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Khan U, Bilal M, Adil HM, Darlington N, Khan A, Khan N, Ihsanullah I. Hydrogen from sewage sludge: Production methods, influencing factors, challenges, and prospects. Sci Total Environ 2024; 919:170696. [PMID: 38340850 DOI: 10.1016/j.scitotenv.2024.170696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/20/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
The rising global population and rapid industrialization have frequently resulted in a significant escalation in energy requirements. Hydrogen, renowned for its eco-friendly and renewable characteristics, has garnered substantial interest as a fuel alternative to address the energy needs currently fulfilled by fossil fuels. Embracing such energy substitutes holds pivotal importance in advancing environmental sustainability, aiding in the reduction of greenhouse gas emissions - the primary catalysts of global warming and climate fluctuations. This study elucidates recent trends in sewage sludge (SS)-derived hydrogen through diverse production pathways and critically evaluates the impact of varying parameters on hydrogen yield. Furthermore, a detailed analysis of the breakdown of the hydrogen generation process from SS is provided, along with an assessment of its economic dimensions. The review culminates by illuminating key obstacles in the adoption of this innovative technology, accompanied by practical recommendations to surmount these challenges. This comprehensive analysis is expected to attract considerable interest from stakeholders within the hydrogen production domain, fostering substantial engagement.
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Affiliation(s)
- Usman Khan
- Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24, Krakow 31-155, Poland
| | - Muhammad Bilal
- Department of Chemical and Biological Engineering, Monash University, Clayton, VIC 3800, Australia
| | - Hossain Md Adil
- Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24, Krakow 31-155, Poland
| | - Nnabodo Darlington
- Faculty of Chemical Engineering and Technology, Cracow University of Technology, Warszawska 24, Krakow 31-155, Poland
| | - Ahsan Khan
- Center of Excellence in Particle Technology and Material Processing, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Nouman Khan
- Faculty of Engineering Sciences, Ghulam Ishaq Khan Institute of Engineering Sciences and Technology, Topi 23640, KPK, Pakistan
| | - I Ihsanullah
- Chemical and Water Desalination Engineering Program, College of Engineering, University of Sharjah, Sharjah 27272, United Arab Emirates.
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Nairan A, Feng Z, Zheng R, Khan U, Gao J. Engineering Metallic Alloy Electrode for Robust and Active Water Electrocatalysis with Large Current Density Exceeding 2000 mA cm -2. Adv Mater 2024:e2401448. [PMID: 38518760 DOI: 10.1002/adma.202401448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Indexed: 03/24/2024]
Abstract
The amelioration of brilliantly effective electrocatalysts working at high current density for the oxygen evolution reaction (OER) is imperative for cost-efficient electrochemical hydrogen production. Yet, the kinetically sluggish and unstable catalysts remain elusive to large-scale hydrogen (H2) generation for industrial applications. Herein, a new strategy is demonstrated to significantly enhance the intrinsic activity of Ni1-xFex nanochain arrays through a trace proportion of heteroatom phosphorus doping that permits robust water splitting at an extremely large current density of 1000 and 2000 mA cm-2 for 760 h. The in situ formation of Ni2P and Ni5P4 on Ni1-xFex nanochain arrays surface and hierarchical geometry of the electrode significantly promote the reaction kinetics and OER activity. The OER electrode provides exceptionally low overpotentials of 222 and 327 mV at current densities of 10 and 2000 mA cm-2 in alkaline media, dramatically lower than benchmark IrO2 and is among the most active catalysts yet reported. Remarkably, the alkaline electrolyzer renders a low voltage of 1.75 V at a large current density of 1000 mA cm-2, indicating outperformed overall water splitting. The electrochemical fingerprints demonstrate vital progress toward large-scale H2 production for industrial water electrolysis.
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Affiliation(s)
- Adeela Nairan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Zhuo Feng
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Ruiming Zheng
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Usman Khan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Junkuo Gao
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
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Ahmad A, Nairan A, Feng Z, Zheng R, Bai Y, Khan U, Gao J. Unlocking the Potential of High Entropy Alloys in Electrochemical Water Splitting: A Review. Small 2024:e2311929. [PMID: 38396229 DOI: 10.1002/smll.202311929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/04/2024] [Indexed: 02/25/2024]
Abstract
The global pursuit of sustainable energy is focused on producing hydrogen through electrocatalysis driven by renewable energy. Recently, High entropy alloys (HEAs) have taken the spotlight in electrolysis due to their intriguing cocktail effect, broad design space, customizable electronic structure, and entropy stabilization effect. The tunability and complexity of HEAs allow a diverse range of active sites, optimizing adsorption strength and activity for electrochemical water splitting. This review comprehensively covers contemporary advancements in synthesis technique, design framework, and physio-chemical evaluation approaches for HEA-based electrocatalysts. Additionally, it explores design principles and strategies aimed at optimizing the catalytic activity, stability, and effectiveness of HEAs in hydrogen evolution reaction (HER), oxygen evolution reaction (OER), and overall water splitting. Through an in-depth investigation of these aspects, the complexity inherent in constituent element interactions, reaction processes, and active sites associated with HEAs is aimed to unravel. Eventually, an outlook regarding challenges and impending difficulties and an outline of the future direction of HEA in electrocatalysis is provided. The thorough knowledge offered in this review will assist in formulating and designing catalysts based on HEAs for the next generation of electrochemistry-related applications.
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Affiliation(s)
- Abrar Ahmad
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Adeela Nairan
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Zhuo Feng
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Ruiming Zheng
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Yelin Bai
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Usman Khan
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Junkuo Gao
- Institute of Functional Porous Materials, School of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, China
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Li H, Nairan A, Niu X, Chen Y, Sun H, Lai L, Qin J, Dang L, Wang G, Khan U, He F. A hidden phase uncovered by ultrafast carrier dynamics in thin Bi 2O 2Se. Nanoscale 2024; 16:4189-4196. [PMID: 38323830 DOI: 10.1039/d3nr05625b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Bi2O2Se has attracted intensive attention due to its potential in electronics, optoelectronics, and ferroelectric applications. Despite that, there have only been a handful of experimental studies based on ultrafast spectroscopy to elucidate the carrier dynamics in Bi2O2Se thin films. Besides, different groups have reported various ultrafast timescales and associated mechanisms across films of different thicknesses. A comprehensive understanding in relation to thickness and fluence is still lacking. In this work, we have systematically explored the thickness-dependent Raman spectroscopy and ultrafast carrier dynamics in chemical vapor deposition (CVD)-grown Bi2O2Se thin films on a mica substrate with thicknesses varying from 22.44 nm down to 4.62 nm in both low and high pump fluence regions. Combining the thickness dependence and fluence dependence of the slow decay time, we demonstrate a hidden photoinduced ferroelectric transition in the thinner (<8 nm) Bi2O2Se films below the material damage thresholds, influenced by substrate-induced compressive strain and far-from-equilibrium excitation. Moreover, this transition can be manifested at high electronic excitation densities. Our results deepen the understanding of the interplay between the ferroelectric phase and semiconducting characteristics of Bi2O2Se thin films, offering potential applications in optoelectronic devices that benefit from the ferroelectric transition.
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Affiliation(s)
- Hao Li
- State Key Laboratory on Tunable Laser Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
- Guangdong Provincial Key Laboratory of Aerospace Communication and Networking Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China.
| | - Adeela Nairan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, P. R. China.
| | - Xiaoran Niu
- State Key Laboratory on Tunable Laser Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
- Guangdong Provincial Key Laboratory of Aerospace Communication and Networking Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China.
| | - Yuxiang Chen
- School of Science and Ministry of Industry and Information Technology, Key Laboratory of Micro-Nano Opto-electronic Information System, Harbin Institute of Technology (Shenzhen), Shenzhen, Guangdong 518055, P. R. China
| | - Huarui Sun
- School of Science and Ministry of Industry and Information Technology, Key Laboratory of Micro-Nano Opto-electronic Information System, Harbin Institute of Technology (Shenzhen), Shenzhen, Guangdong 518055, P. R. China
| | - Linqing Lai
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
| | - Jingkai Qin
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
| | - Leyang Dang
- Shenzhen Key Laboratory for Advanced Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
| | - Guigen Wang
- Shenzhen Key Laboratory for Advanced Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
| | - Usman Khan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, P. R. China.
| | - Feng He
- State Key Laboratory on Tunable Laser Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China
- Guangdong Provincial Key Laboratory of Aerospace Communication and Networking Technology, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, P. R. China.
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Shaikh H, Ionita R, Khan U, Park Y, Jubran A, Tobin MJ, Laghi F. Effect of Atypical-Sleep EEG Patterns on Weaning From Prolonged Mechanical Ventilation. Chest 2024:S0012-3692(24)00011-4. [PMID: 38211699 DOI: 10.1016/j.chest.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Approximately one-third of acute ICU patients display atypical sleep patterns that cannot be interpreted by using standard EEG criteria for sleep. Atypical sleep patterns have been associated with poor weaning outcomes in acute ICUs. RESEARCH QUESTION Do patients being weaned from prolonged mechanical ventilation experience atypical sleep EEG patterns, and are these patterns linked with weaning outcomes? STUDY DESIGN AND METHODS EEG power spectral analysis during wakefulness and overnight polysomnogram were performed on alert, nondelirious patients at a long-term acute care facility. RESULTS Forty-four patients had been ventilated for a median duration of 38 days at the time of the polysomnogram study. Eleven patients (25%) exhibited atypical sleep EEG. During wakefulness, relative EEG power spectral analysis revealed higher relative delta power in patients with atypical sleep than in patients with usual sleep (53% vs 41%; P < .001) and a higher slow-to-fast power ratio during wakefulness: 4.39 vs 2.17 (P < .001). Patients with atypical sleep displayed more subsyndromal delirium (36% vs 6%; P = .027) and less rapid eye movement sleep (4% vs 11% total sleep time; P < .02). Weaning failure was more common in the atypical sleep group than in the usual sleep group: 91% vs 45% (P = .013). INTERPRETATION This study provides the first evidence that patients in a long-term acute care facility being weaned from prolonged ventilation exhibit atypical sleep EEG patterns that are associated with weaning failure. Patients with atypical sleep EEG patterns had higher rates of subsyndromal delirium and slowing of the wakeful EEG, suggesting that these two findings represent a biological signal for brain dysfunction.
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Affiliation(s)
- Hameeda Shaikh
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL
| | - Ramona Ionita
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL
| | - Usman Khan
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL
| | - Youngsook Park
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL
| | - Amal Jubran
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL; RML Specialty Hospital, Hinsdale, IL
| | - Martin J Tobin
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL.
| | - Franco Laghi
- Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL; RML Specialty Hospital, Hinsdale, IL
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Pan Y, Gao J, Li Y, Lv E, Khan U, Yang X, Yao J, Nairan A, Zhang Q. Constructing Nitrogen-Doped Carbon Hierarchy Structure Derived from Metal-Organic Framework as High-Performance ORR Cathode Material for Zn-Air Battery. Small 2024; 20:e2304594. [PMID: 37691089 DOI: 10.1002/smll.202304594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/30/2023] [Indexed: 09/12/2023]
Abstract
The development of efficient and low-cost catalysts for cathodic oxygen reduction reaction (ORR) in Zn-air battery (ZAB) is a key factor in reducing costs and achieving industrialization. Here, a novel segregated CoNiPt alloy embedded in N-doped porous carbon with a nanoflowers (NFs)-like hierarchy structure is synthesized through pyrolyzing Hofmann-type metal-organic frameworks (MOFs). The unique hierarchical NFs structure exposes more active sites and facilitates the transportation of reaction intermediates, thus accelerating the reaction kinetics. Impressively, the resulting 15% CoNiPt@C NFs catalyst exhibits outstanding alkaline ORR activity with a half-wave potential of 0.93 V, and its mass activity is 7.5 times higher than that of commercial Pt/C catalyst, surpassing state-of-the-art noble metal-based catalysts. Furthermore, the assembled CoNiPt@C+RuO2 ZAB demonstrates a maximum power density of 172 mW cm-2 , which is superior to that of commercial Pt/C+RuO2 ZAB. Experimental results reveal that the intrinsic ORR mass activity is attributed to the synergistic interaction between oxygen defects and pyrrolic/graphitic N species, which optimizes the adsorption energy of the intermediate species in the ORR process and greatly enhances catalytic activity. This work provides a practical and feasible strategy for synthesizing cost-effective alkaline ORR catalysts by optimizing the electronic structure of MOF-derived catalysts.
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Affiliation(s)
- Yangdan Pan
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Junkuo Gao
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Yuwen Li
- Department of Chemistry, Zhejiang University, 310018, Hangzhou, China
| | - Enjun Lv
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Usman Khan
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Xiaogang Yang
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Juming Yao
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Adeela Nairan
- School of Materials Science and Engineering, Institute of Functional Porous Materials, The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, Zhejiang Sci-Tech University, 310018, Hangzhou, China
| | - Qichun Zhang
- Department of Materials Science and Engineering, Department of Chemistry & Center of Super-Diamond and Advanced Films (COSDAF), City University of Hong Kong, 999077, Hong Kong, China
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Zaratin P, Khan U, Graffigna G. Comment on "Reflections on patient engagement by patient partners: How it can go wrong". Res Involv Engagem 2023; 9:122. [PMID: 38129935 PMCID: PMC10740255 DOI: 10.1186/s40900-023-00534-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
As patient-advocacy, public policy and clinical researchers with special knowledge on Responsible Research Innovation (RRI) governance and the public health and psychology underlying patient engagement, we read with interest the comment contribution by Richards et al., "Reflections on patient engagement by patient partners: How it can go wrong" (Richards et al. in Res Involv Engagem 9:41, 2023. https://doi.org/10.1186/s40900-023-00454-13 ). As a way to help meet the "take-away actions for readers" included by the authors at the end of the article, we would like to further stimulate discussion with relevant stakeholder communities about the need to rethink the use of "expert patient". Based on our experience, the lack of a governance model engaging patients who are representative of the target patient community, as opposed to expert patients, is at the root of the tokenistic approach, the "patient partner as a checkmark statement" and the "lack of recognizing the vulnerability of patient partners", which results in "patient engagement going wrong". According to our experience, the Responsible Research Innovation (RRI) MULTI-ACT model has the potential to help meet these challenges.
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Affiliation(s)
- Paola Zaratin
- Italian Multiple Sclerosis Society Foundation, Genoa, Italy.
| | - Usman Khan
- Institute for Health Care Policy, KU Louvain, Leuven, Belgium
| | - Guendalina Graffigna
- Department of Psychology, EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
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Allawendy SAA, Khan U, Phipps M, Kenosi M. Head circumference measurements. Ir Med J 2023; 116:878. [PMID: 38258737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
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du Cros P, Greig J, Alffenaar JWC, Cross GB, Cousins C, Berry C, Khan U, Phillips PPJ, Velásquez GE, Furin J, Spigelman M, Denholm JT, Thi SS, Tiberi S, Huang GKL, Marks GB, Turkova A, Guglielmetti L, Chew KL, Nguyen HT, Ong CWM, Brigden G, Singh KP, Motta I, Lange C, Seddon JA, Nyang'wa BT, Maug AKJ, Gler MT, Dooley KE, Quelapio M, Tsogt B, Menzies D, Cox V, Upton CM, Skrahina A, McKenna L, Horsburgh CR, Dheda K, Marais BJ. Standards for clinical trials for treating TB. Int J Tuberc Lung Dis 2023; 27:885-898. [PMID: 38042969 PMCID: PMC10719894 DOI: 10.5588/ijtld.23.0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/21/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND: The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice.METHODS: A global panel of experts participated in a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached.RESULTS: Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.CONCLUSION: These standards should improve the efficiency and effectiveness of evidence generation, as well as the translation of research into policy and practice.
