1
|
Ambrogio S, Narayanan P, Okazaki A, Fasoli A, Mackin C, Hosokawa K, Nomura A, Yasuda T, Chen A, Friz A, Ishii M, Luquin J, Kohda Y, Saulnier N, Brew K, Choi S, Ok I, Philip T, Chan V, Silvestre C, Ahsan I, Narayanan V, Tsai H, Burr GW. An analog-AI chip for energy-efficient speech recognition and transcription. Nature 2023; 620:768-775. [PMID: 37612392 PMCID: PMC10447234 DOI: 10.1038/s41586-023-06337-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/16/2023] [Indexed: 08/25/2023]
Abstract
Models of artificial intelligence (AI) that have billions of parameters can achieve high accuracy across a range of tasks1,2, but they exacerbate the poor energy efficiency of conventional general-purpose processors, such as graphics processing units or central processing units. Analog in-memory computing (analog-AI)3-7 can provide better energy efficiency by performing matrix-vector multiplications in parallel on 'memory tiles'. However, analog-AI has yet to demonstrate software-equivalent (SWeq) accuracy on models that require many such tiles and efficient communication of neural-network activations between the tiles. Here we present an analog-AI chip that combines 35 million phase-change memory devices across 34 tiles, massively parallel inter-tile communication and analog, low-power peripheral circuitry that can achieve up to 12.4 tera-operations per second per watt (TOPS/W) chip-sustained performance. We demonstrate fully end-to-end SWeq accuracy for a small keyword-spotting network and near-SWeq accuracy on the much larger MLPerf8 recurrent neural-network transducer (RNNT), with more than 45 million weights mapped onto more than 140 million phase-change memory devices across five chips.
Collapse
Affiliation(s)
- S Ambrogio
- IBM Research - Almaden, San Jose, CA, USA.
| | | | - A Okazaki
- IBM Research - Tokyo, Kawasaki, Japan
| | - A Fasoli
- IBM Research - Almaden, San Jose, CA, USA
| | - C Mackin
- IBM Research - Almaden, San Jose, CA, USA
| | | | - A Nomura
- IBM Research - Tokyo, Kawasaki, Japan
| | - T Yasuda
- IBM Research - Tokyo, Kawasaki, Japan
| | - A Chen
- IBM Research - Almaden, San Jose, CA, USA
| | - A Friz
- IBM Research - Almaden, San Jose, CA, USA
| | - M Ishii
- IBM Research - Tokyo, Kawasaki, Japan
| | - J Luquin
- IBM Research - Almaden, San Jose, CA, USA
| | - Y Kohda
- IBM Research - Tokyo, Kawasaki, Japan
| | - N Saulnier
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - K Brew
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - S Choi
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - I Ok
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - T Philip
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - V Chan
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - C Silvestre
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - I Ahsan
- IBM Research - Albany NanoTech Center, Albany, NY, USA
| | - V Narayanan
- IBM Thomas J. Watson Research Center, Yorktown Heights, NY, USA
| | - H Tsai
- IBM Research - Almaden, San Jose, CA, USA
| | - G W Burr
- IBM Research - Almaden, San Jose, CA, USA
| |
Collapse
|
2
|
Messika-Zeitoun D, Baumgartner H, Burwash IG, Vahanian A, Bax J, Pibarot P, Chan V, Leon M, Enriquez-Sarano M, Mesana T, Iung B. Unmet needs in valvular heart disease. Eur Heart J 2023:7078714. [PMID: 36924203 DOI: 10.1093/eurheartj/ehad121] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/26/2022] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
Valvular heart disease (VHD) is the next epidemic in the cardiovascular field, affecting millions of people worldwide and having a major impact on health care systems. With aging of the population, the incidence and prevalence of VHD will continue to increase. However, VHD has not received the attention it deserves from both the public and policymakers. Despite important advances in the pathophysiology, natural history, management, and treatment of VHD including the development of transcatheter therapies, VHD remains underdiagnosed, identified late, and often undertreated with inequality in access to care and treatment options, and there is no medication that can prevent disease progression. The present review article discusses these gaps in the management of VHD and potential actions to undertake to improve the outcome of patients with VHD.
Collapse
Affiliation(s)
- David Messika-Zeitoun
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Helmut Baumgartner
- Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany
| | - Ian G Burwash
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | - Jeroen Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Philippe Pibarot
- Division of Cardiology, Québec Heart & Lung Institute-Laval University, Québec, Quebec, Canada
| | - Vince Chan
- Division of Cardiac surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Martin Leon
- Columbia University Medical Center and Cardiovascular Research Foundation, New York, USA
| | | | - Thierry Mesana
- Division of Cardiac surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Bernard Iung
- Cardiology Department, Bichat Hospital, APHP, Université Paris Cité, France
| |
Collapse
|
3
|
Rumman R, Verma S, Chan V, Mazer D, Quan A, De Varennes BE, Chu MWA, Latter D, Teoh H, Yanagawa B, Leong-Poi H, Connelly K. Predictors of mitral valve hemodynamics after mitral valve repair for degenerative mitral regurgitation: a subanalysis of the CAMRA randomized trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Intra-operative predictors of mid-to-late mitral valve dysfunction after surgical repair of mitral regurgitation (MR) caused by prolapse remain poorly characterized. This study aims to evaluate the effect of annuloplasty prosthesis size on post-operative MV hemodynamics at rest and during exercise, and to identify perioperative predictors of MV dysfunction.
Methods
104 patients were randomly assigned to resection and preservation for surgical treatment of posterior leaflet prolapse in the Canadian Mitral Research Alliance CardioLink-2 study. Echocardiograms were performed at baseline and 1 year postoperatively. Intraoperative TEE was performed to assess immediate MV gradients. Exercise TTE was performed 1 year after repair. Linear regression analysis was used to identify associations between MV indices (rest and peak exercise gradients) at 12 months, and perioperative echocardiographic and clinical factors.
Results
Mean age of participants was 65±10 years, and 83% were male. Larger annuloplasty size was associated with lower transmitral gradients at rest and during peak exercise. In multivariable analysis, annuloplasty size ≥34mm was associated with lower mean and peak rest and exercise gradients at 12 months, after adjustment for repair type, age, sex, and BSA (p<0.001). Higher pre-operative pulmonary artery pressures were associated with reduced functional capacity post-operatively. Intra-operative TEE gradients predict resting and exercise MV hemodynamics at 1 year.
