depe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Argo AI, LLC, Pittsburgh, PA 15222 USA
| | - B. W. Domae
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Eldin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Fitzgibbon
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Terran Orbital, Irvine, CA 92618 USA
| | - A. Flemming
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - D. M. Frederick
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
| | - A. Gilbert
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Electrical Engineering, Stanford University, Stanford, CA 94305 USA
| | - B. Hesford
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. Krieger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K. Lian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - E. McKinney
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Geosyntec Consultants, Inc., Costa Mesa, CA 92626 USA
| | - J. P. Miller
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Juniper Networks Sunnyvale, California, 94089 USA
| | - C. Pedersen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z. Qu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Niantic Inc., San Francisco, CA 94111 USA
| | - R. Rozario
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - M. Rubly
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Teledyne Scientific and Imaging, Thousand Oaks, CA 91360 USA
| | - R. Seaton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A. Subramanian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. R. Sundin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Naval Surface Warfare Center Corona Division, Norco, CA 92860 USA
| | - A. Tan
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Epirus Inc., Torrance, CA 90501 USA
| | - D. Thomlinson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - W. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy, Ohio State University, Columbus, OH 43210 USA
| | - G. Wing
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Amazon, Seattle, WA 98109 USA
| | - C. Wong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Radiology, University of California, San Francisco, San Francisco, CA 94143 USA
| | - A. Zarifian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
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Affiliation(s)
- Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania and Department of Medical Imaging, Penn Presbyterian Medical Center, Philadelphia, PA, USA.
| | - Eric J Topol
- Scripps Research Translational Institute, Scripps Research, La Jolla, CA, USA
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8
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Kelly PL, Rodney S, Treu T, Oguri M, Chen W, Zitrin A, Birrer S, Bonvin V, Dessart L, Diego JM, Filippenko AV, Foley RJ, Gilman D, Hjorth J, Jauzac M, Mandel K, Millon M, Pierel J, Sharon K, Thorp S, Williams L, Broadhurst T, Dressler A, Graur O, Jha S, McCully C, Postman M, Schmidt KB, Tucker BE, von der Linden A. Constraints on the Hubble constant from Supernova Refsdal's reappearance. Science 2023:eabh1322. [PMID: 37167351 DOI: 10.1126/science.abh1322] [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: 05/13/2023]
Abstract
The gravitationally lensed Supernova Refsdal appeared in multiple images, produced through gravitational lensing by a massive foreground galaxy cluster. After the supernova appeared in 2014, lens models of the galaxy cluster predicted an additional image of the supernova would appear in 2015, which was subsequently observed. We use the time delays between the images to perform a blinded measurement of the expansion rate of the Universe, quantified by the Hubble constant (H0). Using eight cluster lens models, we infer [Formula: see text], where Mpc is the megaparsec. Using the two models most consistent with the observations, we find [Formula: see text]. The observations are best reproduced by models that assign dark-matter halos to individual galaxies and the overall cluster.
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Affiliation(s)
- Patrick L Kelly
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Steven Rodney
- Department of Physics and Astronomy, University of South Carolina, Columbia, SC 29208, USA
| | - Tommaso Treu
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095, USA
| | - Masamune Oguri
- Center for Frontier Science, Chiba University, Chiba 263-8522, Japan
- Research Center for the Early Universe, University of Tokyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Wenlei Chen
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Adi Zitrin
- Physics Department, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Simon Birrer
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY 11794, USA
| | - Vivien Bonvin
- Laboratoire d'Astrophysique, Ecole Polytechnique Federale de Lausanne, Observatoire de Sauverny, CH-1290 Versoix, Switzerland
| | - Luc Dessart
- Institut d'Astrophysique de Paris, Centre national de la recherche scientifique-Sorbonne Université, F-75014 Paris, France
| | - Jose M Diego
- Instituto de Física de Cantabria, Consejo Superior de Investigaciones Científicas y la Universidad de Cantabria, 39005 Santander, Spain
| | - Alexei V Filippenko
- Department of Astronomy, University of California, Berkeley, CA 94720, USA
- Miller Institute for Basic Research in Science, University of California, Berkeley, CA 94720, USA
| | - Ryan J Foley
- Department of Astronomy and Astrophysics, University of California Observatories/Lick Observatory, University of California, Santa Cruz, CA 95064, USA
| | - Daniel Gilman
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095, USA
- Department of Astronomy and Astrophysics, University of Toronto, Toronto, ON, M5S 3H4, Canada
| | - Jens Hjorth
- Dark Cosmology Centre, Niels Bohr Institute, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Mathilde Jauzac
- Centre for Extragalactic Astronomy, Department of Physics, Durham University, Durham DH1 3LE, UK
- Institute for Computational Cosmology, Durham University, Durham DH1 3LE, UK
- Astrophysics Research Center, University of KwaZulu-Natal, Durban 4041, South Africa
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Kaisey Mandel
- Institute of Astronomy and Kavli Institute for Cosmology, Cambridge CB3 0HA, UK
- Statistical Laboratory, Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge CB3 0WB, UK
| | - Martin Millon
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305, USA
- Laboratoire d'Astrophysique, Ecole Polytechnique Federale de Lausanne, Observatoire de Sauverny, CH-1290 Versoix, Switzerland
| | - Justin Pierel
- Department of Physics and Astronomy, University of South Carolina, Columbia, SC 29208, USA
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - Keren Sharon
- Department of Astronomy, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stephen Thorp
- Institute of Astronomy and Kavli Institute for Cosmology, Cambridge CB3 0HA, UK
- The Oskar Klein Centre, Department of Astronomy, Stockholm University, AlbaNova, 10691, Stockholm, Sweden
| | - Liliya Williams
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Tom Broadhurst
- Ikerbasque Foundation, University of the Basque Country, Donosita International Physics Center, Donostia, Spain
| | - Alan Dressler
- The Observatories of the Carnegie Institution for Science, Pasadena, CA 91101, USA
| | - Or Graur
- Institute of Cosmology and Gravitation, University of Portsmouth, Portsmouth PO1 3FX, UK
- Department of Astrophysics, American Museum of Natural History, New York, NY 10024, USA
| | - Saurabh Jha
- Department of Physics and Astronomy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Curtis McCully
- Las Cumbres Observatory, Goleta, CA 93117, USA
- Department of Physics, University of California, Santa Barbara, CA 93106, USA
| | - Marc Postman
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | | | - Brad E Tucker
- The Research School of Astronomy and Astrophysics, Mount Stromlo Observatory, Australian National University, Canberra, ACT 2611, Australia
- National Centre for the Public Awareness of Science, Australian National University, Canberra, ACT 2611, Australia
- The Australian Research Council Centre of Excellence for All-Sky Astrophysics in 3 Dimensions, ACT 2611, Australia
| | - Anja von der Linden
- Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY 11794, USA
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Williams H, Kelly PL, Chen W, Brammer G, Zitrin A, Treu T, Scarlata C, Koekemoer AM, Oguri M, Lin YH, Diego JM, Nonino M, Hjorth J, Langeroodi D, Broadhurst T, Rogers N, Perez-Fournon I, Foley RJ, Jha S, Filippenko AV, Strolger L, Pierel J, Poidevin F, Yang L. A magnified compact galaxy at redshift 9.51 with strong nebular emission lines. Science 2023; 380:416-420. [PMID: 37053263 DOI: 10.1126/science.adf5307] [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: 04/15/2023]
Abstract
Ultraviolet light from early galaxies is thought to have ionized gas in the intergalactic medium. However, there are few observational constraints on this epoch, due to the faintness of those galaxies and the redshift of their optical light into the infrared. We report the observation, in James Webb Space Telescope (JWST) imaging, of a distant galaxy that is magnified by gravitational lensing. JWST spectroscopy of the galaxy, at rest-frame optical wavelengths, detects strong nebular emission lines due to oxygen and hydrogen. The measured redshift is z = 9.51 ± 0.01, corresponding to 510 million years after the Big Bang. The galaxy has a radius of [Formula: see text] parsecs, substantially more compact than galaxies with equivalent luminosity at z ~ 6 to 8, leading to a high star formation rate surface density.