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Affiliation(s)
- P du Cros
- Burnet Institute, Melbourne, VIC, Monash Infectious Diseases, Monash Health, Melbourne, VIC, Australia
| | - J Greig
- Burnet Institute, Melbourne, VIC, Médecins Sans Frontières (MSF), Manson Unit, London, UK
| | - J-W C Alffenaar
- Sydney Infectious Diseases Institute (Sydney ID), and, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Westmead Hospital, Sydney, NSW
| | - G B Cross
- Burnet Institute, Melbourne, VIC, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Cousins
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - C Berry
- Médecins Sans Frontières (MSF), Manson Unit, London, UK
| | - U Khan
- Interactive Research and Development Global, Singapore City, Singapore
| | - P P J Phillips
- UCSF Center for Tuberculosis, Division of Pulmonary and Critical Care Medicine, and
| | - G E Velásquez
- UCSF Center for Tuberculosis, Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA
| | - J Furin
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA
| | - M Spigelman
- Global Alliance for TB Drug Development, New York, NY, USA
| | - J T Denholm
- Victorian Tuberculosis Program, Melbourne Health, Melbourne, VIC, Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - S S Thi
- Eswatini National TB Control Program, Mbabane, Kingdom of Eswatini
| | - S Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, GlaxoSmithKline, London, UK
| | - G K L Huang
- Burnet Institute, Melbourne, VIC, Northern Health Infectious Diseases, Northern Health, Melbourne, VIC
| | - G B Marks
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - A Turkova
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - L Guglielmetti
- Médecins Sans Frontières (MSF), Paris, Sorbonne Université, Institut national de la santé et de la recherche médicale, Unité 1135, Centre d'Immunologie et des Maladies Infectieuses, Paris, Assistance Publique Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries, Paris, France
| | - K L Chew
- Department of Laboratory Medicine, National University Hospital, Singapore City, Singapore
| | - H T Nguyen
- Research Department, Friends for International TB Relief, Ha Noi, Vietnam
| | - C W M Ong
- Infectious Diseases Translational Research Programme, Department of Medicine, National University of Singapore, Singapore City, Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore City, Institute of Healthcare Innovation & Technology, National University of Singapore, Singapore City, Singapore
| | - G Brigden
- The Global Fund, Geneva, Switzerland
| | - K P Singh
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia, Victorian Infectious Disease Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | - C Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, German Center for Infection Research (DZIF), TTU-TB, Borstel, Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - J A Seddon
- Department of Infectious Disease, Imperial College London, London, UK, Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, South Africa
| | - B-T Nyang'wa
- Public Health Department, Operational Center Amsterdam (OCA), MSF, Amsterdam, The Netherlands
| | - A K J Maug
- Damien Foundation Bangladesh, Dhaka, Bangladesh
| | - M T Gler
- De La Salle Medical and Health Sciences Institute, Dasmariñas, the Philippines
| | - K E Dooley
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - M Quelapio
- Tropical Disease Foundation, Makati City, Manila, the Philippines, KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - B Tsogt
- Mongolian Anti-TB Coalition, Ulaanbaatar, Mongolia
| | - D Menzies
- Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute & McGill International TB Centre, Montreal, QC, Canada
| | - V Cox
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town
| | - C M Upton
- TASK Applied Science, Cape Town, South Africa
| | - A Skrahina
- The Republican Scientific and Practical Center for Pulmonology and TB, Minsk, Belarus
| | - L McKenna
- Treatment Action Group, New York, NY
| | - C R Horsburgh
- Departments of Global Health, Epidemiology, Biostatistics and Medicine, Schools of Public Health and Medicine, Boston University, Boston MA, USA
| | - K Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa, Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
| | - B J Marais
- Sydney Infectious Diseases Institute (Sydney ID), and, The Children's Hospital at Westmead, Sydney, NSW, WHO Collaborating Centre in Tuberculosis, The University of Sydney, Sydney, NSW, Australia
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Khan U, MacKay C, Rigby M, Trites J, Corsten M, Taylor SM. Management of positive resection margins following transoral laser microsurgery for glottic cancer. Laryngoscope Investig Otolaryngol 2023; 8:1579-1583. [PMID: 38130264 PMCID: PMC10731511 DOI: 10.1002/lio2.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/31/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives The current literature provides limited guidance on the management of positive margins (PMs) following transoral laser microsurgery (TLM) for glottic squamous cell carcinoma (SCC). Long-term data exploring the treatment of PMs with both initial observation and re-resection are limited. Our objective was to determine the optimal treatment for PM patients following TLM for glottic SCC. Methods Clinical information on glottic SCC patients with PMs following treatment with TLM was prospectively collected at our institution from 2007 to 2018. We use a laryngeal template during the initial TLM where the area of resection is outlined for future reference. Data were compared with univariate analysis and survival plots were generated using the Kaplan-Meier method. Results A total of 29 patients with PMs were treated with either re-resection (19 patients), close observation (6 patients), or adjuvant radiation alone (4 patients). Re-resection patients had SCC or severe dysplasia on initial margin pathology and 23% with early-stage disease had recurrence (T1-T2). Five (83%) patients who underwent close observation required re-resection based on clinical suspicion of recurrence (confirmed on final pathology), which was significantly different from the re-resection patients (p < .05). Close observation was therefore discontinued as a management of PMs. Four patients (21%) had no residual malignancy on re-resection specimens. Deep margins only accounted for 17% of all PMs. Disease-specific survival for all PM patients at 5 years was 82.4% (SE 9.6%, CI 53.4%-91.6%). Conclusions Our long-term experience with treating early-stage glottic SCC with TLM supports re-resection as an appropriate management for cases of PMs. Level of Evidence 4.
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Affiliation(s)
- Usman Khan
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Colin MacKay
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Matthew Rigby
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Jonathan Trites
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
| | - Martin Corsten
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
| | - S. Mark Taylor
- Division of Otolaryngology—Head and Neck Surgery, Department of SurgeryDalhousie UniversityHalifaxNova ScotiaCanada
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11
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Patil SB, Tamirat M, Khazhidinov K, Ardizzoni E, Atger M, Austin A, Baudin E, Bekhit M, Bektasov S, Berikova E, Bonnet M, Caboclo R, Chaudhry M, Chavan V, Cloez S, Coit J, Coutisson S, Dakenova Z, De Jong BC, Delifer C, Demaisons S, Do JM, Dos Santos Tozzi D, Ducher V, Ferlazzo G, Gouillou M, Khan U, Kunda M, Lachenal N, LaHood AN, Lecca L, Mazmanian M, McIlleron H, Moreau M, Moschioni M, Nahid P, Osso E, Oyewusi L, Panda S, Pâquet A, Thuong Huu P, Pichon L, Rich ML, Rupasinghe P, Salahuddin N, Sanchez Garavito E, Seung KJ, Velásquez GE, Vallet M, Varaine F, Yuya-Septoh FJ, Mitnick CD, Guglielmetti L. Evaluating newly approved drugs in combination regimens for multidrug-resistant tuberculosis with fluoroquinolone resistance (endTB-Q): study protocol for a multi-country randomized controlled trial. Trials 2023; 24:773. [PMID: 38037119 PMCID: PMC10688049 DOI: 10.1186/s13063-023-07701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Treatment for fluoroquinolone-resistant multidrug-resistant/rifampicin-resistant tuberculosis (pre-XDR TB) often lasts longer than treatment for less resistant strains, yields worse efficacy results, and causes substantial toxicity. The newer anti-tuberculosis drugs, bedaquiline and delamanid, and repurposed drugs clofazimine and linezolid, show great promise for combination in shorter, less-toxic, and effective regimens. To date, there has been no randomized, internally and concurrently controlled trial of a shorter, all-oral regimen comprising these newer and repurposed drugs sufficiently powered to produce results for pre-XDR TB patients. METHODS endTB-Q is a phase III, multi-country, randomized, controlled, parallel, open-label clinical trial evaluating the efficacy and safety of a treatment strategy for patients with pre-XDR TB. Study participants are randomized 2:1 to experimental or control arms, respectively. The experimental arm contains bedaquiline, linezolid, clofazimine, and delamanid. The control comprises the contemporaneous WHO standard of care for pre-XDR TB. Experimental arm duration is determined by a composite of smear microscopy and chest radiographic imaging at baseline and re-evaluated at 6 months using sputum culture results: participants with less extensive disease receive 6 months and participants with more extensive disease receive 9 months of treatment. Randomization is stratified by country and by participant extent-of-TB-disease phenotype defined according to screening/baseline characteristics. Study participation lasts up to 104 weeks post randomization. The primary objective is to assess whether the efficacy of experimental regimens at 73 weeks is non-inferior to that of the control. A sample size of 324 participants across 2 arms affords at least 80% power to show the non-inferiority, with a one-sided alpha of 0.025 and a non-inferiority margin of 12%, against the control in both modified intention-to-treat and per-protocol populations. DISCUSSION This internally controlled study of shortened treatment for pre-XDR TB will provide urgently needed data and evidence for clinical and policy decision-making around the treatment of pre-XDR TB with a four-drug, all-oral, shortened regimen. TRIAL REGISTRATION ClinicalTrials.Gov NCT03896685. Registered on 1 April 2018; the record was last updated for study protocol version 4.3 on 17 March 2023.
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Affiliation(s)
- S B Patil
- Indian Council of Medical Research (ICMR) - National AIDS Research Institute, Pune, India
| | | | | | - E Ardizzoni
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - M Atger
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - A Austin
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
| | | | - M Bekhit
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - E Berikova
- Partners In Health, Astana, Kazakhstan
- National Scientific Center of Phthisiopulmonology, Almaty, Kazakhstan
| | - M Bonnet
- Université de Montpellier, IRD, INSERM, Montpellier, TransVIHMI, France
| | - R Caboclo
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - M Chaudhry
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - V Chavan
- Médecins Sans Frontières, Mumbai, India
| | - S Cloez
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - J Coit
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - S Coutisson
- Médecins Sans Frontières, Geneva, Switzerland
| | - Z Dakenova
- City Center of Phthisiopulmonology, Astana, Kazakhstan
| | - B C De Jong
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - C Delifer
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - S Demaisons
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - J M Do
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - V Ducher
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - G Ferlazzo
- Médecins Sans Frontières, Geneva, Switzerland
| | | | - U Khan
- Interactive Research and Development (IRD) Global, Singapore, Singapore
| | - M Kunda
- Partners In Health, Maseru, Lesotho
| | - N Lachenal
- Médecins Sans Frontières, Geneva, Switzerland
| | - A N LaHood
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - L Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Socios En Salud-Sucursal Peru, Lima, Peru
| | - M Mazmanian
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
- Assistance Publique Hôpitaux de Paris (APHP), Unité de Recherche Clinique, Hôpital Pitié-Salpêtrière, Paris, France
- Santé Arménie French-Armenian Research Center, Yerevan, Armenia
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - M Moreau
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - P Nahid
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
| | - E Osso
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - S Panda
- Indian Council of Medical Research Headquarters, New Delhi, India
- Indian Journal of Medical Research, New Delhi, India
| | - A Pâquet
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - L Pichon
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - M L Rich
- Partners In Health, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - P Rupasinghe
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - N Salahuddin
- Indus Hospital & Health Network, Karachi, Pakistan
| | | | | | - G E Velásquez
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - M Vallet
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - F Varaine
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - C D Mitnick
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - L Guglielmetti
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France.
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie Et Des Maladies Infectieuses, Paris, France.
- Assistance Publique Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Centre National De Référence Des Mycobactéries Et De La Résistance Des Mycobactéries Aux Antituberculeux, Paris, France.
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12
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Khan U, Yasin A. Plane invariant segmentation of computed tomography images through weighted cross entropy optimized conditional GANs in compressed formats. Med Biol Eng Comput 2023; 61:2677-2697. [PMID: 37428300 DOI: 10.1007/s11517-023-02846-7] [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] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/12/2023] [Indexed: 07/11/2023]
Abstract
Computed tomography (CT) scan provides first-hand knowledge to doctors to identify an ailment. Deep neural networks help enhance image understanding through segmentation and labeling. In this work, we implement two variants of Pix2Pix generative adversarial networks (GANs) with varying complexities of generator and discriminator networks for plane invariant segmentation of CT scan images and subsequently propose an effective generative adversarial network with a suitably weighted binary cross-entropy loss function followed by image processing layer necessary for getting high-quality output segmentation. Our conditional GAN is powered by a unique set of an encoder-decoder network that coupled with the image processing layer produces enhanced segmentation. The network can be extended to the complete set of Hounsfield units and can also be implemented on smartphones. Furthermore, we also demonstrate effects on accuracy, F-1 score, and Jaccard index by using the conditional GAN networks on the spine vertebrae dataset, thus achieving an average of 86.28 % accuracy, 90.5 % Jaccard index score, and 89.9 % F-1 score in predicting segmented maps for validation input images. In addition, an overall lifting of accuracy, F-1 score, and Jaccard index graph for validation images with better continuity has also been highlighted.
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Affiliation(s)
- Usman Khan
- SS-CASE-IT Islamabad, Islamabad, Pakistan.
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13
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Pauls MMH, Fish J, Binnie LR, Benjamin P, Betteridge S, Clarke B, Dhillon MPK, Ghatala R, Hainsworth FAH, Howe FA, Khan U, Kruuse C, Madigan JB, Moynihan B, Patel B, Pereira AC, Rostrup E, Shtaya ABY, Spilling CA, Trippier S, Williams R, Young R, Barrick TR, Isaacs JD, Hainsworth AH. Testing the cognitive effects of tadalafil. Neuropsychological secondary outcomes from the PASTIS trial. Cereb Circ Cogn Behav 2023; 5:100187. [PMID: 37811523 PMCID: PMC10550803 DOI: 10.1016/j.cccb.2023.100187] [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: 05/04/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
Cerebral small vessel disease (SVD) is a major cause of cognitive impairment in older people. As secondary endpoints in a phase-2 randomised clinical trial, we tested the effects of single administration of a widely-used PDE5 inhibitor, tadalafil, on cognitive performance in older people with SVD. In a double-blinded, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥ 7 days apart (randomised to order of treatment). The Montreal Cognitive Assessment (MOCA) was administered at baseline, alongside a measure to estimate optimal intellectual ability (Test of Premorbid Function). Then, before and after treatment, a battery of neuropsychological tests was administered, assessing aspects of attention, information processing speed, working memory and executive function. Sixty-five participants were recruited and 55 completed the protocol (N = 55, age: 66.8 (8.6) years, range 52-87; 15/40 female/male). Median MOCA score was 26 (IQR: 23, 27], range 15-30). No significant treatment effects were seen in any of the neuropsychological tests. There was a trend towards improved performance on Digit Span Forward (treatment effect 0.37, C.I. 0.01, 0.72; P = 0.0521). We did not identify significant treatment effects of single-administration tadalafil on neuropsychological performance in older people with SVD. The trend observed on Digit Span Forward may help to inform future studies. Clinical trial registration http://www.clinicaltrials.gov. Unique identifier: NCT00123456, https://eudract.ema.europa.eu. Unique identifier: 2015-001,235-20NCT00123456.