Conclusion
Annuloplasty size ≥34mm is associated with improved MV hemodynamics at rest and during peak exercise 1 year post MV repair. MV repair prior to onset of pulmonary hypertension confers favourable post operative functional capacity. Finally, intra-operative TEE can be used to identify patients at risk of mitral valve dysfunction within 1 year of repair.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The Heart and StrokeFoundation of Ontario (GIA 16-00014666)
Collapse
Affiliation(s)
- R Rumman
- St. Michael's Hospital, Department of Medicine , Toronto , Canada
| | - S Verma
- St. Michael's Hospital, Cardiac Surgery , Toronto , Canada
| | - V Chan
- Ottawa Heart Institute, Cardiac Surgery , Ottawa , Canada
| | - D Mazer
- St. Michael's Hospital, Anesthesia , Toronto , Canada
| | - A Quan
- St. Michael's Hospital , Toronto , Canada
| | - B E De Varennes
- McGill University Health Centre, Cardiac Surgery , Montreal , Canada
| | - M W A Chu
- London Health Sciences Centre, Cardiac Surgery , London , Canada
| | - D Latter
- St. Michael's Hospital, Cardiac Surgery , Toronto , Canada
| | - H Teoh
- St. Michael's Hospital , Toronto , Canada
| | - B Yanagawa
- St. Michael's Hospital, Cardiac Surgery , Toronto , Canada
| | - H Leong-Poi
- St. Michael's Hospital, Cardiology , Toronto , Canada
| | - K Connelly
- St. Michael's Hospital, Cardiology , Toronto , Canada
| |
Collapse
|
4
|
Rumman R, Verma S, Chan V, Mazer D, Quan A, De Varennes B, Chu M, d latter, Teoh H, Yanagawa B, Leong-Poi H, Connelly K. PREDICTORS OF MITRAL VALVE HEMODYNAMICS AFTER MITRAL VALVE REPAIR FOR DEGENERATIVE MITRAL REGURGITATION: A SUBANALYSIS OF THE CAMRA RANDOMIZED TRIAL. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.196] [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: 11/02/2022] Open
|
5
|
So H, Li TK, Chan V, Tam LS, Chan PK. POS0776 IMMUNOGENICITY AND SAFETY OF INACTIVATED AND mRNA COVID-19 VACCINES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4312] [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
BackgroundVaccination against SAR-CoV-2 is a new campaign and believed to be the key to end the pandemic. Currently, there are two COVID-19 vaccines with different mechanism of action available in Hong Kong - they are the inactivated virus vaccine and the mRNA-based vaccine. Both vaccines have obtained approval for emergency use by the World Health Organization (WHO) and were widely deployed globally (1). A mass voluntary vaccination program for all Hong Kong residents has started in late February, 2021 (2). However, the efficacy and safety of COVID-19 vaccines in patients with SLE is uncertain due to a complex interplay of underlying autoimmunity and immunosuppressive therapies used.ObjectivesThis study was to investigate the effects of both inactivated and mRNA COVID-19 vaccines in patients with SLE.MethodsThis was a prospective, single-centre, case-control study. Patients with SLE planning to receive COVID-19 vaccines were recruited and matched 1:1 with healthy controls. The immunogenicity of the COVID-19 vaccines was assessed by a surrogate neutralization assay at 28 days after the second dose. The main outcomes included the antibody response and adverse effects comparing SLE patients and controls. Predictors of responses in SLE patients were analyzed. The change of SLE disease activity was evaluated.ResultsSixty-five SLE patients received 2 doses of COVID-19 vaccines (Comirnaty: 38; CoronaVac: 27) were recruited. Many of them were on systemic glucocorticoids (75.8%) and immunosuppressants (54.5%). At day 28 after the second dose of vaccines, 92.3% (Comirnaty: 100%; CoronaVac: 81.5%, p=0.01) had positive neutralizing antibody. However, compared to the age, gender, vaccine type matched controls, the level of neutralizing antibody was significantly lower (p<0.001) in patients with SLE (Figure 1). The self-reported side effects of the vaccines in lupus patients were common but mild, and were more frequent in the Comirnaty group. There was no significant change in lupus disease activity up to 28 days after vaccination. The independent predictors of neutralizing antibody level included the dosage of systemic glucocorticoids, use of mycophenolate and type of vaccines (Table 1).Table 1.Multivariate linear regression analysis for neutralizing antibody activityBeta95% confidence intervalP valueAge-0.022-0.425 – 0.3810.914Gender8.1625 (92.6)0.296SLEDAI-2k-1.96-4.22 – 0.310.088Prednisolone dosage-2.01-3.66 - -0.370.018Mycophenolate mofetil-15.2-24.4 - -6.00.002Type of vaccines: Comirnaty28.820.1 – 37.5<0.001Figure 1.Distribution of neutralizing antibody levels after COVID-19 vaccines comparing (A) SLE patients and matched controls, (B) SLE patients and matched controls in two vaccine subgroups, and (C) two vaccine types in SLE patients. Data for each group are presented as box plots: central values within boxes correspond to median; the range between the lower (Q1) and upper (Q3) bounds of the boxes is the IQR. Whiskers represent scores outside IQR and ends in maximum (higher “calculated value” = Q3 + 1.5 x IQR) and minimum (lower “calculated value” = Q1 – 1.5 x IQR). Spots are outliers above the maximum or under the minimum values. Data regarding were analyzed using Mann-Whitney-U test. Dotted line denotes the cut-off level for positivity (30%).ConclusionCOVID-19 vaccines produced satisfactory but impaired serological response in SLE patients compared to controls which was dependent on the immunosuppressive medications use and type of vaccines received. There was no new short-term safety signal noted. Booster dose is recommended.References[1]Wouters OJ, Shadlen KC, Salcher-Konrad M, Pollard AJ, Larson HJ, Teerawattananon Y, et al. Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment. Lancet. 2021;397(10278):1023-34.[2]COVID-19 Vaccination Programme.Disclosure of InterestsNone declared