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Affiliation(s)
- Hayley Williams
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Patrick L Kelly
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Wenlei Chen
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Gabriel Brammer
- Cosmic Dawn Center, Niels Bohr Institute, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Adi Zitrin
- Physics Department, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Tommaso Treu
- Department of Physics and Astronomy, University of California, Los Angeles, CA 90095, USA
| | - Claudia Scarlata
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Masamune Oguri
- Center for Frontier Science, Chiba University, Chiba 263-8522, Japan
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - Yu-Heng Lin
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jose M Diego
- Instituto de Física de Cantabria, Universidad de Cantabria, Consejo Superior de Investigaciones Científicas, 39005 Santander, Spain
| | - Mario Nonino
- Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Trieste, 34124 Trieste, Italy
| | - Jens Hjorth
- Dark Cosmology Center, Niels Bohr Institute, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Danial Langeroodi
- Dark Cosmology Center, Niels Bohr Institute, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Tom Broadhurst
- Donostia International Physics Center, Ikerbasque Foundation, University of the Basque Country, 20018 Donostia, Spain
| | - Noah Rogers
- Minnesota Institute for Astrophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ismael Perez-Fournon
- Instituto de Astrofisica de Canarias, E-38205 La Laguna, Tenerife, Spain
- Departamento de Astrofísica, Universidad de La Laguna, 38206 La Laguna, Tenerife, Spain
| | - Ryan J Foley
- Department of Astronomy and Astrophysics, University of California Observatories/Lick Observatory, University of California, Santa Cruz, CA 95064, USA
| | - Saurabh Jha
- Department of Physics and Astronomy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Alexei V Filippenko
- Department of Astronomy, University of California, Berkeley, CA 94720-3411, USA
| | - Lou Strolger
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - Justin Pierel
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - Frederick Poidevin
- Instituto de Astrofisica de Canarias, E-38205 La Laguna, Tenerife, Spain
- Departamento de Astrofísica, Universidad de La Laguna, 38206 La Laguna, Tenerife, Spain
| | - Lilan Yang
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan
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Mazumdar S, Sinha S, Jha S, Jagtap B. Computer-aided automated diminutive colonic polyp detection in colonoscopy by using deep machine learning system; first indigenous algorithm developed in India. Indian J Gastroenterol 2023; 42:226-232. [PMID: 37145230 DOI: 10.1007/s12664-022-01331-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 12/18/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Colonic polyps can be detected and resected during a colonoscopy before cancer development. However, about 1/4th of the polyps could be missed due to their small size, location or human errors. An artificial intelligence (AI) system can improve polyp detection and reduce colorectal cancer incidence. We are developing an indigenous AI system to detect diminutive polyps in real-life scenarios that can be compatible with any high-definition colonoscopy and endoscopic video- capture software. METHODS We trained a masked region-based convolutional neural network model to detect and localize colonic polyps. Three independent datasets of colonoscopy videos comprising 1,039 image frames were used and divided into a training dataset of 688 frames and a testing dataset of 351 frames. Of 1,039 image frames, 231 were from real-life colonoscopy videos from our centre. The rest were from publicly available image frames already modified to be directly utilizable for developing the AI system. The image frames of the testing dataset were also augmented by rotating and zooming the images to replicate real-life distortions of images seen during colonoscopy. The AI system was trained to localize the polyp by creating a 'bounding box'. It was then applied to the testing dataset to test its accuracy in detecting polyps automatically. RESULTS The AI system achieved a mean average precision (equivalent to specificity) of 88.63% for automatic polyp detection. All polyps in the testing were identified by AI, i.e., no false-negative result in the testing dataset (sensitivity of 100%). The mean polyp size in the study was 5 (± 4) mm. The mean processing time per image frame was 96.4 minutes. CONCLUSIONS This AI system, when applied to real-life colonoscopy images, having wide variations in bowel preparation and small polyp size, can detect colonic polyps with a high degree of accuracy.
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Affiliation(s)
- Srijan Mazumdar
- Indian Institute of Liver and Digestive Sciences, Sitala (East), Jagadishpur, Sonarpur, 24 Parganas (South), Kolkata, 700 150, India.
| | - Saugata Sinha
- Visvesvaraya National Institute of Technology, South Ambazari Road, Nagpur, 440 010, India
| | - Saurabh Jha
- Visvesvaraya National Institute of Technology, South Ambazari Road, Nagpur, 440 010, India
| | - Balaji Jagtap
- Visvesvaraya National Institute of Technology, South Ambazari Road, Nagpur, 440 010, India
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11
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Jha S. Making Radiology Antifragile. J Am Coll Radiol 2023; 20:470-472. [PMID: 36805491 PMCID: PMC9969334 DOI: 10.1016/j.jacr.2023.02.004] [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: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Saurabh Jha
- Associate Professor of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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12
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Ifedili I, Heckle M, Kabra R, Jha S, Levine Y. Correlation of long term recurrence of atrial fibrillation with early occurrence during the blanking period post ablation and factors that influence this. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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13
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Jha S, Poller A, Shekka Espinosa A, Thorleifsson S, Zeijlon R, Hussain S, Bobbio E, Martinsson A, Pirazzi C, Rydenstam Mellberg T, Elmahdy A, Kakaei Y, Kalani M, Omerovic E, Redfors B. Early changes in myocardial stunning and biomarkers after ST-elevation myocardial infarction compared to the takotsubo syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Takotsubo syndrome (TS) and ST-elevation myocardial infarction (STEMI) are both characterized by sudden cessation of myocardial contractions (myocardial stunning) as well as elevation of cardiac troponins and B-type natriuretic peptides (BNP). Whereas STEMI results in variable degrees of necrosis and persistent cardiac dysfunction, TS results in little to any necrosis and full recovery of cardiac function. No “head-to-head” comparison of the temporal resolution of myocardial stunning and serum biomarkers in STEMI versus takotsubo has been done.
Purpose
To compare the time course of the recovery of cardiac function and serum biomarkers over the acute and subacute phases of takotsubo and STEMI, with patients with STEMI further subdivided into anterior and non-anterior STEMI.
Method
The Stunning In Takotsubo and Acute Myocardial Infarction (STAMI) study is a prospective, multi-center study that enrolls patients with TS or STEMI without known pre-existing cardiac dysfunction. Echocardiography, laboratory testing (including troponins and NT-proBNP), and ECG are acquired within 4 hours after acute coronary angiography and at 24±6, 48±12, 72±12 hours and 7±1, 14±2, and 30±2 days. The primary endpoint is the proportion of reversible myocardial akinesia resolved after 72 hours (Figure 1), as determined by echocardiography. Secondary endpoints include troponin-I, troponin-T, and NT-proBNP.