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Affiliation(s)
- Mathilde MH Pauls
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Jessica Fish
- Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK
- School of Health & Wellbeing, University of Glasgow, UK
| | - Lauren R Binnie
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Philip Benjamin
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Shai Betteridge
- Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Brian Clarke
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Rita Ghatala
- South London Stroke Research Network, London, UK
| | | | - Franklyn A Howe
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Christina Kruuse
- Department of Neurology and Neurovascular Research Unit, Herlev Gentofte Hospital, Denmark
| | - Jeremy B Madigan
- Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Barry Moynihan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Bhavini Patel
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Anthony C Pereira
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Egill Rostrup
- Mental Health Centre, University of Copenhagen, Glostrup, Denmark
| | - Anan BY Shtaya
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Catherine A Spilling
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | | | | | - Robin Young
- Robertson Centre for Biostatistics, University of Glasgow, UK
| | - Thomas R Barrick
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
| | - Jeremy D Isaacs
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Atticus H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
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14
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Coveney J, Khan U, Beattie T. Is high-concentration Nitrous oxide the safest option for short periods of procedural sedation in Paediatric Emergency Medicine. Ir Med J 2023; 116:844. [PMID: 37791896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
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15
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Khan J, Ahmad RTM, Yu Q, Liu H, Khan U, Liu B. A La 2O 3/MXene composite electrode for supercapacitors with improved capacitance and cycling performance. Sci Technol Adv Mater 2023; 24:2242262. [PMID: 37614964 PMCID: PMC10443969 DOI: 10.1080/14686996.2023.2242262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/07/2023] [Accepted: 06/21/2023] [Indexed: 08/25/2023]
Abstract
Developing efficient electrode materials is a key towards high power electrochemical energy storage devices. Two-dimensional (2D) MXene shows excellent conductivity and electrochemical performance among other materials. However, the restacking of MXene layers may degrade their specific capacity and cycling performance. Considering this challenge, here we have designed a composite made of 2D MXene nanosheets and lanthanum oxide (La2O3) nanoparticles to overcome the limitations. The bifunctionality of La2O3 nanoparticles prevents the restacking of MXene layers and enhances the electrochemical properties of the electrode due to its good Faradic characteristics. The specific capacitance of the La2O3/MXene composite electrode is 366 F/g at 1 A/g, which is 4.5 and 3 times higher than those of the individual La2O3 and MXene. The composite electrode displays a capacitance retention of 96% after 1,000 cycles, which is due to synergistic effects between the two components and indicates the potential of La2O3/MXene composite for supercapacitors.
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Affiliation(s)
- Jahangir Khan
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute & Institute of Materials Research, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, P. R. China
- Department of Electrical Engineering, Narowal Campus, University of Engineering and Technology, Lahore, Pakistan
| | - Rana Tariq Mehmood Ahmad
- Department of Electrical Engineering, Narowal Campus, University of Engineering and Technology, Lahore, Pakistan
| | - Qiangmin Yu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute & Institute of Materials Research, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, P. R. China
| | - Heming Liu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute & Institute of Materials Research, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, P. R. China
| | - Usman Khan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, P. R. China
| | - Bilu Liu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute & Institute of Materials Research, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, P. R. China
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16
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Lo Presti A, Montoya NA, Criscuolo V, Khan G, Khan U, Vecchione R, Falconi C. Fundamentals of Skin Bioimpedances. Adv Mater 2023; 35:e2302127. [PMID: 37252818 DOI: 10.1002/adma.202302127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/14/2023] [Indexed: 06/01/2023]
Abstract
The bioimpedances of tissues beyond the stratum corneum, which is the outermost layer of skin, contain crucial clinical information. Nevertheless, bioimpedance measurements of both the viable skin and the adipose tissue are not widely used, mainly because of the complex multilayered skin structure and the electrically insulating nature of the stratum corneum. Here, a theoretical framework is established for analyzing the impedances of multilayered tissues and, in particular, of skin. Then, strategies are determined for the system-level design of electrodes and electronics, which minimize 4-wire (or tetrapolar) measurement errors even in the presence of a top insulating tissue, thus enabling non-invasive characterizations of tissues beyond the stratum corneum. As an example, non-invasive measurements of bioimpedances of living tissues are demonstrated in the presence of parasitic impedances which are much (e.g., up to 350 times) higher than the bioimpedances of the living tissues beyond the stratum corneum, independently on extreme variations of the barrier (tape stripping) or of the skin-electrode contact impedances (sweat). The results can advance the development of bioimpedance systems for the characterization of viable skin and adipose tissues in several applications, including transdermal drug delivery and the assessment of skin cancer, obesity, dehydration, type 2 diabetes mellitus, cardiovascular risk, and multipotent adult stem cells.
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Affiliation(s)
- Andrea Lo Presti
- Department of Electronic Engineering, University of Rome Tor Vergata, Via del Politecnico 1, Roma, 00133, Italy
| | - Nerio Andrés Montoya
- Department of Electronic Engineering, University of Rome Tor Vergata, Via del Politecnico 1, Roma, 00133, Italy
- School of Physics, Universidad Nacional de Colombia, Medellín, A. A. 3840, Colombia
| | - Valeria Criscuolo
- Department of Electronic Engineering, University of Rome Tor Vergata, Via del Politecnico 1, Roma, 00133, Italy
- Center for Advanced Biomaterial for Health Care, Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, Naples, 80125, Italy
- Faculty of Electrical Engineering and IT, RWTH Aachen, 52062, Aachen, Germany
- Institute for Biological Information Processing - Bioelectronics, IBI-3, Forschungszentrum Juelich, 52428, Aachen, Germany
| | - Gulaly Khan
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology, Sector H-12, Islamabad, 44000, Pakistan
| | - Usman Khan
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology, Sector H-12, Islamabad, 44000, Pakistan
| | - Raffaele Vecchione
- Center for Advanced Biomaterial for Health Care, Istituto Italiano di Tecnologia, Largo Barsanti e Matteucci 53, Naples, 80125, Italy
| | - Christian Falconi
- Department of Electronic Engineering, University of Rome Tor Vergata, Via del Politecnico 1, Roma, 00133, Italy
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Khan U, Elseby A, Qureshi H. Diarrhoea: An Inflammatory Disorder Mimicking an Infection. Cureus 2023; 15:e44101. [PMID: 37750152 PMCID: PMC10518136 DOI: 10.7759/cureus.44101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
Diarrhoea is a common presentation in acute emergency with potentially multifactorial causes. Hence, the chances of misdiagnosis can be high. Among these causes are listed diseases which are primarily inflammatory in nature. Presented here is a rare case of Behcet's colitis with valuable clinical lessons, in a patient who is known to have Behcet's disease and was admitted with acute onset bloody diarrhoea. This was a gastrointestinal manifestation of the patient's multisystemic inflammatory disorder as proven by investigations via computed tomography (CT) scan, sigmoidoscopy, and histology. He was treated with steroids and mesalazine, and later switched to infliximab and made a quick recovery.
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Affiliation(s)
- Usman Khan
- Internal Medicine, Royal Preston Hospital, Preston, GBR
| | - Amr Elseby
- Family Medicine, Blackpool Victoria Hospital, Blackpool, GBR
| | - Hassan Qureshi
- Internal Medicine, Blackpool Victoria Hospital, Blackpool, GBR
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Ahmed S, Lotia-Farrukh I, Khan PY, Adnan S, Sodho JS, Bano S, Siddiqui MR, Ghafoor A, Isani AK, Salahuddin N, Khan U. High prevalence of multidrug-resistant TB among household contacts in a high burden setting. Int J Tuberc Lung Dis 2023; 27:646-648. [PMID: 37491755 PMCID: PMC10365561 DOI: 10.5588/ijtld.23.0123] [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: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 07/27/2023] Open
Affiliation(s)
- S Ahmed
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - I Lotia-Farrukh
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - P Y Khan
- Interactive Research and Development, Karachi, Sindh, Pakistan, London School of Hygiene & Tropical Medicine, London, UK
| | - S Adnan
- Indus Hospital and Health Network, Karachi
| | - J S Sodho
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - S Bano
- Indus Hospital and Health Network, Karachi
| | | | - A Ghafoor
- National TB Control Programme, Islamabad
| | - A K Isani
- Communicable Disease Control Sindh, Hyderabad, Pakistan
| | | | - U Khan
- Interactive Research and Development, Karachi, Sindh, Pakistan
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19
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Khan KS, Jawaid S, Memon UA, Perera T, Khan U, Farwa UE, Jindal U, Afzal MS, Razzaq W, Abdin ZU, Khawaja UA. Management of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in Hospitalized Patients From Admission to Discharge: A Comprehensive Review of Therapeutic Interventions. Cureus 2023; 15:e43694. [PMID: 37724212 PMCID: PMC10505355 DOI: 10.7759/cureus.43694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common and debilitating condition that often necessitates hospitalization for exacerbations. Since COPD exacerbations can cause significant morbidity and mortality, managing them is crucial for patient care. Effective management of COPD exacerbations is essential to prevent complications, as COPD exacerbations are associated with increased healthcare costs and decreased quality of life. This review aims to comprehensively discuss the management of COPD exacerbations, covering various pharmacologic and non-pharmacologic strategies. These include inhaled bronchodilators, systemic steroids, antibiotics, invasive and non-invasive ventilation, oxygen therapy, smoking cessation, immunization with pneumococcal vaccine, inhalers at discharge, pulmonary rehabilitation, long-term oxygen therapy (LTOT), ambulatory oxygen therapy, short-burst oxygen therapy, extracorporeal membrane oxygenation (ECMO), lung volume reduction surgery (LVRS), endobronchial procedures, and lung transplant. It is drawn upon various sources, including clinical studies, systemic reviews, and observational studies, to provide a comprehensive overview of current practices and identify areas for future research and innovation in managing COPD exacerbations. Addressing these areas of interest can improve patient outcomes and quality of life.
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Affiliation(s)
- Khizar S Khan
- Basic Sciences, Foundation University Medical College, Islamabad, PAK
| | - Sanyah Jawaid
- Internal Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Unaib Ahmed Memon
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Tharindu Perera
- General Medicine, Grodno State Medical University, Grodno, BLR
| | - Usman Khan
- General Practice, Akhtar Saeed Medical and Dental College, Lahore, PAK
| | - Umm E Farwa
- Emergency Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Urmi Jindal
- Internal Medicine, KJ Somaiya Medical College, Mumbai, IND
| | | | - Waleed Razzaq
- Internal Medicine, Services Hospital Lahore, Lahore, PAK
| | - Zain U Abdin
- Medicine, District Head Quarter Hospital, Faisalabad, PAK
| | - Uzzam Ahmed Khawaja
- Pulmonary and Critical Care Medicine, Jinnah Medical and Dental College, Karachi, PAK
- Clinical and Translational Research, Dr Ferrer BioPharma, South Miami, USA
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20
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Sleiwah A, Patel B, Khan U. Preoperative imaging of open lower limb fractures with CT angiography. J Plast Reconstr Aesthet Surg 2023; 82:279-281. [PMID: 37244014 DOI: 10.1016/j.bjps.2023.04.035] [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: 03/19/2023] [Accepted: 04/07/2023] [Indexed: 05/29/2023]
Affiliation(s)
- A Sleiwah
- Department of Plastic Surgery, Southmead Hospital, Southmead Rd, Bristol BS10 5NB, United Kingdom.
| | - B Patel
- Department of Plastic Surgery, Southmead Hospital, Southmead Rd, Bristol BS10 5NB, United Kingdom
| | - U Khan
- Department of Plastic Surgery, Southmead Hospital, Southmead Rd, Bristol BS10 5NB, United Kingdom
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21
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Yu Q, Wang X, Wu W, Feng X, Kong D, Khan U, Ren X, Li L. In Situ Encapsulation of Graphene Quantum Dots in Highly Stable Porphyrin Metal-Organic Frameworks for Efficient Photocatalytic CO 2 Reduction. Molecules 2023; 28:4703. [PMID: 37375258 DOI: 10.3390/molecules28124703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Photocatalytic CO2 reduction to valuable hydrocarbon solar fuel is of great significance but still challenging. Strong CO2 enrichment ability and easily adjustable structures make metal-organic frameworks (MOFs) potential photocatalysts for CO2 conversion. Even though pure MOFs have the potential for photoreduction of CO2, the efficiency is still quite low due to rapid photogenerated electron-hole recombination and other drawbacks. In this work, graphene quantum dots (GQDs) were in situ encapsulated into highly stable MOFs via a solvothermal method for this challenging task. The GQDs@PCN-222 with encapsulated GQDs showed similar Powder X-ray Diffraction (PXRD) patterns to PCN-222, indicating the retained structure. The porous structure was also retained with a Brunauer-Emmett-Teller (BET) surface area of 2066 m2/g. After incorporation of GQDs, the shape of GQDs@PCN-222 particles remained, as revealed by the scanning electron microscope (SEM). As most of the GQDs were covered by thick PCN-222, it was hard to observe those GQDs using a transmission electron microscope (TEM) and a high-resolution transmission electron microscope (HRTEM) directly, the treatment of digested GQDs@PCN-222 particles by immersion in a 1 mM aqueous KOH solution can make the incorporated GQDs visible in TEM and HRTEM. The linker, deep purple porphyrins, make MOFs a highly visible light harvester up to 800 nm. The introduction of GQDs inside PCN-222 can effectively promote the spatial separation of the photogenerated electron-hole pairs during the photocatalytic process, which was proved by the transient photocurrent plot and photoluminescence emission spectra. Compared with pure PCN-222, the obtained GQDs@PCN-222 displayed dramatically enhanced CO production derived from CO2 photoreduction with 147.8 μmol/g/h in a 10 h period under visible light irradiation with triethanolamine (TEOA) as a sacrificial agent. This study demonstrated that the combination of GQDs and high light absorption MOFs provides a new platform for photocatalytic CO2 reduction.