Collapse
|
6
|
Willner N, Burwash IG, Beauchesne L, Chan V, Vulesevic B, Ascah K, Coutinho T, Promislow S, Stadnick E, Chan KL, Mesana T, Messika-Zeitoun D. Natural History of Mitral Annulus Calcification and Calcific Mitral Valve Disease. J Am Soc Echocardiogr 2022; 35:925-932. [PMID: 35618253 DOI: 10.1016/j.echo.2022.05.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/05/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The natural history of mitral annular calcification (MAC) and risk for developing calcific mitral valve disease (CMVD) has been poorly defined. We sought to evaluate the progression rate of MAC and of the development of CMVD. METHODS Patients with MAC and paired echocardiograms at least one year apart between 2005 and 2019 were included. Progression rates from mild/moderate to severe MAC and to CMVD (defined as severe MAC and significant mitral stenosis and/or regurgitation) were assessed, along with potential association with sex. RESULTS A total of 11,605 patients (73±10years, 51%male) with MAC (78% mild, 17% moderate, 5% severe) were included and had a follow up echocardiogram at 4.2±2.7years. In patients with mild/moderate MAC, 33% presented with severe MAC at 10 years. The rate of severe MAC was higher in females than in males (41% vs. 24%, P<0.001, HR=1.3, P<0.001) and in patients with moderate vs. mild MAC (71% vs. 22%, P<0.001, HR=6.1, P<0.001). At 10 years 10% presented with CMVD (4%, 23% and 60% in patients with mild, moderate, and severe MAC respectively) and was predicted by female sex (15% vs. 5%, P<0.0001), even after adjustment for MAC severity (HR=1.9, P<0.001). CONCLUSION In this large cohort of patients with MAC, progression to severe MAC was common and frequently results in CMVD. Female sex was associated with higher progression rates. MAC and CMVD are expected to dramatically increase as the population ages highlighting the importance of a better understanding of the pathophysiology of MAC in order to develop effective preventive medical therapies.
Collapse
Affiliation(s)
- Nadav Willner
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Ian G Burwash
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Luc Beauchesne
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Vince Chan
- Department of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
| | - Branka Vulesevic
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kathy Ascah
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Thias Coutinho
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Steve Promislow
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Ellamae Stadnick
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Kwan L Chan
- Department of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Thierry Mesana
- Department of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
| | | |
Collapse
|
7
|
Rahmouni K, Shahinian J, Qureshi S, Elmistekawy E, Glineur D, Ruel M, Mesana T, Chan V. LONG-TERM DURABILITY OF SURGICAL MITRAL VALVE REPAIR FOR DEGENERATIVE DISEASE ACCORDING TO AGE AT SURGERY: INSIGHTS FROM > 1000 SURGICAL PROCEDURES. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
8
|
Lau L, Kandil I, Charlebois A, Chan K, Suh K, Fahed R, Garuba H, Law A, Chan V, Boodhwani M, Auclair F, Messika-Zeitoun D, Rubens F. IT TAKES A TEAM: IMPLEMENTATION OF A MULTIDISCIPLINARY ENDOCARDITIS HEART TEAM AT A CANADIAN TERTIARY CARE REFERRAL CENTRE. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.163] [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: 11/24/2022] Open
|
9
|
Messika-Zeitoun D, Hibbert B, Chan V. 'Primary' percutaneous mitral valve repair in patients with acute myocardial infarction: is it ready for primetime? Eur Heart J 2021; 43:651-653. [PMID: 34472599 DOI: 10.1093/eurheartj/ehab540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Benjamin Hibbert
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Vince Chan
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Canada
| |
Collapse
|
10
|
Light A, Gallagher K, Bhatt N, Clement K, Kulkarni MA, Khadhouri S, Zimmermann E, Gao C, Lam C, Anbarasan T, Chan V, Rossi S, Jayaraajan K, Asif A, Shah T, Kasivisvanathan V. 377 Global Recruitment for The RESECT Study (Transurethral Resection and Single-Instillation Intravesical Chemotherapy Evaluation in Bladder Cancer Treatment): An International Observational Cohort Study Aiming to Improve the Quality of Surgery for Non-Muscle Invasive Bladder Cancer. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Non-muscle invasive bladder cancer (NMIBC) can be curatively treated with ‘good quality’ transurethral resection of the bladder tumour (TURBT). However, despite evidence-based international guidelines, there is anecdotal evidence that practice varies widely, and this may affect oncological outcomes. Launching in 2020, RESECT aims to measure and report variation in TURBT quality globally, and determine if outcome reporting improves outcomes.
Method
RESECT was advertised internationally through social media, mailing lists, websites, and in person. Collaborators at each registered site will collect data about current practice and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators.
Results
As of August 27, 508 collaborators have registered to participate. Collaborators represent 321 centres from 54 countries, with the highest number from the United Kingdom (54.5%), Spain (5.9%), and Argentina (3.7%). 51.2% are trainees, 29.9% consultants, and 17.5% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.
Conclusions
RESECT has attracted a large number of collaborators globally and from all training levels. Therefore, the RESECT study has the potential to improve the quality of TURBT surgery across the world.