Results
Preliminary results from 155 patients with STEMI (78 anterior STEMI and 77 non-anterior STEMI) and 32 patients with TS are presented in Figure 1. Mean (SD) age was similar for patients with takotsubo (67±14), anterior STEMI (68±11), and non-anterior STEMI (68±10). All 3 groups showed substantial recovery of cardiac function over the course of the study, with the most pronounced recovery of cardiac function in TS. Compared to both STEMI groups, the TS group also had lower troponin-I to troponin-T ratio, and higher NT-proBNP (Figure 2). The proportion of reversible akinesia that had recovered at 72 hours was similar in patients with TS, anterior STEMI and non-anterior STEMI (p=0.8414).
Conclusion
The STAMI study will provide the comprehensive assessment of cardiac function and serum biomarker profile of patients with takotsubo and STEMI over the early course of the disease. Preliminary data from the study suggest that early myocardial functional recovery is more substantial but follows a similar time-course in takotsubo and STEMI. The differences in the magnitude of troponin elevation after takotsubo versus STEMI were more pronounced for troponin-I than T.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERC - European Research Council
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Affiliation(s)
- S Jha
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | - A Poller
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | | | | | - R Zeijlon
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | - S Hussain
- Sahlgrenska Academy , Gothenburg , Sweden
| | - E Bobbio
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | - A Martinsson
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | - C Pirazzi
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | | | - A Elmahdy
- Sahlgrenska Academy , Gothenburg , Sweden
| | - Y Kakaei
- Sahlgrenska Academy , Gothenburg , Sweden
| | - M Kalani
- Sahlgrenska Academy , Gothenburg , Sweden
| | - E Omerovic
- Sahlgrenska University Hospital , Gothenburg , Sweden
| | - B Redfors
- Sahlgrenska University Hospital , Gothenburg , Sweden
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14
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Clark L, Fitzgerald B, Noble S, MacNeill S, Paramasivan S, Cotterill N, Hashim H, Jha S, Toozs-Hobson P, Greenwell T, Thiruchelvam N, Agur W, White A, Garner V, Cobos-Arrivabene M, Clement C, Cochrane M, Liu Y, Lewis AL, Taylor J, Lane JA, Drake MJ, Pope C. Proper understanding of recurrent stress urinary incontinence treatment in women (PURSUIT): a randomised controlled trial of endoscopic and surgical treatment. Trials 2022; 23:628. [PMID: 35922823 PMCID: PMC9347071 DOI: 10.1186/s13063-022-06546-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women with stress urinary incontinence (SUI) experience urine leakage with physical activity. Currently, the interventional treatments for SUI are surgical, or endoscopic bulking injection(s). However, these procedures are not always successful, and symptoms can persist or come back after treatment, categorised as recurrent SUI. There are longstanding symptoms and distress associated with a failed primary treatment, and currently, there is no consensus on how best to treat women with recurrent, or persistent, SUI. METHODS A two-arm trial, set in at least 20 National Health Service (NHS) urology and urogynaecology referral units in the UK, randomising 250 adult women with recurrent or persistent SUI 1:1 to receive either an endoscopic intervention (endoscopic bulking injections) or a standard NHS surgical intervention, currently colposuspension, autologous fascial sling or artificial urinary sphincter. The aim of the trial is to determine whether surgical treatment is superior to endoscopic bulking injections in terms of symptom severity at 1 year after randomisation. This primary outcome will be measured using the patient-reported International Consultation on Incontinence Questionnaire - Urinary Incontinence - Short Form (ICIQ-UI-SF). Secondary outcomes include assessment of longer-term clinical impact, improvement of symptoms, safety, operative assessments, sexual function, cost-effectiveness and an evaluation of patients' and clinicians' views and experiences of the interventions. DISCUSSION There is a lack of high-quality, randomised, scientific evidence for which treatment is best for women presenting with recurrent SUI. The PURSUIT study will benefit healthcare professionals and patients and provide robust evidence to guide further treatment and improve symptoms and quality of life for women with this condition. TRIAL REGISTRATION International Standard Randomised Controlled Trials Number (ISRCTN) registry ISRCTN12201059. Registered on 09 January 2020.
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Affiliation(s)
- L Clark
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - B Fitzgerald
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - S Noble
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - S MacNeill
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - S Paramasivan
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - N Cotterill
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - H Hashim
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - S Jha
- Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Jessop Wing, Tree Root Walk, Sheffield, UK
| | - P Toozs-Hobson
- Department of Urogynaecology, Birmingham Women's & Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - T Greenwell
- Department of Urology, University College London Hospital, London, UK
| | - N Thiruchelvam
- Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - W Agur
- Department of Obstetrics and Gynaecology, NHS Ayrshire and Arran, University Hospital Crosshouse, Kilmarnock, UK
| | - A White
- Patient and Public Involvement (PPI) Representative, Bristol, UK
| | - V Garner
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - M Cobos-Arrivabene
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - C Clement
- Bristol Trials Centre (BTC), University of Bristol, Bristol, UK
| | - M Cochrane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Y Liu
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A L Lewis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Trials Centre (BTC), University of Bristol, Bristol, UK
| | - J Taylor
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Trials Centre (BTC), University of Bristol, Bristol, UK
| | - J A Lane
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Trials Centre (BTC), University of Bristol, Bristol, UK
| | - M J Drake
- Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, UK. .,Department of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - C Pope
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Trials Centre (BTC), University of Bristol, Bristol, UK
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15
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16
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Thyagaturu H, Bolton A, Jha S, Li S, Shah K, Kumar A. Associations of weekend versus weekday admission on transesophageal echocardiogram utilization and outcomes in infective endocarditis hospitalizations. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Infective endocarditis (IE) occurs worldwide and is associated with high mortality. Diagnosis and management of IE requires timely transesophageal echocardiography (TEE), which may not be consistently available in many institutions, especially on weekends. Hence, we wanted to evaluate the effect of weekend admission on IE in-hospital outcomes.
Purpose
To evaluate the differences in mortality and TEE utilization between weekend and weekday admissions in IE hospitalizations.
Methods
In this retrospective cohort study, we queried the 2017 and 2018 National Inpatient Sample (NIS) database to identify primary diagnosis of IE using appropriate ICD-10 CM codes. The variable for weekend admission which is available in the dataset was used to categorize hospitalizations into weekend and weekday admission groups. TEE procedures were identified using appropriate ICD-10 PCS codes. We used the Chi-square test to evaluate the difference between binary variables, and Student's t- test for differences between continuous variables. Multivariate logistic regression analysis was used to adjust for potential hospital and patient level confounders (age, sex, race, diabetes, hypertension, obesity, acute renal failure, diabetes, and Elixhauser comorbidity index score). Stata SE 16.1 was used to perform all statistical analyses.
Results
Among the identified 27,735 weighted adult IE hospitalizations, 6,145 (22.1%) were admitted on weekends. Weekend IE admissions were similar to weekday in all measured aspects except for elective admissions (Table 1). There were more elective admissions on the weekday compared to the weekend (11.3% for weekday vs. 4.9% for weekend; p<0.01). The mean age was 51 years for both hospitalizations. There were more TEEs in the first 24 hrs in weekday compared to weekend hospitalizations (7.8% vs. 3.4%; p<0.01). After adjusting for potential patient and hospital level confounders, there was no difference in mortality [Adjusted Odds ratio (aOR): 0.91 (0.62–1.33); p=0.63)], valve replacement procedures [aOR: 0.91 (0.62–1.33); p=0.63)] or incidence of atrioventricular (AV) blocks [aOR: 0.91 (0.62–1.33); p=0.63)] comparing weekend versus weekday IE hospitalizations. Additionally, we did not observe any mean difference in length of stay and total hospitalization charges between weekend and weekday hospitalizations.