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Affiliation(s)
- Qin Yu
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Xusheng Wang
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
- Guangdong Provincial Key Laboratory of Functional Supramolecular Coordination Materials and Applications, Jinan University, Guangzhou 510632, China
- Tongxiang Research Institute, Zhejiang Sci-Tech University, Jiaxing 314500, China
- Zhejiang LINIX Motor Co., Ltd., Jinhua 322118, China
| | - Wenbin Wu
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Xinya Feng
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Deyu Kong
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Usman Khan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Xiaohui Ren
- The State Key Laboratory of Refractories and Metallurgy, School of Materials and Metallurgy, Wuhan University of Science and Technology, Wuhan 430081, China
| | - Lan Li
- College of Materials and Chemistry, China Jiliang University, Hangzhou 310018, China
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22
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Rich ML, Khan U, Zeng C, LaHood A, Franke MF, Atwood S, Bastard M, Burhan E, Danielyan N, Dzhazibekova PM, Gadissa D, Ghafoor A, Hewison C, Islam MS, Kazmi E, Khan PY, Lecca L, Maama LB, Melikyan N, Naing YY, Philippe K, Saki NA, Seung KJ, Skrahina A, Tefera GB, Varaine F, Vilbrun SC, Võ L, Mitnick CD, Huerga H. Outcomes of WHO-conforming, longer, all-oral multidrug-resistant TB regimens and analysis implications. Int J Tuberc Lung Dis 2023; 27:451-457. [PMID: 37231598 PMCID: PMC10237267 DOI: 10.5588/ijtld.22.0613] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/02/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND: Evidence of the effectiveness of the WHO-recommended design of longer individualized regimens for multidrug- or rifampicin-resistant TB (MDR/RR-TB) is limited.OBJECTIVES: To report end-of-treatment outcomes for MDR/RR-TB patients from a 2015-2018 multi-country cohort that received a regimen consistent with current 2022 WHO updated recommendations and describe the complexities of comparing regimens.METHODS: We analyzed a subset of participants from the endTB Observational Study who initiated a longer MDR/RR-TB regimen that was consistent with subsequent 2022 WHO guidance on regimen design for longer treatments. We excluded individuals who received an injectable agent or who received fewer than four likely effective drugs.RESULTS: Of the 759 participants analyzed, 607 (80.0%, 95% CI 77.0-82.7) experienced successful end-of-treatment outcomes. The frequency of success was high across groups, whether stratified on number of Group A drugs or fluoroquinolone resistance, and ranged from 72.1% to 90.0%. Regimens were highly variable regarding composition and the duration of individual drugs.CONCLUSIONS: Longer, all-oral, individualized regimens that were consistent with 2022 WHO guidance on regimen design had high frequencies of treatment success. Heterogeneous regimen compositions and drug durations precluded meaningful comparisons. Future research should examine which combinations of drugs maximize safety/tolerability and effectiveness.
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Affiliation(s)
- M L Rich
- Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, Partners In Health, Boston, MA, USA
| | - U Khan
- Interactive Research & Development Global, Singapore, Singapore
| | - C Zeng
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - A LaHood
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - M F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - S Atwood
- Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA
| | | | - E Burhan
- Persahabatan General Hospital, Jakarta, Indonesia
| | - N Danielyan
- Médecins Sans Frontières (MSF), Tbilisi, Georgia
| | | | - D Gadissa
- Partners In Health (PIH), Addis Ababa, Ethiopia
| | - A Ghafoor
- National Tuberculosis Programme (NTP), Ministry of National Health, Islamabad, Pakistan
| | | | - M S Islam
- Interactive Research & Development, Dhaka, Bangladesh
| | - E Kazmi
- Directorate General Health Services, Centers for Disease Control and Prevention, Sindh, Pakistan
| | - P Y Khan
- Partners In Health, Boston, MA, USA, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - L Lecca
- Socios En Salud Sucursal, Lima, Peru
| | - L B Maama
- PIH, Maseru, Lesotho, NTP, Maseru, Lesotho
| | - N Melikyan
- Epicentre, Paris, France, MSF, Yerevan, Armenia
| | | | | | - N A Saki
- World Health Organization, Country Office, Dhaka, Bangladesh
| | - K J Seung
- Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, Partners In Health, Boston, MA, USA
| | | | - G B Tefera
- Partners In Health (PIH), Addis Ababa, Ethiopia
| | | | - S C Vilbrun
- GHESKIO Institute of Infectious Diseases and Reproductive Health, NTP, Port-au-Prince, Haiti
| | - L Võ
- Friends for International TB Relief, Ho Chi Minh City, Vietnam
| | - C D Mitnick
- Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, Partners In Health, Boston, MA, USA, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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23
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Dixon PR, Moshtaghi O, Khan U, Harris JP, Schwartz MS, Friedman RA. Association Between Facility Surgical Volume and Excess Time in the Hospital After Surgical Resection of Vestibular Schwannomas. JAMA Otolaryngol Head Neck Surg 2023; 149:352-358. [PMID: 36862385 PMCID: PMC9982737 DOI: 10.1001/jamaoto.2022.5243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/02/2023] [Indexed: 03/03/2023]
Abstract
Importance High surgical vestibular schwannoma case volume in a medical institution may decrease the risk of adverse outcomes among patients undergoing vestibular schwannoma surgery. Objective To study the association between surgical vestibular schwannoma case volume and excess time in the hospital after vestibular schwannoma surgery. Design, Setting, and Participants This cohort study evaluated data from the National Cancer Database from January 1, 2004, through December 31, 2019, on Commission on Cancer-accredited facilities in the US. The hospital-based sample comprised adult patients aged 18 years or older with a vestibular schwannoma treated with surgery. Exposures Facility case volume, defined as the mean number of surgical vestibular schwannoma cases per year in the 2 years preceding the index case. Main Outcomes and Measures The primary outcome was a composite of prolonged hospital stay (>90th percentile) or 30-day readmission. Risk-adjusted restricted cubic splines were used to model the probability of the outcome according to facility volume. The inflection point (in cases per year) when the declining risk of excess time in the hospital began to plateau was selected as the threshold to define high- and low-volume facilities. Outcomes were compared among patients treated at high- and low-volume facilities, with mixed-effects logistic regression models adjusting for patient sociodemographic characteristics, comorbidities, tumor size, and clustering within facilities. Collected data were analyzed between June 24 and August 31, 2022. Results Among 11 524 eligible patients (mean [SD] age, 50.2 [12.8] years; 53.5% female; 46.5% male) who underwent surgical resection of vestibular schwannoma at 66 reporting facilities, the median length of stay was 4 (IQR, 3-5) days, and 655 patients (5.7%) were readmitted within 30 days. The median case volume was 16 (IQR, 9-26) cases per year. An adjusted restricted cubic spline model identified a downtrending probability of excess time in the hospital with increasing volume. The declining risk of excess time in the hospital began to plateau at a facility volume of 25 cases per year. Surgery at a facility with an annual case volume at or above this threshold was independently associated with a 42% reduction in the odds of excess time in the hospital compared with surgery at a low-volume center (odds ratio, 0.58; 95% CI, 0.44-0.77). Conclusions and Relevance This cohort study found that among adults undergoing vestibular schwannoma surgery, a higher facility case volume was associated with a reduced risk of prolonged hospital stay or 30-day readmission. A facility case volume of 25 cases per year may represent a risk-defining threshold.
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Affiliation(s)
- Peter R. Dixon
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Omid Moshtaghi
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Usman Khan
- Department of Neurological Surgery, University of California San Diego, San Diego
| | - Jeffrey P. Harris
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
| | - Marc S. Schwartz
- Department of Neurological Surgery, University of California San Diego, San Diego
| | - Rick A. Friedman
- Department of Otolaryngology–Head & Neck Surgery, University of California San Diego, San Diego
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24
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Brandel MG, Plonsker JH, Rennert R, Khan U, Nation J, Crawford JR, Levy ML. 347 Management of Rathke Cleft Cysts in Children: The Rady Children’s Hospital Approach. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_347] [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: 03/18/2023] Open
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25
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Plonsker JH, Stone L, Wali AR, Daniel M, Ravindra V, Gonda DD, Khan U, Sattar S. 341 Post-Operative Outcomes and Rare Complications in Pediatric Stereotactic Electroencephalography: A Retrospective Review from a High Volume Pediatric Epilepsy Center. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_341] [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: 03/18/2023] Open
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26
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Alakbarzade V, Maduakor C, Khan U, Khandanpour N, Rhodes E, Pereira AC. Cerebrovascular disease in sickle cell disease. Pract Neurol 2023; 23:131-138. [PMID: 36123118 DOI: 10.1136/pn-2022-003440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 11/04/2022]
Abstract
Sickle cell disease (SCD) is the most common type of hereditary anaemia and genetic disorder worldwide. Cerebrovascular disease is one of its most devastating complications, with consequent increased morbidity and mortality. Current guidelines suggest that children and adults with SCD who develop acute ischaemic stroke should be transfused without delay. Those with acute ischaemic stroke aged over 18 years who present within 4.5 hours of symptom onset should be considered for intravenous thrombolysis; older patients with conventional vascular risk factors are the most likely to benefit. Endovascular thrombectomy should be considered carefully in adults with SCD as there are few data to guide how the prevalence of cerebral vasculopathy may confound the expected benefits or risks of intervention. We present a practical approach to cerebrovascular disease in sickle cell patients based on the available evidence and our experience.
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Affiliation(s)
- Vafa Alakbarzade
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Chinedu Maduakor
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Nader Khandanpour
- Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Elizabeth Rhodes
- Department of Haematology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Anthony C Pereira
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
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27
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Torere BE, Aiwuyo HO, Weigold J, Gerlach G, Ilerhunmwuwa N, Khan U, Belousova T. The Roles and Challenges of Advanced Therapies in the Management of Refractory Immune Thrombocytopenia: A Case Report and Review of the Literature. Cureus 2023; 15:e36146. [PMID: 37065402 PMCID: PMC10101511 DOI: 10.7759/cureus.36146] [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] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
The management of primary immune thrombocytopenia (ITP) is becoming a subject of interest as there appears to be treatment failure and resistance to modern conventional treatment, necessitating a more universal and goal-directed approach to management. Our patient is a 74-year-old male who was diagnosed with ITP six years ago and recently presented to the emergency department (ED) with complaints of melena stools and severe fatigue lasting for two days. Prior to the ED presentation, he had received multiple lines of treatment including splenectomy. On admission, the pathology after splenectomy showed a benign enlarged spleen with a focal area of intraparenchymal hemorrhage/rupture and changes compatible with ITP. He was managed with multiple platelet transfusions, IV methyl prednisone succinate, rituximab, and romiplostim. His platelet counts improved to 47,000, and he was discharged home on oral steroids with outpatient hematology follow-up. However, in a few weeks, his condition deteriorated, and he presented with an increased platelet count and further multiple complaints. Romiplostim was discontinued, and he was continued on prednisone 20 mg daily, after which he improved, and his platelet count reduced to 273,000 on 20 mg prednisone. This case calls attention to the need to review the role of combination therapy in treating refractory ITP and the prevention of complications of thrombocytosis secondary to advanced therapy. Treatment needs to be more streamlined, focused, and goal-directed. Escalation and de-escalation of treatment should be synchronized to prevent adverse complications from overtreating or undertreating.
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28
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Khan U, Nairan A, Khan K, Li S, Liu B, Gao J. Salt-Assisted Low-Temperature Growth of 2D Bi 2 O 2 Se with Controlled Thickness for Electronics. Small 2023; 19:e2206648. [PMID: 36538737 DOI: 10.1002/smll.202206648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Bi2 O2 Se is the most promising 2D material due to its semiconducting feature and high mobility, making it propitious channel material for high-performance electronics that demands highly crystalline Bi2 O2 Se at low-growth temperature. Here, a low-temperature salt-assisted chemical vapor deposition approach for growing single-domain Bi2 O2 Se on a millimeter scale with thicknesses of multilayer to monolayer is presented. Because of the advantage of thickness-dependent growth, systematical scrutiny of layer-dependent Raman spectroscopy of Bi2 O2 Se from monolayer to bulk is investigated, revealing a redshift of the A1g mode at 162.4 cm-1 . Moreover, the long-term environmental stability of ≈2.4 nm thick Bi2 O2 Se is confirmed after exposing the sample for 1.5 years to air. The backgated field effect transistor (FET) based on a few-layered Bi2 O2 Se flake represents decent carrier mobility (≈287 cm2 V-1 s-1 ) and an ON/OFF ratio of up to 107 . This report indicates a technique to grow large-domain thickness controlled Bi2 O2 Se single crystals for electronics.
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Affiliation(s)
- Usman Khan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, P. R. China
- Zhejiang Provincial Innovation Center of Advanced Textile Technology, Shaoxing, 312000, P. R. China
| | - Adeela Nairan
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, P. R. China
- Zhejiang Provincial Innovation Center of Advanced Textile Technology, Shaoxing, 312000, P. R. China
| | - Karim Khan
- School of Electrical Engineering & Intelligentization, Dongguan University of Technology, Dongguan, 523808, P. R. China
| | - Sean Li
- School of Materials Science and Engineering, The University of New South Wales, Sydney, 2052, Australia
| | - Bilu Liu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute & Institute of Materials Research, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, P. R. China
| | - Junkuo Gao
- Institute of Functional Porous Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, P. R. China
- Zhejiang Provincial Innovation Center of Advanced Textile Technology, Shaoxing, 312000, P. R. China
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29
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Zhang L, Trippier S, Banerjee S, Xu T, Leyon J, Taylor E, Shtaya A, Sim CH, Gargalas S, Khan U, Cluckie G, Holt P, Lobotesis K, Clifton A, Markus HS, Goyal M, Ogungbemi A. Dissection-related tandem occlusion may be different from atherothrombotic tandem occlusion. J Stroke Cerebrovasc Dis 2023; 32:106910. [PMID: 36473397 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/10/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The optimal endovascular treatment for tandem occlusion in anterior circulation ischaemic stroke remains unknown. The aim of this study was to examine how the aetiology of carotid pathology, dissection versus atherothrombosis, affects clinical outcomes. MATERIALS AND METHODS Data was obtained from prospectively collected registries from two stroke centres between April 2016 and December 2020. Tandem cases with complete cervical internal carotid artery (ICA) occlusion or near-total occlusion (≥90% stenosis) were included. Patients were divided into two groups based on carotid pathology: dissection versus atherothrombosis. RESULTS A total of 134 patients were included: 36 were dissection and 98 were atherothrombosis. The dissection group had better clinical outcomes compared to the atherothrombosis group, although after adjusting for age and stroke risk factors differences were non-significant. In the non-stented cohort, the dissection patients achieved a better outcome (modified Rankin scale 0-2) than atherothrombotic patients (57% vs. 34%, p=0.04) at 90-days. CONCLUSION Dissection-related tandem occlusions appear to have different clinical features from atherothrombotic tandem occlusions which suggests different management strategies are needed.
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Affiliation(s)
- Liqun Zhang
- Department of Neurology, St George's University Hospital, UK.
| | - Sarah Trippier
- Department of Research and Development, The Royal United Hospitals Bath NHS Foundation Trust, UK
| | - Soma Banerjee
- Department of Stroke Medicine, Imperial College Healthcare NHS Trust, UK
| | - Tian Xu
- Department of Neurology, Affiliated Hospital of Nantong University, China
| | - Joe Leyon
- Department of Neuroradiology, St George's University Hospital, UK
| | - Eleanor Taylor
- Imaging Department, Imperial College Healthcare NHS Trust, UK
| | - Anan Shtaya
- Wessex Spinal Unit, University Hospital Southampton NHS Foundation Trust, UK
| | - Cai Hua Sim
- Department of Neurology, St George's University Hospital, UK
| | - Sergios Gargalas
- Department of Neuroradiology, St George's University Hospital, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospital, UK
| | - Gillian Cluckie
- Department of Neurology, St George's University Hospital, UK
| | - Peter Holt
- Department of Vascular Surgery, St George's University Hospital, UK
| | | | - Andrew Clifton
- Department of Neuroradiology, St George's University Hospital, UK
| | - Hugh S Markus
- Department of Clinical Neuroscience, University of Cambridge, UK
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30
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Zeng C, Mitnick CD, Hewison C, Bastard M, Khan P, Seung KJ, Rich ML, Atwood S, Melikyan N, Morchiladze N, Khachatryan N, Khmyz M, Restrepo CG, Salahuddin N, Kazmi E, Dahri AA, Ahmed S, Varaine F, Vilbrun SC, Oyewusi L, Gelin A, Tintaya K, Yeraliyeva LT, Hamid S, Khan U, Huerga H, Franke MF. Concordance of three approaches for operationalizing outcome definitions for multidrug-resistant TB. Int J Tuberc Lung Dis 2023; 27:34-40. [PMID: 36853128 PMCID: PMC9879081 DOI: 10.5588/ijtld.22.0324] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND: The WHO provides standardized outcome definitions for rifampicin-resistant (RR) and multidrug-resistant (MDR) TB. However, operationalizing these definitions can be challenging in some clinical settings, and incorrect classification may generate bias in reporting and research. Outcomes calculated by algorithms can increase standardization and be adapted to suit the research question. We evaluated concordance between clinician-assigned treatment outcomes and outcomes calculated based on one of two standardized algorithms, one which identified failure at its earliest possible recurrence (i.e., failure-dominant algorithm), and one which calculated the outcome based on culture results at the end of treatment, regardless of early occurrence of failure (i.e., success-dominant algorithm).METHODS: Among 2,525 patients enrolled in the multi-country endTB observational study, we calculated the frequencies of concordance using cross-tabulations of clinician-assigned and algorithm-assigned outcomes. We summarized the common discrepancies.RESULTS: Treatment success calculated by algorithms had high concordance with treatment success assigned by clinicians (95.8 and 97.7% for failure-dominant and success-dominant algorithms, respectively). The frequency and pattern of the most common discrepancies varied by country.CONCLUSION: High concordance was found between clinician-assigned and algorithm-assigned outcomes. Heterogeneity in discrepancies across settings suggests that using algorithms to calculate outcomes may minimize bias.