Collapse
Affiliation(s)
- A Light
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Gallagher
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Western General Hospital, Edinburgh, United Kingdom
| | - N Bhatt
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Queen Elizabeth Hospital, King's Lynn, United Kingdom
| | - K Clement
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Royal Alexandra Hospital, Paisley, United Kingdom
| | - M a Kulkarni
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Guy's Hospital, London, United Kingdom
| | - S Khadhouri
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - E Zimmermann
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Torbay Hospital, Torbay, United Kingdom
| | - C Gao
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- William Harvey Hospital, Ashford, United Kingdom
| | - C Lam
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Bronglais Hospital, Aberystwyth, United Kingdom
| | - T Anbarasan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- NHS Lothian, Edinburgh, United Kingdom
| | - V Chan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leeds School of Medicine, Leeds, United Kingdom
| | - S Rossi
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - K Jayaraajan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Imperial College School of Medicine, London, United Kingdom
| | - A Asif
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Leicester Medical School, Leicester, United Kingdom
| | - T Shah
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- Charing Cross Hospital, London, United Kingdom
| | - V Kasivisvanathan
- British Urology Researchers in Surgical Training (BURST) research collaborative, London, United Kingdom
- University College London, London, United Kingdom
| |
Collapse
|
11
|
Lam CM, Gallagher K, Bhatt N, Clement K, Zimmermann E, Shah T, Khadhouri S, Kulkarni M, Gao C, Light A, Jayaraajan K, Asif A, Anbarasan T, Chan V, Kasivisvanathan V. P57 Global recruitment for the RESECT study (transurethral REsection and Single-instillation intravesical chemotherapy Evaluation in bladder Cancer Treatment) - an international observational cohort study aiming to improve the quality of surgery for non-muscle invasive bladder cancer. BJS Open 2021. [PMCID: PMC8153804 DOI: 10.1093/bjsopen/zrab032.056] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Non-muscle invasive bladder cancer (NMIBC) is one of the most expensive cancers to treat, driven by high recurrence rates and disease progression. Mortality rates in the UK for all bladder cancers have remained relatively stable over the past decade. NMIBC can be curatively treated with transurethral resection of the bladder tumour (TURBT). Despite international evidence-based guidelines on the TURBT procedure and postoperative single instillation of mitomycin-C, TURBT quality continues to vary widely. RESECT will be the first ever international study of TURBT surgery evaluating the achievement of TURBT quality indicators globally and assessing if audit and performance feedback can improve surgical outcomes.
Methods
RESECT is a prospective, multicentre international observational cohort study. Collaborators at each site will collect data using REDCap about local TURBT practice, early recurrence rates and the experience of local TURBT surgeons. The primary outcome is the rate of achievement of key TURBT quality indicators. Advertisement for the study launched in 2020.
Results
As of October 1st, 2020, 524 collaborators have registered to participate. Collaborators represent 334 centres from 54 countries, with the highest number of centres from the United Kingdom (133), Spain (17), and India (16). 50.8% are trainees, 30.3% consultants, and 17.2% medical students. Based on current registrations, patient recruitment will far exceed initial projections and considerably improve statistical power.
Conclusion
RESECT has attracted many collaborators internationally from consultants and trainees at all stages. RESECT has significant potential to positively impact TURBT practice, health economics and ultimately improve outcomes for patients with NMIBC globally.
Collapse
Affiliation(s)
- C M Lam
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Gallagher
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - N Bhatt
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Clement
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - E Zimmermann
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - T Shah
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - S Khadhouri
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - M Kulkarni
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - C Gao
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - A Light
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - K Jayaraajan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - A Asif
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - T Anbarasan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - V Chan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| | - V Kasivisvanathan
- Bronglais Hospital, Aberystwyth; British Urology Researchers in Surgical Training (BURST)
| |
Collapse
|
12
|
Chan V, Mazer C, Mesana T, De Varennes B, Gregory A, Bouchard D, Zuo F, Mohamad Ali F, Tsang W, Latter D, Juni P, Teoh H, Quan A, Leong-Poi H, Verma S. A randomized surgical trial of mitral valve repair with leaflet resection versus leaflet preservation on functional mitral stenosis – primary results of the CAMRA CardioLink-2 trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The gold standard treatment for mitral valve regurgitation due to prolapse involves surgery with annuloplasty and either leaflet resection or leaflet preservation, with placement of artificial neochordae. It has been suggested that leaflet resection may be prone to functional mitral stenosis, whereby a patient may have a higher mitral gradient at peak exercise compared to a leaflet preservation strategy. Although both techniques are widely used, there has been no prospective randomized study conducted to compare these two techniques, particularly in regard to functional mitral stenosis.
Methods
A total of 104 patients with posterior leaflet prolapse were randomized to undergo mitral repair with either leaflet resection (N=54) or leaflet preservation (N=50) at 7 specialized Canadian cardiac centers. Patient age, proportion of female patients, and mean Society of Thoracic Surgeons risk score was 63.9±10.4 years, 19%, and 1.4% for those who underwent leaflet resection, and 66.3±10.8 years, 16%, and 1.9% for those who underwent leaflet preservation, respectively. The primary endpoint was the mean trans-mitral repair gradient at peak exercise 12-months after repair.
Results
Baseline characteristics were similar between the groups. At 12-months, the mean trans-mitral repair gradient at peak exercise in patients who underwent leaflet resection and preservation was 9.1±5.2 and 8.3±3.3 mmHg (P=0.4), respectively. The two groups had similar mean mitral valve gradient at rest (3.2±1.9 mmHg following resection and 3.1±1.1 mmHg following leaflet preservation, P=0.7). There was no between-group difference for the 6-minute walk distance (451±147 m and 481±95 m for the resection and preservation groups, respectively, P=0.3).