Conclusion
In patients with IE, weekend admissions did not have a clinically significant difference in mortality, length of stay, incidence of AV blocks or valve replacements compared to weekday admissions. TEEs were performed equally in IE hospitalizations regardless of day of admission; however, early TEEs (within 24 hours of admission) were more commonly associated with weekday admission. Despite this, there was no clinically significant difference in the mortality between early TEEs and TEEs done after 24 hours of admission.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Thyagaturu
- Bassett Healthcare, Cooperstown, United States of America
| | - A Bolton
- University of Iowa College of Public Health, Iowa, United States of America
| | - S Jha
- Bassett Healthcare, Cooperstown, United States of America
| | - S Li
- The Wright Center for Graduate Medical Education, Internal Medicine, Scranton, United States of America
| | - K Shah
- St. Lukes University Hospital, Internal Medicine, Bethlehem, United States of America
| | - A Kumar
- University of Arkansas for Medical Sciences, Little Rock, United States of America
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17
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Jha S. Final nail in the coffin. BJOG 2021; 128:2199. [PMID: 34536978 DOI: 10.1111/1471-0528.16930] [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] [Received: 06/13/2021] [Accepted: 07/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- S Jha
- Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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18
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Muller P, Gurol-Urganci I, Thakar R, Ehrenstein MR, Van Der Meulen J, Jha S. Impact of a mid-urethral synthetic mesh sling on long-term risk of systemic conditions in women with stress urinary incontinence: a national cohort study. BJOG 2021; 129:664-670. [PMID: 34524725 PMCID: PMC9292923 DOI: 10.1111/1471-0528.16917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/29/2022]
Abstract
Objective To compare the incidence of systemic conditions between women who had surgical treatment for stress incontinence with mesh and without mesh. Design National cohort study. Setting English National Health Service. Population Women with no previous record of systemic disease who had first‐time urinary incontinence surgery between 1 January 2006 and 31 December 2013, followed up to the earliest of 10 years or 31 March 2019. Methods Competing‐risks regression was used to estimate hazard ratios (HR), adjusted for patient characteristics, with HR > 1 indicating increased incidence following mesh surgery. Main outcome measures First postoperative admission with a record of autoimmune disease, fibromyalgia or myalgic encephalomyelitis up to 10 years following the first incontinence procedure. Results The cohort included 88 947 women who had mesh surgery and 3389 women who had non‐mesh surgery. Both treatment groups were similar with respect to age, socio‐economic deprivation, comorbidity and ethnicity. The 10‐year cumulative incidence of autoimmune disease, fibromyalgia or myalgic encephalomyelitis was 8.1% (95% CI 7.9–8.3%) in the mesh group and 9.0% (95% CI 8.0–10.1%) in the non‐mesh group (adjusted HR 0.89, 95% CI 0.79–1.01; P = 0.07). A sensitivity analysis including only autoimmune diseases as an outcome returned a similar result. Conclusions These findings do not support claims that synthetic mesh slings cause systemic disease. Tweetable abstract No evidence of increased risk of systemic conditions after stress incontinence treatment with a mesh sling. No evidence of increased risk of systemic conditions after stress incontinence treatment with a mesh sling.
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Affiliation(s)
- P Muller
- London School of Hygiene & Tropical Medicine, London, UK.,Royal College of Obstetricians and Gynaecologists, London, UK
| | - I Gurol-Urganci
- London School of Hygiene & Tropical Medicine, London, UK.,Royal College of Obstetricians and Gynaecologists, London, UK
| | - R Thakar
- Royal College of Obstetricians and Gynaecologists, London, UK.,Croydon University Hospital, Croydon, UK
| | | | - J Van Der Meulen
- London School of Hygiene & Tropical Medicine, London, UK.,Royal College of Obstetricians and Gynaecologists, London, UK
| | - S Jha
- British Society of Urogynaecology, London, UK.,Sheffield Teaching Hospitals, Sheffield, UK
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19
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Jha S. Understanding risk: scrutinising PROSPECT. BJOG 2021; 128:2190. [PMID: 34473907 DOI: 10.1111/1471-0528.16898] [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] [Received: 06/13/2021] [Revised: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Affiliation(s)
- S Jha
- Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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20
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Gupta K, Saraiyia KJ, Jha S. Ironic Currency. AMA J Ethics 2021; 23:E660-661. [PMID: 34459737 DOI: 10.1001/amajethics.2021.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A 3-panel comic illustrates an offer of data to pay for health care services.
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Affiliation(s)
- Kashvi Gupta
- First-year resident at University of Missouri-Kansas City
| | - Kehaan J Saraiyia
- Artist and the founder of the Blue Matchbox Studio in Bangalore, India
| | - Saurabh Jha
- Associate professor at the University of Pennsylvania in Philadelphia
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21
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Patel S, Parekh V, Patel K, Jha S. Plant Growth-promoting Activities of Penicillium sp. NAUSF2 Ameliorate Vigna radiata Salinity Stress in Phosphate-deficient Saline Soil. APPL BIOCHEM MICRO+ 2021. [DOI: 10.1134/s000368382104013x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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22
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Puri P, Jha S. Artificial Intelligence, Automation, and Medical Education: Lessons From Economic History. J Am Coll Radiol 2021; 18:1345-1347. [PMID: 34089666 DOI: 10.1016/j.jacr.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Pranav Puri
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona.
| | - Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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23
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Wilmot A, Jha S. Re: "Contrast Coverage: Focus on Patient Safety". J Am Coll Radiol 2021; 18:1225. [PMID: 34038750 DOI: 10.1016/j.jacr.2021.04.016] [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] [Received: 03/31/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Andrew Wilmot
- Brighton Radiology Associates, 1000 Dutch Ridge Road, Beaver, PA 15009.
| | - Saurabh Jha
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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24
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Bigio J, Kohli M, Klinton JS, MacLean E, Gore G, Small PM, Ruhwald M, Weber SF, Jha S, Pai M. Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review. PLoS One 2021; 16:e0251236. [PMID: 33961639 PMCID: PMC8104425 DOI: 10.1371/journal.pone.0251236] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/22/2021] [Indexed: 01/15/2023] Open
Abstract
The advent of affordable, portable ultrasound devices has led to increasing interest in the use of point-of-care ultrasound (POCUS) for the detection of pulmonary TB (PTB). We undertook a systematic review of the diagnostic accuracy of POCUS for PTB. Five databases were searched for articles published between January 2010 and June 2020. Risk of bias was assessed using QUADAS-2. Data on sensitivity and specificity of individual lung ultrasound findings were collected, with variable reference standards including PCR and sputum smear microscopy. Six of 3,919 reviewed articles were included: five in adults and one in children, with a total sample size of 564. Studies had high risk of bias in many domains. In adults, subpleural nodule and lung consolidation were the lung ultrasound findings with the highest sensitivities, ranging from 72.5% to 100.0% and 46.7% to 80.4%, respectively. Only one study reported specificity data. Variability in sensitivity may be due to variable reference standards or may imply operator dependence. There is insufficient evidence to judge the diagnostic accuracy of POCUS for PTB. There is also no consensus on the optimal protocols for acquiring and analysing POCUS images for PTB. New studies which minimise potential sources of bias are required to further assess the diagnostic accuracy of POCUS for PTB.