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Affiliation(s)
- C Zeng
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - C D Mitnick
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA, Partners In Health (PIH), Boston, MA, USA, Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, USA
| | - C Hewison
- Medical Department, Médecins Sans Frontières (MSF), Paris, France
| | - M Bastard
- Field Epidemiology Department, Epicentre, Paris, France
| | - P Khan
- Interactive Research and Development Global, Singapore, Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - K J Seung
- Partners In Health (PIH), Boston, MA, USA, Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, USA
| | - M L Rich
- Partners In Health (PIH), Boston, MA, USA, Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, USA
| | - S Atwood
- Division of Global Health Equity, Brigham and Women´s Hospital, Boston, MA, USA
| | - N Melikyan
- Field Epidemiology Department, Epicentre, Paris, France
| | | | | | | | | | - N Salahuddin
- Indus Hospital & Health Network (IHHN), Karachi, Pakistan
| | - E Kazmi
- Center for Disease Control and Prevention, Directorate General Health Services, Sindh, Pakistan
| | - A A Dahri
- Center for Disease Control and Prevention, Directorate General Health Services, Sindh, Pakistan
| | - S Ahmed
- Interactive Research and Development, Karachi, Pakistan
| | - F Varaine
- Medical Department, Médecins Sans Frontières (MSF), Paris, France
| | - S C Vilbrun
- Haitian Group for the Study of Kaposi´s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
| | | | - A Gelin
- Zanmi Lasante, Port-au-Prince, Haiti
| | - K Tintaya
- PIH/Socios En Salud Sucursal Peru, Lima, Peru
| | - L T Yeraliyeva
- National Scientific Center of Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan, Kazakhstan
| | - S Hamid
- Bishoftu General Hospital, Bishoftu, Ethiopia
| | - U Khan
- Interactive Research and Development Global, Singapore
| | - H Huerga
- Field Epidemiology Department, Epicentre, Paris, France
| | - M F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Khan U, Guglielmetti L. Tailored TPT for drug-resistant TB - promoting equity and access to optimal care. Int J Tuberc Lung Dis 2023; 27:89b-90. [PMID: 36853142 DOI: 10.5588/ijtld.22.0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- U Khan
- Interactive Research & Development Global, Singapore City, Singapore
| | - L Guglielmetti
- Unité 1135, Centre d´Immunologie et des Maladies Infectieuses Paris, Institut national de la santé et de la recherche médicale, Sorbonne Université, Paris, France, Hôpital Pitié-Salpêtrière, Groupe Hospitalier Universitaire Sorbonne Université, Assistance publique Hôpitaux de Paris, Centre national de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
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32
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Pauls MMH, Binnie LR, Benjamin P, Betteridge S, Clarke B, Dhillon MPK, Ghatala R, Hainsworth FAH, Howe FA, Khan U, Kruuse C, Madigan JB, Moynihan B, Patel B, Pereira AC, Rostrup E, Shtaya ABY, Spilling CA, Trippier S, Williams R, Young R, Barrick TR, Isaacs JD, Hainsworth AH. The PASTIS trial: Testing tadalafil for possible use in vascular cognitive impairment. Alzheimers Dement 2022; 18:2393-2402. [PMID: 35135037 PMCID: PMC10078742 DOI: 10.1002/alz.12559] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/13/2021] [Accepted: 12/07/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION There are few randomized clinical trials in vascular cognitive impairment (VCI). This trial tested the hypothesis that the PDE5 inhibitor tadalafil, a widely used vasodilator, increases cerebral blood flow (CBF) in older people with symptomatic small vessel disease, the main cause of VCI. METHODS In a double-blind, placebo-controlled, cross-over trial, participants received tadalafil (20 mg) and placebo on two visits ≥7 days apart (randomized to order of treatment). The primary endpoint, change in subcortical CBF, was measured by arterial spin labelling. RESULTS Tadalafil increased CBF non-significantly in all subcortical areas (N = 55, age: 66.8 (8.6) years) with greatest treatment effect within white matter hyperintensities (+9.8%, P = .0960). There were incidental treatment effects on systolic and diastolic blood pressure (-7.8, -4.9 mmHg; P < .001). No serious adverse events were observed. DISCUSSION This trial did not identify a significant treatment effect of single-administration tadalafil on subcortical CBF. To detect treatment effects may require different dosing regimens.
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Affiliation(s)
- Mathilde M H Pauls
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Lauren R Binnie
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Philip Benjamin
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Shai Betteridge
- Department of Neuropsychology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Brian Clarke
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Mohani-Preet K Dhillon
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Rita Ghatala
- South London Stroke Research Network, London, UK
| | - Fearghal A H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Franklyn A Howe
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Christina Kruuse
- Department of Neurology and Neurovascular Research Unit, Herlev Gentofte Hospital, Hellerup, Denmark
| | - Jeremy B Madigan
- Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Barry Moynihan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.,Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Bhavini Patel
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Anthony C Pereira
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Egill Rostrup
- Mental Health Centre, University of Copenhagen, Glostrup, Denmark
| | - Anan B Y Shtaya
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Catherine A Spilling
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | | | | | - Robin Young
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Thomas R Barrick
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Jeremy D Isaacs
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Atticus H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, London, UK.,Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
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33
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Hainsworth AH, Pauls M, Binnie L, Benjamin P, Betteridge S, Clarke B, Dhillon M, Ghatala R, Hainsworth F, Howe F, Khan U, Kruuse C, Madigan J, Moynihan B, Patel B, Pereira A, Rostrup E, Shtaya A, Spilling CA, Trippier S, Williams R, Young R, Barrick TR, Isaacs JD. Does tadalafil increase brain blood flow? The PASTIS trial. Alzheimers Dement 2022. [DOI: 10.1002/alz.062171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Atticus H Hainsworth
- St George’s University of London London United Kingdom
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Lauren Binnie
- St George’s University of London London United Kingdom
| | | | - Shai Betteridge
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | - Brian Clarke
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Rita Ghatala
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Franklyn Howe
- St George’s University of London London United Kingdom
| | - Usman Khan
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Jeremy Madigan
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Bhavini Patel
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | - Anthony Pereira
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | | | - Anan Shtaya
- St George’s University of London London United Kingdom
| | | | - Sarah Trippier
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | - Rebecca Williams
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
| | - Robin Young
- Robertson Centre for Biostatistics Glasgow United Kingdom
| | | | - Jeremy D Isaacs
- St George’s University Hospitals NHS Foundation Trust London United Kingdom
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Selim Y, Di Lena É, Abu-Omar N, Baig Z, Verhoeff K, La J, Purich K, Albacete S, Valji R, Purich K, Safar A, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Schellenberg M, Daza J, Glass LT, Verhoeff K, Johnson G, Guidolin K, Glass LT, Balvardi S, Gawad N, McKechnie T, McKechnie T, Purich K, Henley J, Imbert E, Li C, Skinner S, Lenet T, Lenet T, Metz J, Ahn H(S, Do U, Rouhi A, Greenberg B, Muaddi H, Park L, Vogt K, Bradley N, Deng SX, Murphy P, Alhabboubi M, Lie J, Laplante S, Lie J, Drung J, Nixon T, Allard-Coutu A, Mansouri S, Lee A, Tweedy J, D’Elia MA, Hopkins B, Srivastava A, Alibhai K, Lee C, Moon J(J, How N, Spoyalo K, Lalande A, Baig Z, Schweitzer C, Keogh J, Huo B, Patel YS, Patel YS, Jogiat U, McGuire AL, Jogiat U, Lee Y, Barber E, Akhtar-Danesh GG, Bondzi-Simpson A, Bowker R, Ahmadi N, Abdul SA, Patel P, Harrison L, Shi G, Shi G, Alaichi JA, Kidane B, Qu LC, Alaichi J, Mackay E, Lee J, Purich K, Castelo M, Caycedo-Marulanda A, Caycedo-Marulanda A, Brennan K, Brennan K, Brennan K, Garfinkle R, Sharma S, Candy S, Patel S, LeGal G, Spadafora S, Maclellan S, Trottier D, Jonker D, Asmis T, Mallick R, Ramsay T, Carrier M, McKechnie T, Shojaei D, Motamedi A, Ghuman A, Karimuddin A, Raval M, Brown C, Shojaei D, Wang H, Buie D, Wang H, McKechnie T, Buie D, Al Busaidi N, Rajabiyazdi F, Demian M, Boutros M, Farooq A, Brown C, Phang T, Ghuman A, Karimuddin A, McKechnie T, Raval M, Udwadia F, Marinescu D, Alqahtani M, Pang A, Vasilevsky CA, Boutros M, Oviedo SC, McFadden N, Spence R, Lee L, Hirsch G, Neumann K, Neumann K, Spence R, Johnson G, Singh H, Helewa R, Yilbas A, Netto FS, Katz J, Robitaille S, Sharma B, Khan U, Selzner M, Mocanu V, Dang J, Wilson H, Switzer N, Birch D, Karmali S, Mocanu V, Robitaille S, Jogiat U, Forbes H, Switzer N, Birch D, Karmali S, Verhoeff K, Mocanu V, Kung J, Purich K, Switzer N, Sadri H, Birch D, Karmali S, Tassé N, Tchernof A, Nadeau M, Dawe P, Beckett A, Biertho L, Lin A, Verhoeff K, Selznick S, Mocanu V, Kung JY, Birch DW, Karmali S, Switzer NJ, Fowler-Woods M, Fowler-Woods A, Shingoose G, Hatala A, Daeninck F, Wiseman V, Vergis A, Hardy K, Clouston K, Debru E, Sun W, Dang J, Switzer N, Birch D, Karmali S, De Gara C, Wiseman V, Halasz J, Dang J, Switzer N, Kanji A, Birch D, Modi R, Karmali S, Gu J, Jarrar A, Kolozsvari N, Wiseman V, Samarasinghe Y, Chen L, Hapugall A, Javidan A, McKechnie T, Doumouras A, Hong D, Laplante S, Stogryn S, Maeda A, Brennan K, Jackson T, Okrainec A, Birch D, Karmali S, Kanji A, Switzer N, Balas M, Gee D, Hutter M, Meireles O, Baker L, Jung J, Vergis A, Hardy K, Boudreau V, Hong D, Anvari M, Iranmanesh P, Barlow K, Cookson T, Bolis R, Ichhpuniani S, Shanthanna H, Shiroky J, Deghan S, Zevin B, Cloutier Z, Cookson T, Barlow K, Boudreau V, Anvari M, Brodie J, Johnson G, O’Brien E, Tedman-Aucoin K, Lawlor D, Murphy R, Twells L, Pace D, Ellsmere J, Evans B, Zhang T, Deehan E, Zhang L, Kao D, Hotte N, Birch D, Karmali S, Samarasinghe K, Walter J, Madsen K, Williams E, Kong W, Fundytus A, Holden J, Booth C, Patel S, Caycedo-Marulanda A, Chung W, Nanji S, Merchant S, Hansen B, Paszat L, Baxter N, Scheer A, Moon J(J, Ghezeljeh TN, Lapointe-Gagner M, Nguyen-Powanda P, Elhaj H, Rajabiyazdi F, Lee L, Feldman LS, Fiore J, Sutradhar R, Haas B, Moon J(J, Guttman M, Eskander A, Coburn N, Chesney T, Tillman B, Zuk V, Mahar A, Hsu A, Chan W, Hallet J, Moon J(J, Guidolin K, Servidio-Italiano F, Quereshy F, Sapisochin G, Prisman E, Mitmaker E, Walker R, Wu J, Nguyen A, Wiseman S, Moon J(J, Hong D, Gupta M, Pasternak J, Vergara-Fernandez O, Brar A, Conner J, Kirsch R, Brar M, Kennedy E, Govindarajan A, Paradis T, Gryfe R, MacRae H, Cohen Z, McLeod R, Swallow C, Ghasemi F, Delisle M, Stacey D, Abou-Khalil J, Balaa F, Bayat Z, Bertens K, Dingley B, Martel G, McAlpine K, Nessim C, Tadros S, Carrier M, Auer R, Lim D, Eskander A, Patel S, Coburn N, Sutradhar R, Chan W, Hallet J, Pickard F, Mathieson A, Hogan M, Seal M, Acidi B, Johnston W, Maalouf MF, Callegaro D, Brar S, Gladdy R, Chung P, Catton C, Khalili K, Honore C, Swallow C, Fu N, Kazazian K, Wachtel A, Pacholczyk K, Ng D, Swett-Cosentino J, Savage P, Shibahara Y, Kalimuthu S, Espin-Garcia O, Conner J, Yeung J, Darling G, Baronas V, Swallow C, Mercier F, Barabash V, Law C, Coburn N, Singh S, Myrehaug S, Chan W, Hallet J, Auer RC, Wiseman V, Muhn N, Heller B, Lovrics P, Ng D, Koerber D, Al-Sukhni E, Cyr D, Kazazian K, Swallow C, Apte S, Lie J, Nessim C, Ban J, Chen L, McKevitt E, Warburton R, Pao JS, Dingee C, Kuusk U, Bazzarelli A, Hong NL, Hajjar R, Gagliardi A, Nyhof B, Marfil-Garza B, Sandha G, Cooper D, Dajani K, Bigam D, Anderson B, Kin T, Lam A, Ehlebracht A, O’Gorman D, Senior P, Ricordi C, Shapiro AJ, Moser M, Lam H, Flemming J, Jalink D, Nanji S, Bennett S, Caminsky N, Zhang B, Tywonek K, Meyers B, Serrano P, Lenet T, Shorr R, Abou-Khalil J, Bertens K, Balaa F, Martel G, Caminsky N, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Williams P, Claasen M, Ivanics T, Gilbert R, Englesakis M, Gallinger S, Hansen B, Sapisochin G, Ivanics T, Claasen M, Gallinger S, Hansen B, Sapisochin G, Lenet T, Morin G, Abou-Khalil J, Balaa F, Martel G, Brind’Amour A, Bertens K, Balaa F, Bertens K, Martel G, Abou-Khalil J, Collin Y, Auer RC, Ivanics T, Toso C, Adam R, Ijzermans J, Sapisochin G, Polak W, Léveillé M, Lawson C, Collin Y, Tai LH, Phang T, Greene B, Jayaraman S, Tsang M, Al-Arnawoot A, Rajendran L, Lamb T, Turner A, Reid M, Rekman J, Mimeault R, Hopkins J, Abou-Khalil J, Bertens K, Martel G, Balaa F, Zhang C, Lemke M, Glinka J, Leslie K, Skaro A, Tang E, Hopkins J, Greene B, Tsang M, Jayaraman S, Bubis L, Jayaraman S, Tsang ME, Ganescu O, Vanounou T, Pelletier JS, Greene B, Levin Y, Tsang M, Jayaraman S, Ganescu O, Pelletier JS, Vanounou T, Choi WJ, Muaddi H, Ivanics T, Classen