Conclusion
We report the first prospective surgical randomized trial to evaluate commonly used mitral valve repair strategies for posterior leaflet prolapse. Leaflet resection and leaflet preservation both yield acceptable results with no difference in postoperative valve gradient and functional status 12-months after surgical mitral valve repair.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Heart and Stroke Foundation of Canada
Collapse
Affiliation(s)
- V Chan
- University of Ottawa Heart Institute, Ottawa, Canada
| | - C.D Mazer
- St. Michael's Hospital, Anesthesia, Toronto, Canada
| | - T Mesana
- University of Ottawa Heart Institute, Ottawa, Canada
| | | | - A.J Gregory
- Libin Cardiovascular Institute of Alberta, Calgary, Canada
| | - D Bouchard
- Montreal Heart Institute, Montreal, Canada
| | - F Zuo
- St. Michael's Hospital, Applied Health Research Centre, Toronto, Canada
| | | | - W Tsang
- St. Michael's Hospital, Cardiology, Toronto, Canada
| | - D.A Latter
- St. Michael's Hospital, Cardiac Surgery, Toronto, Canada
| | - P Juni
- St. Michael's Hospital, Applied Health Research Centre, Toronto, Canada
| | - H Teoh
- St. Michael's Hospital, Cardiac Surgery, Toronto, Canada
| | - A Quan
- St. Michael's Hospital, Cardiac Surgery, Toronto, Canada
| | - H Leong-Poi
- St. Michael's Hospital, Cardiology, Toronto, Canada
| | - S Verma
- St. Michael's Hospital, Cardiac Surgery, Toronto, Canada
| |
Collapse
|
13
|
Yeo W, Li L, Lau T, Lai K, Chan V, Wong K, Yip C, Pang E, Cheung M, Chan V, Kwok C, Suen J, Mo F. Evaluation of optimal prophylactic antiemetic regimens for doxorubicin-cyclophosphamide chemotherapy. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Chan V, Garza R. PATIENTS WITH SEVERE COPD WHO HAVE FREQUENT READMISSIONS HAVE HIGH MORTALITY RATES AND MAY NOT RESPOND TO STANDARD PATHWAYS. Chest 2020. [DOI: 10.1016/j.chest.2020.05.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
15
|
Chan V, Garza R, Theodoric N. IMPROVED LENGTH OF STAY FOLLOWING EMR CLINICAL PATHWAY IMPLEMENTATION FOR ACUTE COPD EXACERBATION. Chest 2020. [DOI: 10.1016/j.chest.2020.05.349] [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: 10/24/2022] Open
|
16
|
Molassiotis A, Suen LKP, Cheng HL, Mok TSK, Lee SCY, Wang CH, Lee P, Leung H, Chan V, Lau TKH, Yeo W. A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy. Integr Cancer Ther 2019; 18:1534735419836501. [PMID: 30905173 PMCID: PMC6434440 DOI: 10.1177/1534735419836501] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [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] [Indexed: 01/20/2023] Open
Abstract
Purpose: Chemotherapy-induced peripheral neuropathy is a complex side effect with few available treatment options. The aim of the study was to test the effectiveness of an 8-week course of acupuncture in the management of chemotherapy-induced peripheral neuropathy in cancer patients who were receiving or had received neurotoxic chemotherapy. Methods: Randomized assessor-blinded controlled trial with 2 arms; one arm received acupuncture twice weekly for 8 weeks, while the other arm was a wait-list control group receiving only standard care. Primary outcome was pain intensity and interference over the past week using the Brief Pain Inventory at the end of the intervention. Secondary outcomes included clinical assessment (CTCAE [Common Toxicity Criteria for Adverse Events] grading and Total Neuropathy Score–Clinical Version) and nerve conduction studies; and patient-reported outcome measures (Functional Assessment of Cancer Therapy–Gynecologic Oncology Group–Neurotoxicity Quality of Life scale and Symptom Distress Scale) assessed at baseline, end of treatment (8 weeks), week 14, and week 20 from the beginning of treatment. Results: Eighty-seven patients were randomized to the experimental arm (n = 44) and to the standard care wait-list control arm (n = 43). Significant changes at 8 weeks were detected in relation to primary outcome (pain), the clinical neurological assessment, quality of life domains, and symptom distress (all P < .05). Improvements in pain interference, neurotoxicity-related symptoms, and functional aspects of quality of life were sustained in the 14-week assessment (P < .05), as were physical and functional well-being at the 20-week assessment (P < .05). Conclusions: Acupuncture is an effective intervention for treating chemotherapy-induced peripheral neuropathy and improving patients’ quality of life and experience with neurotoxicity-related symptoms with longer term effects evident.
Collapse
Affiliation(s)
| | - Lorna K P Suen
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Hui Lin Cheng
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - T S K Mok
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Sara C Y Lee
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - C H Wang
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Paul Lee
- 1 The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Howan Leung
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - V Chan
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - T K H Lau
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| | - Winnie Yeo
- 2 Prince of Wales Hospital, Sha Tin, Hong Kong SAR
| |
Collapse
|
17
|
Jian X, Holland C, Candy J, Belli E, Chan V, Garofalo AM, Ding S. Role of Microtearing Turbulence in DIII-D High Bootstrap Current Fraction Plasmas. Phys Rev Lett 2019; 123:225002. [PMID: 31868395 DOI: 10.1103/physrevlett.123.225002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/03/2019] [Indexed: 06/10/2023]
Abstract
We report on the first direct comparisons of microtearing turbulence simulations to experimental measurements in a representative high bootstrap current fraction (f_{BS}) plasma. Previous studies of high f_{BS} plasmas carried out in DIII-D with large radius internal transport barriers (ITBs) have found that, while the ion energy transport is accurately reproduced by neoclassical theory, the electron transport remains anomalous and not well described by existing quasilinear transport models. A key feature of these plasmas is the large value of the normalized pressure gradient, which is shown to completely stabilize conventional drift-wave and kinetic ballooning mode instabilities in the ITB, but destabilizes the microtearing mode. Nonlinear gyrokinetic simulations of the ITB region performed with the cgyro code demonstrate that the microtearing modes are robustly unstable and capable of driving electron energy transport levels comparable to experimental levels for input parameters consistent with the experimental measurements. These simulations uniformly predict that the microtearing mode fluctuation and flux spectra extend to significantly shorter wavelengths than the range of linear instability, representing significantly different nonlinear dynamics and saturation mechanisms than conventional drift-wave turbulence, which is also consistent with the fundamental tearing nature of the instability. The predicted transport levels are found to be most sensitive to the magnetic shear, rather than the temperature gradients more typically identified as driving turbulent plasma transport.