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Affiliation(s)
- Jacob Bigio
- Research Institute of the McGill University Health Centre, Montreal, Canada
- McGill International TB Centre, Montreal, Canada
- * E-mail:
| | - Mikashmi Kohli
- McGill International TB Centre, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Joel Shyam Klinton
- McGill International TB Centre, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Emily MacLean
- McGill International TB Centre, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - Peter M. Small
- Renaissance School of Medicine at SUNY, Stony Brook, NY, United States of America
| | - Morten Ruhwald
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Stefan Fabian Weber
- Department of Infectious Diseases, University of Heidelberg, Heidelberg, Germany
| | - Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Madhukar Pai
- McGill International TB Centre, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
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25
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Wilmot A, Jha S. Competing Risks: Death From Contrast Versus Fatal Car Crash. J Am Coll Radiol 2021; 18:1048-1049. [PMID: 33741374 DOI: 10.1016/j.jacr.2021.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/04/2021] [Accepted: 01/10/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Andrew Wilmot
- Brighton Radiology Associates, Beaver, Pennsylvania.
| | - Saurabh Jha
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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26
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Affiliation(s)
- Saurabh Jha
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
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27
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Kulkarni S, Szeto WY, Jha S. Preoperative Computed Tomography in the Adult Cardiac Surgery Patient. Curr Probl Diagn Radiol 2020; 51:121-129. [PMID: 33414038 DOI: 10.1067/j.cpradiol.2020.10.008] [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] [Received: 08/21/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
Increasingly, computed tomography is requested for preoperative planning prior to cardiac surgery. Common pathologies, such as aortic and mitral annular calcification, can influence the choice of surgical technique or approach. In this article, we present a case-based review of primary and reoperative sternotomies that focuses on the clinical relevance of the common pathologies and findings in pre-operative computed tomography images, with respect to surgical decision-making and management.
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Affiliation(s)
- Sagar Kulkarni
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA.
| | - Wilson Y Szeto
- Division of Cardiovascular Surgery, Penn Presbyterian Medical Center, Philadelphia, PA
| | - Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA
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28
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Roshkovan L, Chatterjee N, Galperin-Aizenberg M, Gupta N, Shah R, Barbosa EM, Simpson S, Cook T, Nachiappan A, Knollmann F, Litt H, Desjardins B, Jha S, Panebianco N, Baston C, Thompson JC, Katz SI. The Role of Imaging in the Management of Suspected or Known COVID-19 Pneumonia: A Multidisciplinary Perspective. Ann Am Thorac Soc 2020. [PMID: 33022182 DOI: 10.1513/annalsats.202006-600cme] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/06/2020] [Indexed: 11/20/2022] Open
Abstract
COVID-19 is an illness caused by a novel coronavirus that has rapidly escalated into a global pandemic leading to an urgent medical effort to better characterize this disease biologically, clinically and by imaging. In this review, we present the current approach to imaging of COVID-19 pneumonia. We focus on the appropriate utilization of thoracic imaging modalities to guide clinical management. We will also describe radiologic findings that are considered typical, atypical and generally not compatible with of COVID-19 infection. Further, we review imaging examples of COVID-19 imaging mimics, such as organizing pneumonia, eosinophilic pneumonia and other viral infections.
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Affiliation(s)
- Leonid Roshkovan
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States;
| | - Neil Chatterjee
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Maya Galperin-Aizenberg
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Narainder Gupta
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Rosita Shah
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Eduardo Mortani Barbosa
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Scott Simpson
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Tessa Cook
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Arun Nachiappan
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Friedrich Knollmann
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Harold Litt
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Benoit Desjardins
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Saurabh Jha
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
| | - Nova Panebianco
- University of Pennsylvania Perelman School of Medicine, 14640, Emergency Medicine, Philadelphia, Pennsylvania, United States
| | - Cameron Baston
- University of Pennsylvania Perelman School of Medicine, 14640, Emergency Medicine, Philadelphia, Pennsylvania, United States
| | - Jeffrey C Thompson
- University of Pennsylvania Perelman School of Medicine, 14640, Pulmonary, Allergy and Critical Care , Philadelphia, Pennsylvania, United States
| | - Sharyn I Katz
- University of Pennsylvania Perelman School of Medicine, 14640, Radiology, Philadelphia, Pennsylvania, United States
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29
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Angelopoulos V, Tsai E, Bingley L, Shaffer C, Turner DL, Runov A, Li W, Liu J, Artemyev AV, Zhang XJ, Strangeway RJ, Wirz RE, Shprits YY, Sergeev VA, Caron RP, Chung M, Cruce P, Greer W, Grimes E, Hector K, Lawson MJ, Leneman D, Masongsong EV, Russell CL, Wilkins C, Hinkley D, Blake JB, Adair N, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Capitelli MR, Castro R, Chao G, Chung N, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Fox I, Frederick DM, Gilbert A, Gildemeister A, Gonzalez A, Hesford B, Jha S, Kang N, King J, Krieger R, Lian K, Mao J, McKinney E, Miller JP, Norris A, Nuesca M, Palla A, Park ESY, Pedersen CE, Qu Z, Rozario R, Rye E, Seaton R, Subramanian A, Sundin SR, Tan A, Turner W, Villegas AJ, Wasden M, Wing G, Wong C, Xie E, Yamamoto S, Yap R, Zarifian A, Zhang GY. The ELFIN Mission. Space Sci Rev 2020; 216:103. [PMID: 32831412 PMCID: PMC7413588 DOI: 10.1007/s11214-020-00721-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
The Electron Loss and Fields Investigation with a Spatio-Temporal Ambiguity-Resolving option (ELFIN-STAR, or heretoforth simply: ELFIN) mission comprises two identical 3-Unit (3U) CubeSats on a polar (∼93∘ inclination), nearly circular, low-Earth (∼450 km altitude) orbit. Launched on September 15, 2018, ELFIN is expected to have a >2.5 year lifetime. Its primary science objective is to resolve the mechanism of storm-time relativistic electron precipitation, for which electromagnetic ion cyclotron (EMIC) waves are a prime candidate. From its ionospheric vantage point, ELFIN uses its unique pitch-angle-resolving capability to determine whether measured relativistic electron pitch-angle and energy spectra within the loss cone bear the characteristic signatures of scattering by EMIC waves or whether such scattering may be due to other processes. Pairing identical ELFIN satellites with slowly-variable along-track separation allows disambiguation of spatial and temporal evolution of the precipitation over minutes-to-tens-of-minutes timescales, faster than the orbit period of a single low-altitude satellite (Torbit ∼ 90 min). Each satellite carries an energetic particle detector for electrons (EPDE) that measures 50 keV to 5 MeV electrons with Δ E/E < 40% and a fluxgate magnetometer (FGM) on a ∼72 cm boom that measures magnetic field waves (e.g., EMIC waves) in the range from DC to 5 Hz Nyquist (nominally) with <0.3 nT/sqrt(Hz) noise at 1 Hz. The spinning satellites (Tspin ∼ 3 s) are equipped with magnetorquers (air coils) that permit spin-up or -down and reorientation maneuvers. Using those, the spin axis is placed normal to the orbit plane (nominally), allowing full pitch-angle resolution twice per spin. An energetic particle detector for ions (EPDI) measures 250 keV - 5 MeV ions, addressing secondary science. Funded initially by CalSpace and the University Nanosat Program, ELFIN was selected for flight with joint support from NSF and NASA between 2014 and 2018 and launched by the ELaNa XVIII program on a Delta II rocket (with IceSatII as the primary). Mission operations are currently funded by NASA. Working under experienced UCLA mentors, with advice from The Aerospace Corporation and NASA personnel, more than 250 undergraduates have matured the ELFIN implementation strategy; developed the instruments, satellite, and ground systems and operate the two satellites. ELFIN's already high potential for cutting-edge science return is compounded by concurrent equatorial Heliophysics missions (THEMIS, Arase, Van Allen Probes, MMS) and ground stations. ELFIN's integrated data analysis approach, rapid dissemination strategies via the SPace Environment Data Analysis System (SPEDAS), and data coordination with the Heliophysics/Geospace System Observatory (H/GSO) optimize science yield, enabling the widest community benefits. Several storm-time events have already been captured and are presented herein to demonstrate ELFIN's data analysis methods and potential. These form the basis of on-going studies to resolve the primary mission science objective. Broad energy precipitation events, precipitation bands, and microbursts, clearly seen both at dawn and dusk, extend from tens of keV to >1 MeV. This broad energy range of precipitation indicates that multiple waves are providing scattering concurrently. Many observed events show significant backscattered fluxes, which in the past were hard to resolve by equatorial spacecraft or non-pitch-angle-resolving ionospheric missions. These observations suggest that the ionosphere plays a significant role in modifying magnetospheric electron fluxes and wave-particle interactions. Routine data captures starting in February 2020 and lasting for at least another year, approximately the remainder of the mission lifetime, are expected to provide a very rich dataset to address questions even beyond the primary mission science objective.