MP, Sapisochin G, Alam A, Caminsky N, Mansouri S, Lagace P, Lagace P, El-Kefraoui C, Mainprize M, Melland-Smith M, Verhoeff K, Verhoeff K, Nasser K, Mailloux O, Purich K, Whyte M, Li T, Ahmad MS, Sun W, Ahn H(S, Lee Y, Roach E, Chow A, Trac J, He W, Ramji K, Kouzmina E, Koziak C, Hossain I, Mocanu V, Hanna N, Castelo M, Pook M, Zuckerman J, Choi WJ, Watanabe A, Saravana-Bawan B, Cyr D, Brackstone M, Ivankovic V, Nair AG, Hirpara D, Stockley C, Ng D, Luu S, Meloche-Dumas L, D’Elia MA, Eom A, Tang K, Khan S, Schmitz E, Chen KT, Newman-Bremang J, Verhoeff K, Jette N, Mir Z, Griffiths C, Rajendran L, Zuckerman J, Choi WJ, Choi WJ, Gilbert R, Lenet T, Amhis N, Claasen M, Mansouri S, Workewych A, Lee A, Waugh E, Zhu A, Nabavian H, Roldan J, Lagrotteria A, Roldan J, Rajendran L, Safa N, Rahman S, Kaneva P, Feldman L, Baig Z, Ginther N, Gill D, Sarwar Z, Verdiales C, Moser M, Mocanu V, Fang B, Dang J, Sun W, Switzer N, Birch D, Karmali S, Alqaydi A, Wei X, Digby G, Brogly S, Merchant S, Verhoeff K, Miles A, Kung JY, Shapiro AJ, Bigam DL, Matkin A, Dumestre D, Peiris L, Turner S, Verhoeff K, Mador B, McLennan S, Jastaniah A, Owattanapanich N, Grigorian A, Lam L, Nahmias J, Inaba K, Liasidis P, Inaba K, Demetriades D, Benjamin ER, Cowan S, Owattanapanich N, Wong MD, Inaba K, Demetriades D, Owattanapanich N, Emigh B, Karavites L, Clark DH, Lam L, Inaba K, Benjamin ER, Owattanapanich N, Inaba K, Demetriades D, Anderson GA, Owattanapanich N, Cheng V, Lam L, Inaba K, Myers L, Cuthbertson B, Myles P, Shulman M, Wijeysundera D, Murphy PB, Allen L, Minkhorst K, Bowker D, Tang ES, Leslie K, Hawel JE, Ma O, Purich K, Skinner S, Dhaliwal R, Strickland M, Park J, Vergis A, Gillman L, Rivard J, Lin J, Zorigtbaatar A, Nadeem M, Ibrahim T, Neilson Z, Kim KY(P, Rajendran L, Chadi S, Quereshy F, Davidson M, Friedrich E, Champion C, Semsar-Kazerooni K, Kaneva P, Mueller C, Vassiliou M, Al Mahroos M, Fiore J, Schwartzman K, Feldman L, Purich K, Verhoeff K, Anderson B, Daniel R, Kruse C, Levin M, Lee Y, Doumouras A, Hong D, Eskicioglu C, Povolo C, Lee J, Lee Y, Park L, Doumouras A, Hong D, Bhandari M, Eskicioglu C, Lee E, Verhoeff K, Sydora D, Turner S, Strickland M, Boone D, Roberts S, McGrouther D, Manuel P, Dykstra M, Wang H, Snelgrove R, Verhoeff K, Purich K, Perry T, Strickland M, Dhaliwal R, Skanes S, Tropiano J, McIsaac D, Tinmouth A, Hallet J, Nicholls S, Fergusson D, Martel G, Tropiano J, Skanes S, Ivankovic V, McIsaac D, Tinmouth A, Patey A, Fergusson D, Martel G, Naqvi R, Noppens R, Hawel J, Elnahas A, Schlachta C, Alkhamesi N, Lenet T, Gilbert R, Mallick R, Shaw J, McIsaac D, Martel G, Pook M, Najafi T, Rajabiyazdi F, El-Kefraoui C, Balvardi S, Barone N, Elhaj H, Nguyen-Powanda P, Lee L, Baldini G, Feldman L, Fiore J, Purich K, Jogiat U, Mapiour D, Kim M, Nadler A, Stukel T, De Mestral C, Nathens A, Pautler S, Shayegan B, Hanna W, Schlachta C, Breau R, Hopkins L, Jackson T, Karanicolas P, Griffiths C, Ali S, Archer V, Cloutier Z, Choi D, McKechnie T, Serrano P, McClure JA, Jones P, Mrkobrada M, Flier S, Welk B, Dubois L, Khwaja K, Allen L, Tung L, Hameed M, Spoyalo K, Lampron J, Garcia-Ochoa C, Jastaniah A, Engels P, Talwar G, Cloutier Z, Minor S, Moffat B, Parry N, Vogt K, Ebeye T, Sharma BT, Samman A, Zulfiqar A, Purzner RH, Greene B, Tsang M, Jayaraman S, Allen L, Ball CG, Hameed M, Engels P, Nenshi R, Widder S, Minor S, Parry N, Bradley N, Moffat B, Vogt K, Liberman S, Wong E, Chughtai T, Turner J, Wiseman S, Li J, Mak N, Namazi B, Kiani P, Hashimoto D, Alseidi A, Pasten M, Brunt LM, Gill S, Davis B, Bloom M, Pernar L, Okrainec A, Madani A, Hamilton T, Nabata K, Zhang JW, Zhao D, Dawe P, Hameed M, Allen L, Leslie K, Drung J, Purich K, Verhoeff K, Skinner S, Dhaliwal R, Strickland M, Heller B, Wright V, Cho W, Wong M, Singh K, Comeau É, Collin Y, Oviedo SC, Rajendran L, Lamb T, Reid M, Turner A, Bertens K, Rekman J, Balaa F, Neumann K, Porter G, Teo I, Forse CL, Musselman R, Grozman L, Alshawan N, Fraser S, Bergman S, Pelletier JS, Vanounou T, Wong EG, Nolan B, Qiao L, Jung J, Raîche I, McDonald H, Gawad N, Cheifetz R, Hawley P, Rehany Z, Bakhshi M, Razek T, Grushka J, Boulanger N, Watt L, Vivier A, Clark G, Fata P, Deckelbaum D, Khwaja K, Jastaniah A, Wong E, Ren K, Qiu Y, Hamann K, Lalande A, MacNeill A, Park J, Alexis S, Spoyalo K, Patterson K, Gadhari N, Zhao J, MacNeill A, Ahmed R, Farooq A, Karimuddin A, Wiseman S, Chhor A, Begum H, Akhtar-Danesh N, Finley C, Manos D, Xu Z, Matheson K, Chun S, Fris J, Wallace A, French D, Baste JM, Shargall Y, Waddell TK, Yasufuku K, Machuca TN, Xie F, Thabane L, Hanna WC, Beauchamp MK, Wald J, Mbuagbaw L, Key BL, Green SM, Hanna WC, Behzadi A, Donahoe L, Nasralla A, Poon J, Safieddine N, Seyednejad N, Tavakoli I, Turner S, Sharma S, Hilzenrat RA, McConechy M, Frank I, Hughsman C, Yip S, Choi JJ, Yee J, Sasewich H, Turner S, Baracos V, Eurich D, Filafilo H, Bedard E, Samarasinghe Y, Patel J, Khondker A, McKechnie T, Samarasinghe N, Finley C, Hanna W, Shargall Y, Agzarian J, Whidden M, Aguirre F, Graham A, Chhor A, Begum H, Ewusie J, Mbuagbaw L, Yaron S, Keshishi M, Ademe Y, Tizazu A, Rose M, Uddin S, Ko M, Ddamba J, French 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M, Nanji S, Merchant SJ, Caycedo-Marulanda A, Flemming J, Robitaille S, Penta R, Pook M, Fiore JF, Feldman L, Lee L, Wong-Chong N, Marinescu D, Bhatnagar S, Morin N, Ghitulescu G, Vasilevsky CA, Faria J, Boutros M, Arif A, Ladua G, Bhang E, Brown C, Donellan F, Stuart H, Loree J, Patel S, Zhang L, MacDonald PH, Merchant S, Barnett KW, Caycedo-Marulanda A, Brown C, Karimuddin A, Stuart H, Ghuman A, Phang T, Raval M, Yoon HM, Fragoso G, Oliero M, Calvé A, Rendos HV, Gonzalez E, Brereton NJ, Cuisiniere T, Gerkins C, Djediai S, Annabi B, Diop K, Routy B, Laplante P, Cailhier JF, Taleb N, Alratrout H, Dagbert F, Loungnarath R, Sebajang H, Schwenter F, Wassef R, Ratelle R, Debroux E, Richard C, Santos MM, Hamad D, Alsulaim H, Monton O, Marinescu D, Pang A, Vasilevsky CA, Boutros M, Marinescu D, Alqahtani M, Pang A, Ghitulescu G, Vasilevsky CA, Boutros M, Marinescu D, Garfinkle R, Boutros M, Zwiep T, Greenberg J, Lenet T, Musselman R, Williams L, Raiche I, McIsaac D, Thavorn K, Fergusson D, 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Surgeon-specific encounters within a multidisciplinary care pathway: Is there a role for shared care models in surgery?59. A pan-Canadian analysis of approach to treatment for acute appendicitis60. Appendix neoplasm stratified by age: understanding the best treatment for appendicitis61. Predicting acute cholecystitis on final pathology to prioritize surgical urgency: an evaluation of the Tokyo criteria and development of a novel predictive score62. Obesity is an independent predictor of acute renal failure after surgery64. Validation of a clinical decision-making assessment tool in general surgery65. Moral distress in the provision of palliative care delivery for surgical patients in British Columbia: lessons learned from the perspectives of general surgeons66. Delays in presentation and severity of illness predict adverse surgical outcomes among patients transferred from rural Indigenous communities for acute care surgery67. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial68. Modified Delphi consensus on appropriate use of laboratory investigations in acute care surgery patients72. Impacts of inpatient food at a tertiary care centre on patient satisfaction, nutrition and planetary health73. Racial disparities in health outcomes for oncological surgery in Canada75. Risk of recurrent laryngeal nerve injury from thyroidectomy is lower when intraoperative nerve monitoring (IONM) is used: an analysis of 17 688 patients from the NSQIP database01. The impact of the COVID-19 pandemic on non-smallcell lung cancer pathologic stage and presentation02. Screening criteria evaluation for expansion in pulmonary neoplasias (screen)03. Robotic-assisted lobectomy for early-stage lung cancer provides better patient-reported quality of life than video-assisted lobectomy: early results of the RAVAL trial04. 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Initiating Ethiopia’s first minimally invasive surgery program: a novel approach for collaborations in global surgical education12. Patient outcomes following salvage lung cancer surgery after definitive chemotherapy or radiation13. Replacing chest X-rays after chest tube removal with clinical assessment in postoperative thoracic surgery patients14. Updating the practice of thoracic surgery in Canada: a survey of the Canadian Association of Thoracic Surgeons15. The impact of COVID-19 on the diagnosis and treatment of lung cancer16. Development of a prediction model for survival time in esophageal cancer patients treated with resection17. The development and validation of a mixed reality thoracic surgical anatomy atlas18. Routine placement of feeding tubes should be avoided in esophageal cancer patients undergoing surgery19. Nodal count is no different during robotic segmentectomy compared with robotic lobectomy20. Point-of-care ultrasound-guided percutaneous biopsy of solid masses in the thoracic outpatient clinic: a safe, high-yield procedure to accelerate tissue diagnosis for patients with advanced thoracic malignancy21. Sarcopenia and modified frailty index are not associated with adverse outcomes after esophagectomy for esophageal cancer: a retrospective cohort study22. Near-infrared-guided segmental resection for lung cancer: an analysis of the learning curve23. Routine use of feeding jejunostomy tubes in patients undergoing esophagectomy for esophageal malignancy is safe and associated with low complication rates01. Ghost ileostomy versus loop ileostomy following total mesorectal excision for rectal cancer: a systematic review and meta-analysis02. Analysis of 100 consecutive colorectal cancers presenting at a Canadian tertiary care centre: delayed diagnosis and advanced disease03. Clinical delays and comparative outcomes in younger and older adults with colorectal cancer: a systematic review04. Recurrence rates of rectal cancer after transanal total mesorectal excision (taTME): a systematic review and meta-analysis05. Transanal total mesorectal excision for abdominoperineal resection (taTME-APR) is associated with poor oncological outcomes in rectal cancer patients: a word of caution from a multicentric Canadian cohort study06. Association between survival and receipt of recommended and timely treatment in locally advanced rectal cancer: a population-based study07. Trends and the impact of incomplete preoperative staging in rectal cancer08. Postoperative outcomes after elective colorectal surgery in patients with cirrhosis09. Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicentre, single-blinded, randomized controlled trial10. Recurrence following perineal rectosigmoidectomy ( Altemeier) with levatorplasty: a systematic review and meta-analysis11. Nonmodifiable risk factors and receipt of surveillance investigations following treatment of rectal cancer12. Safety and effectiveness of endoscopic full-thickness resection for the management of colorectal lesions: a systematic review and meta-analysis13. Impact of preoperative carbohydrate loading before colectomy: a systematic review and meta-analysis of randomized controlled trials14. Statin therapy in patients undergoing short-course neoadjuvant radiotherapy for rectal cancer15. Feasibility of targeted lymphadenectomy during complete mesocolic excision for colon cancer using indocyanine green immunofluorescence lymphatic mapping16. Feasibility of expanding an ambulatory colectomy protocol: a retrospective analysis of early discharge following minimally invasive colectomy in an enhanced recovery pathway17. Impact of rectal cancer on bowel dysfunction before treatment and its relationship with post-treatment function18. Canadian cost–utility analysis of artificial-intelligence-assisted colonoscopy for adenoma detection in fecal immunochemical-based colorectal cancer screening19. A comparison of outcomes following intracorporeal and extracorporeal anastomotic techniques in laparoscopic right colectomies20. Assessment of metabolic signatures using desorption electrospray ionization mass spectrometry (DESI) and rapid evaporative ionization mass spectrometry (REIMS) of rectal cancer samples to assist in determining treatment response21. The association between hospital characteristics and minimally invasive rectal cancer surgery: a population-based study22. Cancer centre level designation and the impact on treatment and outcomes in those with rectal cancer: a population-based study23. 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Closed-incision negative-pressure wound therapy following pancreaticoduodenectomy for prevention of surgical site infections in high-risk patients21. Robotic Appleby procedure for recurrent pancreatic cancer22. The influence of viral hepatitis status on posthepatectomy complications in patients with hepatocellular carcinoma: a NSQIP analysis. Can J Surg 2022. [DOI: 10.1503/cjs.014322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Shoman NM, Khan U, Hong P. Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population. J of Otolaryngol - Head & Neck Surg 2022; 51:44. [DOI: 10.1186/s40463-022-00595-5] [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] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/05/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Objective
Transcutaneous bone anchored hearing devices (BAHDs) were introduced in an effort to avoid potential complications associated with the abutment of percutaneous BAHDs. Transcutaneous BAHDs can be active or passive. While studies have demonstrated good outcomes with both, a direct comparison of audiological and clinical outcomes of these devices in the pediatric population has not yet been studied.