Collapse
Affiliation(s)
- X Jian
- University of California, San Diego, La Jolla, California 92093-0417, USA
| | - C Holland
- University of California, San Diego, La Jolla, California 92093-0417, USA
| | - J Candy
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - E Belli
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - V Chan
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - A M Garofalo
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - S Ding
- Oak Ridge Associated Universities, Oak Ridge, Tennessee 37831, USA
- Institute of Plasma Physics, Chinese Academy of Sciences, P.O. Box 1126, Hefei, Anhui, 230031, China
| |
Collapse
|
18
|
Morris J, Chan V, Chen J, Mao S, Ye M. Validation and sensitivity of CFETR design using EU systems codes. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
19
|
Chan V, Sarkari M, Sunderland R, St John AE, White NJ, Kastrup CJ. Platelets loaded with liposome-encapsulated thrombin have increased coagulability. J Thromb Haemost 2018; 16:1226-1235. [PMID: 29573326 DOI: 10.1111/jth.14006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 01/02/2018] [Indexed: 02/02/2023]
Abstract
Essentials Platelet transfusions can have limited efficacy during hemorrhage associated with coagulopathy. Thrombin can be shielded by encapsulation into nanoliposomes and delivered to platelets ex vivo. Loading platelets with liposomal thrombin improved several aspects of platelet coagulability. Platelets loaded with liposomal thrombin can overcome some coagulopathic deficiencies in vitro. SUMMARY Background Platelets are integral to clot formation and are often transfused to stop or prevent bleeding. However, transfusions of platelets are not always effective, particularly in the most severe cases of hemorrhage. Nanoparticle systems have been developed to mimic platelets but inherently lack important aspects of platelet function, which limits their potential effectiveness. Objectives Increasing the natural coagulability of transfusable platelets could increase their efficacy during treatment of severe hemorrhage. Thrombin is a potent platelet agonist that currently cannot be used intravenously because of the risk of thrombosis. We hypothesized that delivery of thrombin to ex vivo platelets via liposomal encapsulation would enable transfusable platelets to become more coagulable in response to platelet agonists. Methods Thrombin was encapsulated into nanoliposomes and delivered to platelets ex vivo. Platelet coagulability was measured by monitoring platelet activation, clot contraction, clot time and clot stability in several in vitro assays. These parameters were also measured under conditions where coagulation is compromised, including during acidosis, antiplatelet drugs, hemophilia A and trauma-induced coagulopathy. Results Liposomal thrombin was endocytosed and used by platelets ex vivo but was not secreted upon activation. These modified platelets became more sensitive and responsive to agonists and improved clotting time even under conditions that normally cause platelet dysfunction or have impaired coagulation. Conclusions Several aspects of platelet function were enhanced by ex vivo delivery of liposomal thrombin.
Collapse
Affiliation(s)
- V Chan
- Michael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - M Sarkari
- Michael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - R Sunderland
- Michael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - A E St John
- Department of Emergency Medicine, University of Washington, Seattle, WA, USA
| | - N J White
- Department of Emergency Medicine, University of Washington, Seattle, WA, USA
| | - C J Kastrup
- Michael Smith Laboratories, Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
20
|
Lee K, Chan O, Mok T, Chan A, Lee C, Fontela A, Yung T, Chan V, Wong A, Wong K, Fung S, Gai W. P3.02-031 Detection of Activating EGFR Mutations and Resistant T790M Mutation from cfDNA in Malignant Pleural Effusion(MPE-DNA). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1561] [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: 11/25/2022]
|
21
|
Yeo W, Mo F, Pang E, Suen J, Lee K, Ho W, Chan V, Koh J, Liem G. Quality of life of premenopausal Chinese breast cancer patients after adjuvant chemotherapy. Breast 2017. [DOI: 10.1016/s0960-9776(17)30119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
22
|
Tran J, Maloney M, Chan V, Porter C, Humberstone C. Anthropometry, fitness, sensorimotor skills, and performance of developing junior taekwondo athletes. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Kruisselbrink R, Arzola C, Jackson T, Okrainec A, Chan V, Perlas A. Ultrasound assessment of gastric volume in severely obese individuals: a validation study. Br J Anaesth 2017; 118:77-82. [DOI: 10.1093/bja/aew400] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2016] [Indexed: 12/27/2022] Open
|
24
|
Mohajeri S, McLean K, Kapralik J, Chan V, Coutinho T, Boodhwani M. PREDICTORS OF LEFT VENTRICULAR RECOVERY FOLLOWING SURGICAL INTERVENTION FOR AORTIC INSUFFICIENCY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
25
|
Russo J, James T, Ruel M, Dupuis J, Singh K, Goubran D, Malhotra N, Chan V, Chong A, Hibbert B, Tanguay J, Lordkipanidzé M, Perrault L, Wells G, Bourke M, Rubens F, So D. ISCHEMIC AND BLEEDING OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING AMONG PATIENTS INITIALLY TREATED WITH A P2Y12 RECEPTOR ANTAGONIST FOR ACUTE CORONARY SYNDROMES - INSIGHTS ON THE USE OF TICAGRELOR VERSUS CLOPIDOGREL PRIOR TO SURGERY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.175] [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: 11/30/2022] Open
|
26
|
Ngu J, Jafar R, Toeg H, Sohmer B, Chan V, Labrosse M, Boodhwani M. CUSP INTERVENTIONS IN AORTIC VALVE REPAIR: ARE ALL PERICARDIAL PATCHES CREATED EQUALLY? Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
27
|
Chan V, Elmistekawy E, Ruel M, Hynes M, Glineur D, Mesana T. HOW DURABLE IS REPAIR OF DEGENERATIVE MITRAL REGURGITATION IN THE YOUNG? Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
28
|
Russo J, James T, Ruel M, Dupuis J, Singh K, Goubran D, Malhotra N, Chan V, Chong A, Hibbert B, Tanguay J, Lordkipanidzé M, Perrault L, Wells G, Bourke M, Rubens F, So D. ISCHEMIC AND BLEEDING OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING AMONG PATIENTS INITIALLY TREATED WITH A P2Y12 RECEPTOR ANTAGONIST FOR ACUTE CORONARY SYNDROMES - INSIGHTS ON TIMING OF DISCONTINUATION OF TICAGRELOR AND CLOPIDOGREL PRIOR TO SURGERY. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
29
|
Affiliation(s)
- V Chan
- Department of Chemical Pathology, St. Bartholomew's Hospital, London
| | | | | | | | | |
Collapse
|
30
|
Chan V, Major-Cook N. Transition of Children with Medical Complexity To Adult Care: A Survey of Current Canadian Practices. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND: Children with medical complexity (CMC), among the most medically fragile and resource-intensive patients, are an ever-growing population. Unique barriers exist for successful transition of CMC to adult care. Transition care specific to CMC has not been previously studied.
OBJECTIVES: To describe transition policy and procedures used by Canadian pediatricians who care for CMC, and whether this is consistent with core elements of transition according to nationalguidelines. To identify pediatricians'; perceived barriers to successful transition of CMC.