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Affiliation(s)
- V Angelopoulos
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Tsai
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Bingley
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Shaffer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - D L Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - A Runov
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - W Li
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Department of Astronomy and Center for Space Physics, Boston University, Boston, MA 02215 USA
| | - J Liu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A V Artemyev
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - X-J Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R J Strangeway
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R E Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Y Y Shprits
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- GFZ German Research Centre for Geosciences, Potsdam, 14473 Germany
| | - V A Sergeev
- Saint Petersburg State University, St. Petersburg, 199034 Russia
| | - R P Caron
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - P Cruce
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - W Greer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Grimes
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Hector
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - M J Lawson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Leneman
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E V Masongsong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C L Russell
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wilkins
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Hinkley
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - J B Blake
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - N Adair
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Allen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - M Anderson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Aptiv, Agoura Hills, CA 91301 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J Artinger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - J Asher
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - D Branchevsky
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- The Aerospace Corporation, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M R Capitelli
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Castro
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - G Chao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: The Boeing Company, Long Beach, CA 90808 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SF Motors, Santa Clara, CA 95054 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Cliffe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Colton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, Inc., San Francisco, CA 94107 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Costello
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Depe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B W Domae
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Eldin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Fitzgibbon
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Flemming
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - I Fox
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - D M Frederick
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gilbert
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gildemeister
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - A Gonzalez
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B Hesford
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Jha
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Kang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J King
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Krieger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K Lian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J Mao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Verona, WI 53593 USA
| | - E McKinney
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: California State Polytechnic University, Pomona, CA 91768 USA
| | - J P Miller
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Norris
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
| | - M Nuesca
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Palla
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E S Y Park
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Economics Department, University of California, Los Angeles, CA 90095 USA
| | - C E Pedersen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z Qu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Rozario
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Rye
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Seaton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A Subramanian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - S R Sundin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Tan
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Experior Laboratories, Oxnard, CA 93033 USA
| | - W Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - A J Villegas
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - M Wasden
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - G Wing
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - E Xie
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Yamamoto
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Yap
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
| | - A Zarifian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - G Y Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Qualcomm, San Diego, CA 92121 USA
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Acharya N, Jha S, Mishra D, Chattopadhyay A, Jain S, Sharma SK, Sharma A, Jain S, Dhir V. AB0395 SYSTEMIC LUPUS ASSOCIATED MACROPHAGE ACTIVATION SYNDROME – A SINGLE CENTRE EXPERIENCE FROM INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Macrophage activation syndrome (MAS) is a potentially fatal complication of systemic lupus erythematosus (SLE).(1) Overlapping clinical features of SLE activity with MA makes it a clinical diagnosis. There is limited data from developing countries like India.Objectives:To study the clinical features, treatment, and outcomes in SLE-MAS.Methods:This single-centre, retrospective study included patients fulfilling SLICC 2011 criteria for SLE, admitted from January 2017 to November 2019, and diagnosed as MAS by a team of attending physicians. Their demographic and clinical data, treatment, and outcomes were recorded. H score and SLEDAI were calculated. Patients were assessed for HLH classification criteria (2004) and preliminary diagnostic criteria for MAS in childhood SLE (cSLE).Results:Sixteen patients (median age – 26 years, 15 females) were included. Twelve patients (75%) had MAS as the initial presentation of SLE. The common clinical features were fever (100%) and cytopenias (100%). The mean duration of symptoms was 60 days. The most frequent biochemical abnormalities were high ferritin (>500 ng/ml, 100%) and elevated transaminases (100%, aspartate transaminase > alanine transaminase). Common complications were renal (43.8%), neurological (43.8%), and coagulopathy (43.8%). Seven and 16 patients fulfilled the HLH 2004 and cSLE – MAS preliminary criteria, respectively. The median H score was 222, giving a cumulative probability of 96%. All the patients received high-dose steroids. Cyclophosphamide pulse and cyclosporine were administered to 8 (50%) and 6 (37.5%) patients respectively. There were four (25%) in-hospital mortalities.CharacteristicN=16Age (years)26 (19.5 – 30)Duration of symptoms (days)60 (18.7 – 90)Fever16 (100)Pancreatitis1 (6.3)Renal7 (43.8)Neurological7 (43.8)Myocarditis6 (37.5)Hepatomegaly7 (43.8)Splenomegaly3 (18.8)Lymphadenopathy12 (75)Anaemia16 (100)Leukopenia13 (82)Thrombocytopenia14 (88.2)Coagulopathy7 (43.8)Concomitant infection3 (18.8)H score222 (193 – 