Study design
Retrospective, multicenter study.
Setting
Two tertiary academic centers.
Methods
Between 2015 and 2019, all patients who received an active transcutaneous BAHD (Bonebridge, BB) at one center, and patients that received a passive transcutaneous BAHD (Attract, AT) at another center, were included in this study. Exclusion criteria included age > 18 years, and mixed hearing loss or single-sided deafness. Study outcomes included patient demographics, indications, complications and preoperative and one-year postoperative audiometric data.
Results
Eighteen BB and eight AT patients met the inclusion criteria. The age range was 5–16 years. There were no significant differences in complication outcomes. Both devices demonstrated similar mean improvements in hearing thresholds at frequencies of 250 Hz (38 dB Active vs. 38 dB Passive), 500 Hz (34 dB vs. 42 dB), 1000 Hz (34 dB vs. 40 dB) and 2000 Hz (31 dB vs. 22 dB). The BB was significantly more effective at frequencies of 4000 Hz (28 dB vs. 7 dB) and 8000 Hz (29 dB vs. 6 dB) (p < 0.05).
Conclusion
This is the first study comparing audiological outcomes between an active and a passive transcutaneous BAHD in the pediatric population. While both devices improved audiometric outcomes in the low and mid frequencies, the active BAHD demonstrated significantly better outcomes in the higher frequencies.
Graphical Abstract
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Mehmood S, Khan A, Farooqui S, Zahoor AW, Adnan QUA, Khan U. High-intensity circuit training for improving anthropometric parameters for women from low socioeconomic communities of Sikandarabad: A clinical trial. PLoS One 2022; 17:e0275895. [PMID: 36251656 PMCID: PMC9576086 DOI: 10.1371/journal.pone.0275895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022] Open
Abstract
Background An alarming trend of sustained physical inactivity has been observed among women in socioeconomically disadvantaged areas, mainly due to the lack of time and high cost of gym facilities. Although physical activity essentially contributes to disease prevention, evidence supporting time-efficient exercise on anthropometric measures is limited. This study aimed to identify the effectiveness of interval-based high-intensity circuit training (HICT) on anthropometric measures and the nature of the relationship between these measures. Methods A single-group, quasi-experimental study was conducted in the community park of Ziauddin Hospital at Sikandarabad. Sixty women who were overweight and had sedentary lifestyles were recruited for a six-week HICT-based program conducted at 85%–95% maximum heart rate (MHR) on every alternate day. Outcome measures were assessed at baseline and at 6-weeks including anthropometric parameters (body mass index [BMI], body fat percentage [BF%], and waist-to-hip ratio [WHR]). Results The six-week HICT-based program demonstrated a significant reduction in BMI (p<0.001), BF% (p<0.001), and WHR (p<0.001). Reductions in the BMI mean from 27.3±1.3 to 25.1±1.4 and BF% mean from 31.9±2.3 to 27.6±2.4 were observed following 18 sessions of HICT. The effect of age on BF% and WHR was linearly significant (p<0.001) with increasing age (BF%) and WHR. Conclusion Interval-based HICT was an effective exercise regimen for improving BMI, BF%, and WHR. Furthermore, the exercise protocol was feasible and well tolerated, with no reported adverse events, and it could be easily implemented in real-world community settings. BF% and WHR were significantly influenced by increasing age; therefore, our findings support the importance of exercise implementation, especially with increasing age, for the maintenance of a disease-free healthy lifestyle.
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Affiliation(s)
- Sana Mehmood
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
| | - Amna Khan
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
- * E-mail:
| | - Sumaira Farooqui
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
| | - Al-Wardha Zahoor
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
| | - Qurat Ul Ain Adnan
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
| | - Usman Khan
- Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
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Khan U, Khan R, Benchimol E, Salim M, Telford J, Enns R, Mohamed R, Forbes N, Sandha G, Kohansal A, Mosko J, Chatterjee A, May G, Waschke K, Barkun A, James PD. Learning curves in ERCP during advanced endoscopy training: a Canadian multicenter prospective study. Endosc Int Open 2022; 10:E1174-E1180. [PMID: 36118648 PMCID: PMC9473840 DOI: 10.1055/a-1795-9037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/13/2021] [Indexed: 10/31/2022] Open
Abstract
Background and study aims Growing emphasis on quality and patient safety has supported the shift toward competency-based medical education for advanced endoscopy trainees (AETs). In this study, we aimed to examine Canadian AETs learning curves and achievement of competence using an ERCP assessment tool with strong evidence of validity. Methods This prospective study was conducted at five institutions across Canada from 2017-2018. Data on every fifth procedure performed by trainees were collected using the United Kingdom Joint Advisory Joint Advisory Group of Gastrointestinal Endoscopy (JAG) ERCP Direct Observation of Procedural Skills (DOPS) tool, which includes a four-point rating scale for 27 items. Cumulative sum (CUSUM) analysis was used to create learning curves for overall supervision ratings and ERCP DOPS items by plotting scores for procedures performed during training. Results Eleven trainees who were evaluated for 261 procedures comprised our sample. The median number of evaluations by site was 49 (Interquartile range (IQR) 31-76) and by trainee was 15 (IQR 11-45). The overall cannulation rate by trainees was 82 % (241/261), and the native papilla cannulation rate was 78 % (149/191). All trainees achieved competence in the "overall supervision" domain of the ERCP DOPS by the end of their fellowship. Trainees achieved competency in all individual domains, except for tissue sampling and sphincteroplasty. Conclusions Canadian AETs are graduating from fellowship programs with acceptable levels of competence for overall ERCP performance and for the most specific tasks. Learning curves may help identify areas of deficiency that may require supplementary training, such as tissue sampling.
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Affiliation(s)
- Usman Khan
- Division of General Surgery, Department of Surgery, University of Toronto
| | - Rishad Khan
- Department of Medicine, University of Toronto
| | - Eric Benchimol
- Division of Gastroenterology, Hepatology, and Nutrition, the Hospital for Sick Children, University of Toronto
| | - Misbah Salim
- Division of Gastroenterology, University Health Network, University of Toronto
| | - Jennifer Telford
- Division of Gastroenterology and Hepatology, Department of Medicine, University of British Columbia
| | - Robert Enns
- Division of Gastroenterology and Hepatology, Department of Medicine, University of British Columbia
| | - Rachid Mohamed
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary
| | - Nauzer Forbes
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary
| | - Gurpal Sandha
- Division of Gastroenterology and Hepatology, University of Alberta Hospital, University of Alberta
| | - Ali Kohansal
- Division of Digestive Care and Endoscopy, Department of Medicine, Dalhousie University
| | - Jeffrey Mosko
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto
| | - Avijit Chatterjee
- Division of Gastroenterology and Hepatology, The Ottawa Hospital, University of Ottawa
| | - Gary May
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto
| | - Kevin Waschke
- Division of Gastroenterology, McGill University Health Centre, McGill University
| | - Alan Barkun
- Division of Gastroenterology, McGill University Health Centre, McGill University
| | - Paul D. James
- Division of Gastroenterology, University Health Network, University of Toronto
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Torkington J, Harries R, O'Connell S, Knight L, Islam S, Bashir N, Watkins A, Fegan G, Cornish J, Rees B, Cole H, Jarvis H, Jones S, Russell I, Bosanquet D, Cleves A, Sewell B, Farr A, Zbrzyzna N, Fiera N, Ellis-Owen R, Hilton Z, Parry C, Bradbury A, Wall P, Hill J, Winter D, Cocks K, Harris D, Hilton J, Vakis S, Hanratty D, Rajagopal R, Akbar F, Ben-Sassi A, Francis N, Jones L, Williamson M, Lindsey I, West R, Smart C, Ziprin P, Agarwal T, Faulkner G, Pinkney T, Vimalachandran D, Lawes D, Faiz O, Nisar P, Smart N, Wilson T, Myers A, Lund J, Smolarek S, Acheson A, Horwood J, Ansell J, Phillips S, Davies M, Davies L, Bird S, Palmer N, Williams M, Galanopoulos G, Rao PD, Jones D, Barnett R, Tate S, Wheat J, Patel N, Rahmani S, Toynton E, Smith L, Reeves N, Kealaher E, Williams G, Sekaran C, Evans M, Beynon J, Egan R, Qasem E, Khot U, Ather S, Mummigati P, Taylor G, Williamson J, Lim J, Powell A, Nageswaran H, Williams A, Padmanabhan J, Phillips K, Ford T, Edwards J, Varney N, Hicks L, Greenway C, Chesters K, Jones H, Blake P, Brown C, Roche L, Jones D, Feeney M, Shah P, Rutter C, McGrath C, Curtis N, Pippard L, Perry J, Allison J, Ockrim J, Dalton R, Allison A, Rendell J, Howard L, Beesley K, Dennison G, Burton J, Bowen G, Duberley S, Richards L, Giles J, Katebe J, Dalton S, Wood J, Courtney E, Hompes R, Poole A, Ward S, Wilkinson L, Hardstaff L, Bogden M, Al-Rashedy M, Fensom C, Lunt N, McCurrie M, Peacock R, Malik K, Burns H, Townley B, Hill P, Sadat M, Khan U, Wignall C, Murati D, Dhanaratne M, Quaid S, Gurram S, Smith D, Harris P, Pollard J, DiBenedetto G, Chadwick J, Hull R, Bach S, Morton D, Hollier K, Hardy V, Ghods M, Tyrrell D, Ashraf S, Glasbey J, Ashraf M, Garner S, Whitehouse A, Yeung D, Mohamed SN, Wilkin R, Suggett N, Lee C, Bagul A, McNeill C, Eardley N, Mahapatra R, Gabriel C, Datt P, Mahmud S, Daniels I, McDermott F, Nodolsk M, Park L, Scott H, Trickett J, Bearn P, Trivedi P, Frost V, Gray C, Croft M, Beral D, Osborne J, Pugh R, Herdman G, George R, Howell AM, Al-Shahaby S, Narendrakumar B, Mohsen Y, Ijaz S, Nasseri M, Herrod P, Brear T, Reilly JJ, Sohal A, Otieno C, Lai W, Coleman M, Platt E, Patrick A, Pitman C, Balasubramanya S, Dickson E, Warman R, Newton C, Tani S, Simpson J, Banerjee A, Siddika A, Campion D, Humes D, Randhawa N, Saunders J, Bharathan B, Hay O. Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART). Br J Surg 2022; 109:943-950. [PMID: 35979802 PMCID: PMC10364691 DOI: 10.1093/bjs/znac198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery. METHODS A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed. RESULTS Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011). CONCLUSION The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years. REGISTRATION NUMBER ISRCTN25616490 (http://www.controlled-trials.com).
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Khan U, Guglielmetti L. Evidence and ethical considerations for the treatment of contacts exposed to drug-resistant TB. Int J Tuberc Lung Dis 2022; 26:900-901. [PMID: 35996292 DOI: 10.5588/ijtld.22.0328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- U Khan
- Interactive Research & Development Global, Singapore, Singapore
| | - L Guglielmetti
- Sorbonne Université, Institut national de la santé et de la recherche médicale, Unité 1135, Centre d´Immunologie et des Maladies Infectieuses, Centre of Immunology and Microbial Infections-Paris, Paris, France, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
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Logan AM, Lee N, Patel B, Dolling R, Pink K, Nitkunan A, Mansour N, Khan U, Wilkinson T, Nirmalananthan N. 020 The headache hub: a multidisciplinary diagnosis and management resource for GPs. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.64] [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
The need to improve care of patients with headache prompted development of a new model in South West London. The Headache Hub, piloted at St George’s University Hospitals NHS Foundation Trust, consisted of a multidisciplinary team; Consultant Neurologists, GP with Extended Role and Allied Health Professionals. The Hub triages new GP referrals and offers an online migraine group clinic (engaging patients through shared medical appointments in a group setting).Between April-December 2021, 171 GP referred patients were seen, of which 96 (48%) had Chronic Migraine (CM), 36 (18%) High Frequency Episodic Migraine and 23 (12%) Low Frequency Episodic Migraine patients. CM patients reported 31 ED attendances in the prior year and 53% had the highest unmet needs, HURT 8 (Headache Under Response to Treatment) score 17-24. Real-time data on waiting times enabled clini- cians to make informed follow up choices.Triage to “consultant only” occurred in 56% of referrals, enabling a subsequent reduction in consultant caseload to address tertiary headache waiting lists. Patient satisfaction was high (80%) and group clinic feedback highlighted beneficial shared experiences; “super productive and made me feel not so alone in a challenging time”.This model is being considered at other secondary care hospitals in the region.
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Tang L, Teng C, Xu R, Zhang Z, Khan U, Zhang R, Luo Y, Nong H, Liu B, Cheng HM. Controlled Growth of Wafer-Scale Transition Metal Dichalcogenides with a Vertical Composition Gradient for Artificial Synapses with High Linearity. ACS Nano 2022; 16:12318-12327. [PMID: 35913980 DOI: 10.1021/acsnano.2c03263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Artificial synapses are promising for dealing with large amounts of data computing. Great progress has been made recently in terms of improving the on/off current ratio, the number of states, and the energy efficiency of synapse devices. However, the nonlinear weight update behavior of a synapse caused by the uncertain direction of the conductive filament leads to complex weight modulation, which degrades the delivery accuracy of information. Here we propose a strategy to improve the weight update behavior of synapses using chemical-vapor-deposition-grown transition metal dichalcogenides (TMDCs) with a vertical composition gradient, where the sulfur concentration decreases gradually along the thickness direction of TMDCs and thus forms a certain direction of the conduction filament for synapse devices. It is worth noting that the devices show an excellent linear conductance of potentiation and depression with a high linearity of 0.994 (surpassing most state-of-the-art synapses), have a large number of states, and are able to fabricate synapse arrays with wafer-scale. Furthermore, the devices based on the TMDCs with the vertical composition gradient exhibit an asymmetric feature of potentiation and depression behaviors with high linearity and follow the simulated linear Leaky ReLU function, resulting in a high recognition accuracy of 94.73%, which overcomes the unreliability issue in the Sigmoid function due to the vanishing gradient phenomenon. This study not only provides a universal method to grow TMDCs with a vertical composition gradient but also contributes to exploring highly linear synapses toward neuromorphic computing.