DESIGN/METHODS: We conducted a 29-item online survey using REDCap of Canadian general pediatricians who provide transition care to CMC. Use of core elements of transition as per Canadian Paediatric Society (CPS) and American Academy of Pediatrics (AAP) statements, and perceived barriers to transition were measured using 5-point Likert scales. Descriptive analysis was performed using SAS 9.3.
RESULTS: The response rate was 30% (77/). 19% of pediatricians reported feeling satisfied with their success in transitioning CMC to adult care. 51% and 40% have read the CPS and AAP policy statements on transition, respectively. 22% have a specified set of procedures on transition for CMC at their institution. 23% performed assessments for transition readiness. In transition planning for capable CMC, 69% assessed knowledge of own medical condition and 54% assessed preparedness to navigate adult services independently. For CMC with neurocognitive disabilities, 65% discussed capacity and 53% reviewed care directives. 2% felt the legal process regarding capacity was easy to navigate for families, and 52% provided no legal resources to families during transition. 59% did not have existing relationships with adult practitioners willing to take on care coordination of CMC. 86% communicated with receiving adult practitioners upon transfer of care. Pediatricians' major perceived barriers to successful transition are listed in Table 1.
CONCLUSION: Only 1 in 5 Canadian pediatricians working with CMC reported satisfaction with the transition care they provide. Core elements of transition from national guidelines are inconsistently implemented, highlighting the need to develop evidence-based transition policy considering the unique needs and barriers experienced by CMC.
Collapse
|
31
|
Affiliation(s)
- M. Dam
- Copenhagen University Hospital; Roskilde Denmark
| | - C. K. Hansen
- Copenhagen University Hospital; Roskilde Denmark
| | - J. Børglum
- Copenhagen University Hospital; Roskilde Denmark
| | - V. Chan
- Toronto Western Hospital; Ontario Canada
| | | |
Collapse
|
32
|
Leung D, Chan S, Chan V, Lam TH. Hardcore smoking after comprehensive smoke-free legislation and health warnings on cigarette packets in Hong Kong. Public Health 2016; 132:50-6. [DOI: 10.1016/j.puhe.2015.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 03/25/2015] [Accepted: 10/15/2015] [Indexed: 11/28/2022]
|
33
|
Kapralik J, Boodhwani M, Chan V, McLean K, Sohmer B, Ruel M, Mesana T. AORTIC VALVE REPAIR IMPROVES MID-TERM OUTCOME COMPARED TO VALVE REPLACEMENT FOR AORTIC INSUFFICIENCY: A PROPENSITY MATCHED STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.455] [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: 10/22/2022] Open
|
34
|
Kapralik J, Boodhwani M, Chan V, McLean K, Sohmer B, Ruel M, Mesana T. OUTCOMES WITH THE SUTURELESS INTUITY VERSUS STENTED BIOLOGICAL AORTIC EDWARDS PERIMOUNT. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
35
|
Chan V, Malas T, Ruel M, Rubens F. APPLICATION OF HIGH FIDELITY SIMULATION IN TEACHING MITRAL VALVE ANNULOPLASTY TO CARDIAC SURGERY RESIDENTS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
36
|
Rubens FD, Rao RV, Chan V, Burwash IG. A Matched-Paired Comparative Analysis of the Hemodynamics of the Trifecta and Perimount Aortic Bioprostheses. J Heart Valve Dis 2015; 24:487-495. [PMID: 26897822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Current cohort studies comparing the Trifecta valve to alternative pericardial bioprostheses are limited by selection bias. The study aim was to determine if hemodynamics are improved after the aortic valve implantation of a Trifecta valve as compared to a standard pericardial valve, when evaluated using strict paired matching for specific key relevant confounders. METHODS Valve hemodynamics were compared in patients undergoing implantation with a Trifecta or Perimount valve matched for left ventricular outflow tract (LVOT) diameter, gender, age, body size, and days since surgery, using a 1:1 matched-paired cohort analysis (n = 20 per group). RESULTS Patients receiving a Trifecta valve had a larger increase in indexed stroke volume (SVi) relative to baseline compared to the Perimount patients (p = 0.013), in whom SVi was decreased. The mean transvalvular pressure gradient was lower in Trifecta patients despite the larger SVi (p = 0.02). The effective orifice area (EOA) and indexed EOA (EOAi) were significantly larger in Trifecta patients compared to Perimount patients (2.04 +/- 0.46 versus 1.77 +/- 0.45 cm2, p = 0.049; 1.10 +/- 0.22 versus 0.95 +/- 0.06 cm2/m2, p = 0.027, respectively), and there was a greater increase in EOA and EOAi from baseline (p = 0.010 for both). Severe prosthesis-patient mismatch (PPM) (EOAi < or = 0.65 cm2/m2) was seen in two (10%) of the Perimount cases, but in none of the patients with the Trifecta valve (p = 0.072). CONCLUSION Trifecta valve implantation is associated with a significant improvement in EOA and a decreased incidence of PPM as compared to the Perimount valve. The superior hemodynamic outcomes observed support consideration of this valve for aortic valve replacement, particularly in patients with a small LVOT at risk for PPM.
Collapse
|
37
|
Yeo W, Yip C, Mo F, Pang E, Yip C, Lee K, Chan V, Suen J, Ho W, Liem T. Lipid profiles of young Chinese breast cancer after adjuvant chemotherapy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv113.05] [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: 11/14/2022] Open
|
38
|
Das D, Yan Z, Menon NV, Kang Y, Chan V, Yang C. Continuous detection of trace level concentration of oil droplets in water using microfluidic AC electroosmosis (ACEO). RSC Adv 2015. [DOI: 10.1039/c5ra15624f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel design for high throughput detection of oil micro-droplets in water which is important to environmental oil spill monitoring agencies.