254)cSLE-MAS diagnostic criteria16 (100%)HLH 2004 (≥5)7 (43.8)Corticosteroids16 (100%)Cyclophosphamide8 (50%)Intravenous immunoglobulin2 (12.5%)Cyclosporine6 (37.5%)Death4 (25%)All data presented as n (%) and median (IQR)cSLE-MAS – Childhood systemic lupus erythematosus – Macrophage activation syndrome, HLH – Hemophagocytic lymphohistiocytosisParameterN = 16Haemoglobin (g/dL)6.9 (5.7 – 7.8)Total leucocyte count (cells/mm3)1400 (1025 -3175)<10003 (18.8)1000 – 25009 (56.3)2500 - 40001 (6.3)Platelet (cells/mm3)57500 (23500 – 95250)<200003 (18.8)20000 – 500003 (18.8)50000 – 1 lac8 (50)Serum ferritin > 500 ng/ml16 (100%)Fibrinogen2.48 (1.6 – 4)Triglycerides (mg/dL)375 (294 -470)AST/ALT (U/L)153 (113 – 234) / 90 (68 – 170)Procalcitonin (pg/mL)0.8 (0.3 – 1.4)Lactate dehydrogenase (U/L)1674 (1081 – 2184)Erythrocyte sedimentation rate (mm in 1sthour)61 (44 – 69)C- reactive protein (mg/L)36 (6.3 – 52)Bone marrow examination14 (87.5)Increased histiocytes with hemophagocytosis5 (32.5)All data presented as n (%) and median (IQR)ALT – Alanine transaminase, AST – Aspartate transaminaseConclusion:Fever, cytopenia, high ferritin, and elevation of transaminases were the commonest features in this series of SLE-MAS. SLE-MAS carried a high mortality (25%) despite aggressive treatment.References:[1]Gavand P-E, Serio I, Arnaud L, Costedoat-Chalumeau N, Carvelli J, Dossier A, et al. Clinical spectrum and therapeutic management of systemic lupus erythematosus-associated macrophage activation syndrome: A study of 103 episodes in 89 adult patients. Autoimmun Rev. 2017;16(7):743–9.Acknowledgments:NONEDisclosure of Interests:None declared
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Dhir V, Jha S, Sharma A, Jain S, Sharma SK, Naidu G. AB0570 MIXED CONNECTIVE TISSUE DISEASE: NOT THAT UNCOMMON, A SINGLE-CENTER EXPERIENCE FROM INDIA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Mixed connective tissue disease (MCTD) is considered to be uncommon; specifically there is sparse data on MCTD from developing countries like India.Objectives:This study examines the clinical and serological features of these patients in a single center in North-India.Methods:This was a retrospective single-center study of patients diagnosed as MCTD in last 20 years. The patients included fulfilled at least one of the diagnostic criteria namely Alarcón-Segovia, Kasukawa, and Kahns. Demographic details, clinical signs and symptoms, laboratory parameters, treatment and outcome were extracted from medical records and clinic files in a pre-designed proforma.Results:This study included 41 MCTD patients. There was a marked female preponderance (F: M=40:1), and mean age of disease onset and diagnosis was 33.8 ± 10.7 and 39.3 ± 10.2 years. 39 (92%) of the patients fulfilled both Kahn and Kasukawa criteria, while 31 (76%) fulfilled Alarcon-Segovia criteria. Initially patients had been (mis)diagnosed as rheumatoid arthritis, systemic lupus erythematosus (or UCTD) (in five patients each), overlap syndromes or myositis (in 4 patients). ANA was commonly high-titer and specked, U1RNP was positive in all. (Table 1) Other autoantibodies on immunoblot included SSA and Ro52 in half the patients. Raynaud’s was seen in three-fourth at presentation and all the patients over time. Digital gangrene and puffy fingers were seen in 8 (20%) and 18 (46%) patients. Other clinical features included arthritis in 33 (81%), sclerodactyly in 23 (56%) and proximal weakness in 20 patients (49%). Interstitial lung disease and pulmonary arterial hypertension were seen in 20 (57%) and 15 (44%) patients. All patients (except one) received prednisolone, and it was currently used in almost 90%. Intravenous cyclophosphamide was used in one-third, commonly for ILD.Table 1.Laboratory features of patients with MCTDLabs n (%)Leucopenia9 (22)Thrombocytopenia10 (24)Raised globulinsb22 (69)Mean globulins, mean (SD)a5±3.4Elevated CPKb10 (31)CPK Levels U/L, median (IQR)256 (57.5-1036)ANA Speckled Pattern N (%)31d(82)U1RNP N (%)b32 (100%)U1RNP Blot Intensity1+8 (25%)2+1 (3.2%)3+7 (21.8%)4+16 (50%)U1RNP EIA, mean(SD), n=19141.3 ± 82.4Raised RF Titersh10 (35.7%)Low C3 mg/dlf8 (40%)Low C4 mg/dlf3 (15%)FVC, mean (SD) n=2082.4 ± 18.9 ILD on HRCTg20 (57) Dilated PA on CTf10 (50)PAHeon ECHO15 (44.1%)RA/RV Dilated5 (18)SD-standard deviation, IQR- Interquartile range, CPK- Creatinine phosphokinase,, ILD- Interstitial lung disease, PAH- Pulmonary arterial hypertension, ANA- Anti nuclear antibody, IIF- Indirect Immunofluorescence, PA- pulmonary artery, RA/RV- Right atrium/Right Ventricle,a34b32d38e34f20g34h28Conclusion:MCTD was not uncommon in the single-center in North India. Kahn and Kasukawa criteria were found to be the most sensitive for its diagnosis. Digital gangrene was relatively common and sometimes the presenting feature; whereas puffy fingers was present in only half the patients.Disclosure of Interests:None declared
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Affiliation(s)
- S Jha
- Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Abstract
Coronavirus disease 2019 has spread to every inhabited continent in the world. So far, plain radiography and computed tomography have been the mainstay of imaging methods used. The present analytical paper on the role of point-of-care lung ultrasound in this pandemic examines its diagnostic accuracy, clinical utility, and physical practicality in the intensive care unit. POCUS has a high sensitivity for pulmonary manifestations of COVID-19. POCUS minimises nosocomial spread. POCUS can prognosticate and assess response to therapy. Healthcare providers with skills in POCUS are encouraged to help provide this service.
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Affiliation(s)
- S Kulkarni
- Oxford University Clinical Academic Graduate School (OUCAGS), Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxfordshire OX3 9DU, UK; Department of Critical Care, Milton Keynes University Hospital, Milton Keynes University Hospital NHS Foundation Trust, Standing Way, Milton Keynes, Buckinghamshire MK6 5LD, UK.
| | - B Down
- Department of Critical Care, Milton Keynes University Hospital, Milton Keynes University Hospital NHS Foundation Trust, Standing Way, Milton Keynes, Buckinghamshire MK6 5LD, UK
| | - S Jha
- Department of Radiology, Hospital of the University of Pennsylvania, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Jha S, Mehta A, Azad C. A fuzzy logic based approach for prediction of basal cell carcinoma and squamous cell carcinoma among the data of skin cancer. EAI Endorsed Transactions on Pervasive Health and Technology 2020. [DOI: 10.4108/eai.13-7-2018.163989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Jha S. The Factors Making Americans Litigious. J Am Coll Radiol 2020; 17:551-553. [DOI: 10.1016/j.jacr.2019.10.011] [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] [Received: 06/13/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 11/29/2022]
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Affiliation(s)
- Saurabh Jha
- Department of Radiology, MRI Learning Center Hospital, University of Pennsylvania, 3400 Spruce Street, Phila, PA 19104, United States.
| | - Tessa Cook
- Department of Radiology, MRI Learning Center Hospital, University of Pennsylvania, 3400 Spruce Street, Phila, PA 19104, United States
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Abstract
Tuberculosis is a leading cause of death from infectious disease worldwide, and is an epidemic in many developing nations. Countries where the disease is common also tend to have poor access to medical care, including diagnostic tests. Recent advancements in artificial intelligence may help to bridge this gap. In this article, we review the applications of artificial intelligence in the diagnosis of tuberculosis using chest radiography, covering simple computer-aided diagnosis systems to more advanced deep learning algorithms. In so doing, we will demonstrate an area where artificial intelligence could make a substantial contribution to global health through improved diagnosis in the future.