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Affiliation(s)
- Lei Tang
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Changjiu Teng
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Runzhang Xu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Zehao Zhang
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Usman Khan
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Rongjie Zhang
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Yuting Luo
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Huiyu Nong
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Bilu Liu
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
| | - Hui-Ming Cheng
- Shenzhen Geim Graphene Center, Tsinghua-Berkeley Shenzhen Institute and Institute of Materials Research, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, People's Republic of China
- Shenyang National Laboratory for Materials Sciences, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, People's Republic of China
- Faculty of Materials and Engineering/Institute of Technology for Carbon Neutrality, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, People's Republic of China
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Khan U, Tang K, Guo W, Perera H, Na S, Clark R. 164 Association between atopic dermatitis and celiac disease: A systematic review and meta-analysis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Binnie LR, Pauls MMH, Benjamin P, Dhillon MPK, Betteridge S, Clarke B, Ghatala R, Hainsworth FAH, Howe FA, Khan U, Kruuse C, Madigan JB, Moynihan B, Patel B, Pereira AC, Rostrup E, Shtaya ABY, Spilling CA, Trippier S, Williams R, Isaacs JD, Barrick TR, Hainsworth AH. Test-retest reliability of arterial spin labelling for cerebral blood flow in older adults with small vessel disease. Transl Stroke Res 2022; 13:583-594. [PMID: 35080734 PMCID: PMC9232403 DOI: 10.1007/s12975-021-00983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 12/03/2022]
Abstract
Cerebral small vessel disease (SVD) is common in older people and is associated with lacunar stroke, white matter hyperintensities (WMH) and vascular cognitive impairment. Cerebral blood flow (CBF) is reduced in SVD, particularly within white matter.Here we quantified test-retest reliability in CBF measurements using pseudo-continuous arterial spin labelling (pCASL) in older adults with clinical and radiological evidence of SVD (N=54, mean (SD): 66.9 (8.7) years, 15 females/39 males). We generated whole-brain CBF maps on two visits at least 7 days apart (mean (SD): 20 (19), range 7-117 days).Test-retest reliability for CBF was high in all tissue types, with intra-class correlation coefficient [95%CI]: 0.758 [0.616, 0.852] for whole brain, 0.842 [0.743, 0.905] for total grey matter, 0.771 [0.636, 0.861] for deep grey matter (caudate-putamen and thalamus), 0.872 [0.790, 0.923] for normal-appearing white matter (NAWM) and 0.780 [0.650, 0.866] for WMH (all p<0.001). ANCOVA models indicated significant decline in CBF in total grey matter, deep grey matter and NAWM with increasing age and diastolic blood pressure (all p<0.001). CBF was lower in males relative to females (p=0.013 for total grey matter, p=0.004 for NAWM).We conclude that pCASL has high test-retest reliability as a quantitative measure of CBF in older adults with SVD. These findings support the use of pCASL in routine clinical imaging and as a clinical trial endpoint.All data come from the PASTIS trial, prospectively registered at: https://eudract.ema.europa.eu (2015-001235-20, registered 13/05/2015), http://www.clinicaltrials.gov (NCT02450253, registered 21/05/2015).
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Affiliation(s)
- Lauren R Binnie
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Mathilde M H Pauls
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Philip Benjamin
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
- Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Mohani-Preet K Dhillon
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Shai Betteridge
- Department of Neuropsychology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Brian Clarke
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Rita Ghatala
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Fearghal A H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Franklyn A Howe
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Usman Khan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Christina Kruuse
- Department of Neurology and Neurovascular Research Unit, Herlev Gentofte Hospital, Herlev, Denmark
| | - Jeremy B Madigan
- Department of Neuroradiology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Barry Moynihan
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
- Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Bhavini Patel
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Anthony C Pereira
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Egill Rostrup
- Mental Health Centre, University of Copenhagen, Glostrup, Denmark
| | - Anan B Y Shtaya
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Catherine A Spilling
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Sarah Trippier
- South London Stroke Research Network, St George's Hospital, London, UK
| | - Rebecca Williams
- South London Stroke Research Network, St George's Hospital, London, UK
| | - Jeremy D Isaacs
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK
| | - Thomas R Barrick
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Atticus H Hainsworth
- Molecular & Clinical Sciences Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK.
- Department of Neurology, St George's University Hospitals NHS Foundation Trust London, London, UK.
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Manla Y, Bhatnagar G, Aljabery Y, Kakar V, Bajwa G, Sanger S, Almahmeed W, Bafadel A, Khan U, Ahmed W, Gobolos L. The impact of COVID-19 pandemic on type A aortic dissection care. European Heart Journal. Acute Cardiovascular Care 2022. [PMCID: PMC9383727 DOI: 10.1093/ehjacc/zuac041.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Introduction COVID-19 created a challenging situation for cardiac surgery and associated acute care programs around the world. While non-urgent cases might be postponed, operating on life-threatening conditions, including type A aortic dissection (TAAD), must be sustained despite the ongoing pandemic. Therefore, we investigated the impact of the COVID-19 pandemic on our urgent aortic program. Methods 36 individuals presenting with TAAD in a single centre were analysed from the pre-pandemic period (2019, n=16) and the pandemic era (2020, n=20). Retrospective data review was conducted on patient characteristics, TAAD presenting symptoms, operative techniques, postoperative outcomes and length of stay. A comparison was made between both eras applying appropriate testing methods, and a p-value <0.05 was considered statistically significant. Results A 25% increase in TAAD referrals occurred during the pandemic era. Patients were featured by younger age of presentation in contrast to Western data (pre-pandemic group: 47.6 ± 18.7, and the pandemic group: 50.6 ± 16.2 years, p=0.6) but showed similar male predominance (4:1) in both groups. There was no statistical difference in baseline comorbidities between the groups. Length of hospital and intensive care unit stays were comparable between both groups. Low rates of postoperative complications were registered in both groups with no significant between-group difference. Conclusion Emergent surgical management remains essential in patients with TAAD regardless of the pandemic. Furthermore, temporary structural departmental re-configuration and optimal personal protective equipment utilisation warrant maintained satisfactory outcomes in such critical healthcare scenarios.
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Affiliation(s)
- Y Manla
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - G Bhatnagar
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - Y Aljabery
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - V Kakar
- Cleveland Clinic Abu Dhabi, Critical Care Institute, Abu Dhabi, United Arab Emirates
| | - G Bajwa
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - S Sanger
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - W Almahmeed
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - A Bafadel
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
| | - U Khan
- Cleveland Clinic Abu Dhabi, Critical Care Institute, Abu Dhabi, United Arab Emirates
| | - W Ahmed
- Cleveland Clinic Abu Dhabi, Critical Care Institute, Abu Dhabi, United Arab Emirates
| | - L Gobolos
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Abu Dhabi, United Arab Emirates
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Al Afif A, Rigby MH, MacKay C, Brown TF, Phillips TJ, Khan U, Trites JRB, Corsten M, Taylor SM. Injection laryngoplasty during transoral laser microsurgery for early glottic cancer: a randomized controlled trial. J Otolaryngol Head Neck Surg 2022; 51:12. [PMID: 35317850 PMCID: PMC8939150 DOI: 10.1186/s40463-022-00564-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transoral laser microsurgery is widely used for treating T1/T2 glottic cancers. Hyaluronic acid (HA) is commonly used in vocal cord augmentation. We investigated the impact of intra-operative injection laryngoplasty on voice outcomes in early glottic cancer. METHODS Twenty patients were randomized to the treatment group receiving HA injection to the vocal cord contralateral to the lesion; or the control group, receiving no injection. Patients had a Voice Handicap Index-10 (VHI-10) questionnaire and a Maximum Phonation Time (MPT) measurement preoperatively and at 3, 12 and 24 months post-operatively. Mean change in VHI-10 and MPT, compared to baseline and between time points, were compared. Survival estimates were calculated. RESULTS Mean VHI-10 scores improved over time amongst all patients. There were no changes in mean VHI-10 from pre-operative values to 3, 12 or 24 months post-operatively. There were no significant differences when comparing various timepoints between groups. There were no significant changes in MPT amongst the groups, or the time-points compared. Two-year overall survival was 91.7%; disease free survival was 80.9%; no difference in recurrence free survival was seen between the groups. CONCLUSION Subjective voice scores improved over time in both groups; there were no improvements in VHI-10 or MPT scores in the injection group, over control, at any time points. We saw no significant impact for intra-operative HA injection laryngoplasty on subjective or objective voice outcomes following surgery for early glottic cancers.
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Affiliation(s)
- Ayham Al Afif
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada. .,University of Alabama at Birmingham, 1155 Faculty Office Tower, 510 20th Street South, Birmingham, AL, 35233, USA.
| | - Matthew H Rigby
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - Colin MacKay
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - Timothy F Brown
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - Timothy J Phillips
- Department of Surgery, Queen's University, Victory 3, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada
| | - Usman Khan
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - Jonathan R B Trites
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - Martin Corsten
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
| | - S Mark Taylor
- Queen Elizabeth II Health Sciences Centre, 3rd Floor Dickson Building, 5820 University Avenue, Halifax, NS, B3H 1Y9, Canada
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Abstract
OBJECTIVE Describe the effect of preoperative hearing on the likelihood of hearing preservation after middle cranial fossa (MCF) approach for resection of vestibular schwannoma (VS) and the effect of hearing preservation on disease-specific quality of life (QOL). STUDY DESIGN Retrospective chart review. SETTING Academic tertiary care skull base surgery program. PATIENTS Sixty three adult patients with preoperative word recognition score (WRS) ≥50% who underwent MCF resection of VS between 2017 and 2020. INTERVENTIONS All patients underwent MCF VS resection with attempted hearing preservation. MAIN OUTCOME MEASURES Hearing preservation (postoperative WRS ≥50%), hearing-related Penn Acoustic Neuroma Quality of Life (PANQOL) score. RESULTS Sixty three patients with mean age 47.4 (±9.6) years and tumor size 11.5 (±0.5) mm were analyzed. Hearing was preserved (+HP) and lost (-HP) in 37 (58.7%) and 26 (41.3%) patients, respectively. Preoperatively, pure tone average audiometry was significantly lower among the +HP group (20.0 dB) versus -HP (31.0 dB, p < 0.003). WRS was higher among +HP versus -HP (94% vs. 84%, respectively; p < 0.002). Linear regression showed that intra- versus extra-canalicular tumor location, sudden hearing loss history, fundal fluid cap thickness, and tumor size had no relationship to hearing preservation outcomes. When evaluating postoperative QOL data (n = 37) hearing-related PANQOL score differed between +HP and -HP (t35 = 2.458, p = 0.0191) groups. CONCLUSIONS In this cohort of patients undergoing MCF resection of VS, rates of HP were higher for patients with excellent preoperative hearing. Postoperatively, +HP patients reported improved hearing-related PANQOL scores compared to -HP patients.
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Affiliation(s)
- Olivia A La Monte
- Acoustic Neuroma Program, University of California, San Diego, La Jolla, California, and Vanderbilt University Medical Center, Nashville, Tennessee
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Zaratin P, Vermersch P, Amato MP, Brichetto G, Coetzee T, Cutter G, Edan G, Giovannoni G, Gray E, Hartung HP, Hobart J, Helme A, Hyde R, Khan U, Leocani L, Mantovani LG, McBurney R, Montalban X, Penner IK, Uitdehaag BM, Valentine P, Weiland H, Bertorello D, Battaglia MA, Baneke P, Comi G. The agenda of the global Patient Reported Outcomes for Multiple Sclerosis (PROMS) Initiative: progresses and open questions. Mult Scler Relat Disord 2022; 61:103757. [DOI: 10.1016/j.msard.2022.103757] [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: 02/09/2022] [Revised: 03/14/2022] [Accepted: 03/20/2022] [Indexed: 11/25/2022]
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Xiao Y, Salim M, Meng Z, Khan U, Kohansal AR, Forbes N, Heitman S, James PD. A205 IS REPEAT ERCP REQUIRED AFTER INITIAL ENDOSCOPIC MANAGEMENT OF POST-SURGICAL BILE LEAKS? MULTI-CENTER VALIDATION OF THE CALGARY BILE LEAK RULE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859123 DOI: 10.1093/jcag/gwab049.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The Calgary Bile Leak Rule was developed to identify patients in whom biliary stent removal via gastroscopy could be safely performed in lieu of ERCP for post-surgical bile leaks. Aims This study aimed to evaluate a Modified Calgary Bile Leak Rule (MCBLR) for a cohort of patients who underwent laparoscopic cholecystectomy complicated by bile leak. Methods This retrospective cohort study included patients who underwent ERCP for management of laparoscopic cholecystectomy-induced bile leaks between 2005 and 2017. The primary outcome was defined as the absence of persisting bile leak or other pathology on follow-up ERCP. The MCBLR includes a) normal post-surgical serum alkaline phosphatase, b) small or absent leak with no other biliary pathology on initial ERCP, and c) time between initial and follow-up ERCP was 4–8 weeks. Test performance of the prediction rule was analyzed by calculating sensitivity, specificity, positive predictive value and negative predictive value. Results 124 cases met inclusion criteria, of which 116 (94%) of bile leak cases had no leak identified during the follow-up ERCP. 8 (6.4%) had a persisting bile leak on follow-up ERCP. Bivariate analysis found no factors significantly associated with the primary outcome. The MCBLR demonstrated a sensitivity of 100% (95% CI 63% - 100%), a specificity of 35% (95% CI 26% - 44%), a positive predictive value of 10% (95% CI 4% - 18%), and a negative predictive value of 100.0% (91% to 100%). Conclusions The MCBLR demonstrated high sensitivity and negative predictive value for determining the need for repeat ERCP following endoscopic management of laparoscopic cholecystectomy-induced bile leaks. Funding Agencies None
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Affiliation(s)
- Y Xiao
- University of Toronto, Toronto, ON, Canada
| | - M Salim
- University Health Network, Toronto, ON, Canada
| | - Z Meng
- University of Alberta, Edmonton, AB, Canada
| | - U Khan
- University of Toronto, Toronto, ON, Canada
| | - A R Kohansal
- Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - N Forbes
- University of Calgary, Calgary, AB, Canada
| | - S Heitman
- University of Calgary, Calgary, AB, Canada
| | - P D James
- University of Toronto, Toronto, ON, Canada
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Tan Y, Lu J, Goh Y, Khan U, Teo R, Tiong H. Diabetes mellitus in expanded criteria donors may impair the outcomes of dual kidney transplantation. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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50
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Khan U, Tchomobe G, Vakharia S, Suryadevara M, Nagarakanti S. A case of Strongyloides Stercoralis induced duodenitis and pancreatitis. IDCases 2022; 27:e01442. [PMID: 35198385 PMCID: PMC8844764 DOI: 10.1016/j.idcr.2022.e01442] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- U. Khan
- Department of Internal Medicine, Rutgers – RWJBH Newark Beth Israel Medical Center, Newark NJ, United States
- Corresponding author.
| | - G. Tchomobe
- Department of Internal Medicine, Rutgers – RWJBH Newark Beth Israel Medical Center, Newark NJ, United States
| | - S. Vakharia
- Department of Internal Medicine, Rutgers – RWJBH Newark Beth Israel Medical Center, Newark NJ, United States
| | - M. Suryadevara
- Department of Infectious Disease, Rutgers – RWJBH Newark Beth Israel Medical Center, Newark, NJ, United States
| | - S. Nagarakanti
- Department of Infectious Disease, Rutgers – RWJBH Newark Beth Israel Medical Center, Newark, NJ, United States
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