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Affiliation(s)
- Sagar Kulkarni
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA.
| | - Saurabh Jha
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA
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Affiliation(s)
- R R Kumar
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Jha
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Dhooria
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - V Dhir
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Jha S. P759Electrocardiographic predictors of adverse in-hospital outcomes in the Takotsubo syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The takotsubo syndrome is a life-threatening acute cardiac condition. However, little is known about risk factors associated with worse outcomes in TS, and no high-risk electrocardiographic criteria have been defined for patients with TS. We sought to identify high-risk admission ECG findings among patients with TS.
Methods
Using the Swedish Angiography and Angioplasty Registry (SCAAR) we identified all cases of TS who were treated at our university hospital between 2008 and 2017. We reviewed all cases and included patients who met the revised Gothenburg diagnostic criteria. We conducted an in-depth review of all presenting electrocardiograms, using a pre-defined case report form (CRF), including the following variables: heart rate; rhythm; PR-interval; QRS axis; QTc-interval; T-wave inversion.; presence of Q-wave; T-wave axis; and the magnitude of ST-segment deviation in each individual lead. The primary endpoint was the occurrence of in-hospital major adverse cardiac event (MACE), defined as the composite of death, ventricular tachycardia or fibrillation (VT/VF), atrioventricular block ≥2 or asystole >10 seconds.
Results
We identified 161 patients with TS, of whom 151 (93.8%) were women. The mean age was 69±13 years. MACE occurred in 19 patients (11.8%), and VT/VF occurred in 14 patients (8.7%). No clinical variables were significantly different between patients with and without MACE. Patients with MACE were less likely than those without MACE to have sinus rhythm (79.0% versus 95.8%, p=0.02) or T-wave inversion (15.8% versus 52.8%, p=0.02). T-wave inversion was less common among patients with than without VT/VF (14.3% versus 51.7%, p=0.01). After adjustment for age and sex T-wave inversion was independently associated with lower risk of MACE (Odds ratio 0.13, 95% confidence interval 0.04 to 0.48, p>0.001).
Conclusions
T-wave inversion is common in TS and is associated with lower risk of adverse events, driven by a lower risk of VT/VF.
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Affiliation(s)
- S Jha
- Sahlgrenska University Hospital, Goteborg, Sweden
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Udintsev V, Danani S, Taylor G, Giacomin T, Guirao J, Pak S, Hughes S, Worth L, Vayakis G, Walsh M, Schneider M, Pandya H, Kumar R, Kumar V, Jha S, Thomas S, Padasalagi SB, Kumar S, Phillips PE, Rowan WL, Austin M, Khodak A, Feder R, Neilson H, Basile A, Hubbard AE, Saxena A, Nazare C, Maquet P, Gimbert N. Progress in ITER ECE Diagnostic Design and Integration. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920303003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The ITER Electron Cyclotron Emission (ECE) diagnostic is progressing towards its Preliminary Design Review (PDR). In parallel, the diagnostic integration in the Equatorial Port is ongoing. Port Integration has to address the structural integrity to withstand various loads, maintenance and the safety aspects of ECE diagnostic. The ITER ECE system includes radial and oblique lines-of-sight. Recently, a successful peer-review of the in-port plug Hot Calibration Source has taken place and its performance and integration feasibility has been demonstrated. Four 45-meter long low-loss transmission lines are designed to transmit mm-wave power in the frequency range of 70- 1000 GHz in both X- and O-mode polarization from the port plug to the ECE instrumentation room in the diagnostic building. Prototype transmission lines are being tested [1]. A prototype polarizing Martin-Puplett type Fourier Transform Spectrometer (FTS) operating in the frequency range 70-1000 GHz, has a fast scanning mechanism and a cryo-cooled dual-channel THz detector system. Its performance has been tested as per ITER requirements. Assessment of the instrumentation and control requirements, functional and non-functional requirements, operation procedures, plant automation are ongoing for the PDR. The current status of the diagnostic, together with integration activities, is presented.
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Abstract
Coronary computed tomography (CT) is one of the most rigorously tested imaging modalities. The history of evidence of coronary CT reflects the hierarchical model of efficacy of diagnostic imaging proposed by Fryback and Thornbury. Coronary CT has gone through technological evolution from electron beam CT to helical CT to multidetector CT. As technology improved, it also had to meet higher bars for evidence from proof of concept to diagnostic accuracy to evidence that it improves outcomes compared with its competitors.
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Affiliation(s)
- Saurabh Jha
- Hospital of University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Lalwani N, Shanbhogue KP, Jambhekar K, Jha S, Ram R, Itri JN, Tappouni R. New Job, New Challenges: Life After Radiology Training. AJR Am J Roentgenol 2019; 212:483-489. [DOI: 10.2214/ajr.18.20398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Neeraj Lalwani
- Department of Radiology, Wake Forest University and Baptist Health, 1 Medical Center Blvd, Winston-Salem, NC 27157
| | | | - Kedar Jambhekar
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Saurabh Jha
- Department of Radiology, University of Pennsylvania, Philadelphia, PA
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Jason Neil Itri
- Department of Radiology, Wake Forest University and Baptist Health, 1 Medical Center Blvd, Winston-Salem, NC 27157
| | - Rafel Tappouni
- Department of Radiology, Wake Forest University and Baptist Health, 1 Medical Center Blvd, Winston-Salem, NC 27157
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Abstract
Sexual dysfunction in women with prolapse and incontinence is well documented in the literature, but the impact of treatment, particularly surgical correction, remains very limited and confusing. Age, on the other hand, has been shown to be an independent risk factor for deteriorating sexual function, with all aspects of the sexual function (i.e. desire, arousal, penetration, and orgasm) being affected. When combined with surgical correction of prolapse or incontinence there is potential for further worsening of sexual function, and hence this should be assessed before any pelvic floor surgery and patient expectations established. In this article the current evidence will be reviewed looking at the impact of pelvic floor dysfunction on sexual function and the effect of commonly performed surgery for these problems. Ways and means of preserving sexual function in women undergoing corrective surgery will also be investigated.
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Affiliation(s)
- S Jha
- a Department of Urogynaecology , Sheffield Teaching Hospitals NHS Foundation Trust , Sheffield , UK
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Affiliation(s)
- R R Kumar
- Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - S Jha
- Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - A Sharma
- Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
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Affiliation(s)
- Saurabh Jha
- From the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
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Díaz Candamio MJ, Jha S, Martel Villagrán J. Overdiagnosis in imaging. Radiologia (Engl Ed) 2018; 60:362-367. [PMID: 29685554 DOI: 10.1016/j.rx.2018.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 03/11/2018] [Accepted: 03/15/2018] [Indexed: 01/22/2023]
Abstract
Overdiagnosis, more than an error regarding the diagnosis, is an error regarding the prognosis. We cannot know what consequences some lesions that we detect by imaging would have on our patients' lives if they were left untreated. As long as it is not possible for imaging techniques to differentiate between lesions that will have an indolent course from those that will have an aggressive course, there will be overdiagnosis. Advanced imaging techniques, radiomics, and radiogenomics, together with artificial intelligence, promise advances in this sense. In the meantime, it is important that radiologists be careful to ensure that only strictly necessary imaging tests are done. Moreover, we need to participate, together with patients, in making multidisciplinary decisions about diagnosis and clinical management. Finally, of course, we need to continue to contribute to the technological and scientific advance of our profession, so that we can continue to improve the diagnosis and early detection of abnormalities, especially those that require treatment.
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Affiliation(s)
| | - S Jha
- Hospital of The University of Pennsylvania, Silverstein, Filadelfia, Estados Unidos
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