Collapse
Affiliation(s)
- D. Das
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore-637459
- Nanyang Environment and Water Research Institute
- Nanyang Technological University
| | - Z. Yan
- School of Mechanical and Aerospace Engineering
- Nanyang Technological University
- Singapore-639798
| | - N. V. Menon
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore-637459
| | - Y. Kang
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore-637459
| | - V. Chan
- School of Chemical and Biomedical Engineering
- Nanyang Technological University
- Singapore-637459
| | - C. Yang
- School of Mechanical and Aerospace Engineering
- Nanyang Technological University
- Singapore-639798
| |
Collapse
|
39
|
Chan V, Lai CL, Chan KM, Yuen MF. Hepatitis B virus array for genotyping and mutation detection. Hong Kong Med J 2014; 20 Suppl 6:25-27. [PMID: 25482967] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- V Chan
- Department of Medicine, Queen Mary Hospital
| | | | | | | |
Collapse
|
40
|
Mesana L, Une D, Chaudry S, Maklin M, Chan R, Chan V, Boodhwani M, Mesana T, Ruel M. EVOLUTION OF LEFT VENTRICULAR HYPERTROPHY IN AORTIC VALVE REPLACEMENT PATIENTS: A LONGITUDINAL ANALYSIS OF 639 PATIENTS. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.176] [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: 10/24/2022] Open
|
41
|
Jackson R, Ye B, Chan V, Boodhwani M, Davies R, Haddad H, Davis D. ISOLATION AND RECOVERY OF HUMAN CARDIAC STEM CELLS FROM CRYOPRESERVED CARDIAC TISSUE. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.292] [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: 10/24/2022] Open
|
42
|
Cheung Y, Lee P, Leung M, Lam C, Chan V, Ng W. THU0587-HPR Nurse-Led Biologic Infusion – A Safe Service That Saves. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2925] [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]
|
43
|
Doggrell SA, Chan V. Do interventions by allied health professionals discussing adherence to insulin improve this adherence? Diabetes Res Clin Pract 2014; 104:e61-3. [PMID: 24768512 DOI: 10.1016/j.diabres.2014.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 03/07/2014] [Accepted: 03/22/2014] [Indexed: 11/29/2022]
Abstract
It is assumed that interventions to improve the adherence to insulin by allied health professionals discussing adherence to insulin will improve this adherence. However, there is little evidence to support this, as interventions by a pharmacist or nurse educator have not been shown conclusively to improve adherence to insulin.
Collapse
Affiliation(s)
- S A Doggrell
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Gardens Point, GPO 2434, Brisbane, QLD 4001, Australia.
| | - V Chan
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Gardens Point, GPO 2434, Brisbane, QLD 4001, Australia
| |
Collapse
|
44
|
Elmistekawy E, Chan V, Grisoli D, Ruel M, Chaudry S, Tran A, Ressler L, Lambert S, Mesana T. Outcomes following repair of bileaflet prolapse due to myxomatous disease of the mitral valve. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2013.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
45
|
Chan V, Blazey W, Tegay D, Harper B, Koehler S, Laurent B, Lipka S, Cohn J, Jung MK, Krishnamachari B. Impact of academic affiliation and training on knowledge of hereditary colorectal cancer. Public Health Genomics 2014; 17:76-83. [PMID: 24458016 DOI: 10.1159/000356938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowledge about hereditary colorectal cancer (CRC) can aid cancer screening and prevention in high-risk patients. Genetic testing, once conducted primarily at academic centers, is now routinely performed in a variety of clinics. Nonacademic physicians may not be aware of hereditary CRC standards of care. METHODS From August to November 2012, a survey was administered to predominantly primary care physicians evaluating academic center affiliation, past training in genetics and knowledge regarding hereditary CRC. RESULTS One hundred forty physicians completed the survey. Knowledge of hereditary CRC was neither associated with academic affiliation nor with training during medical school or residency, but with continuing medical education (CME) training. Those with CME training were more likely to know that screening could be enhanced for patients with a hereditary cancer risk (OR = 4.49, 95% CI = 1.40-14.38) and that an individual with hereditary CRC would have different screening recommendations (OR = 7.49, 95% CI = 1.37-40.81). Residency training and CME training were associated with more frequent hereditary risk assessment. CONCLUSION Genetics training may be associated with physicians' knowledge and assessment of hereditary CRC. Training at the CME level in particular may be integral to the delivery of genetic services in clinical practice.
Collapse
Affiliation(s)
- V Chan
- Department of Medicine, NYIT College of Osteopathic Medicine, Old Westbury, N.Y., USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Chan V, Kong HJ, Bashir R. 3D fabrication of biological machines. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:314-7. [PMID: 24109687 DOI: 10.1109/embc.2013.6609500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cell-based biological machines can be defined as a set of sub-components consisting of living cells and cell-instructive micro-environments that interact to perform a range of prescribed tasks. The realization of biological machines and their sub-components will require a number of suitable cell sources, biomaterials, and enabling technologies. Here, we review our group's recent accomplishments and continuing efforts toward the development of building biological machines.
Collapse
|
47
|
Toeg H, Rao R, Chan K, Al-Atassi T, Ruel M, Mesana T, Chan V, Boodhwani M. Mid-Term Clinical and Echocardiographic Outcomes of Bentall and Aortic Valve Sparing Root Replacement: a Propensity Matched Analysis. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
48
|
Chan V, Ahrari A, Ruel M, Elmestekawy E, Mesana T. Perioperative Mortality Following Mitral Valve Surgery May Be Overestimated by Contemporary Risk Models. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.625] [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: 11/17/2022] Open
|
49
|
Saleem N, Saczkowski R, Hudson C, Ruel M, Rubens F, Chan V, Hendry P, Boodhwani M. Normothermia Is Associated With Reduced Kidney and Brain Injury During Cardiopulmonary Bypass. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.691] [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: 11/24/2022] Open
|
50
|
Ng SC, Ching JYL, Chan V, Wong MCS, Suen BY, Hirai HW, Lam TYT, Lau JYW, Ng SSM, Wu JCY, Chan FKL, Sung JJY. Diagnostic accuracy of faecal immunochemical test for screening individuals with a family history of colorectal cancer. Aliment Pharmacol Ther 2013; 38:835-41. [PMID: 23957462 DOI: 10.1111/apt.12446] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 06/13/2013] [Accepted: 07/19/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of a faecal immunochemical test (FIT) in screening individuals with a positive family history of colorectal cancer (CRC) is not clear. AIM To assess the diagnostic accuracy of FIT using colonoscopy findings as the gold standard in identifying colorectal neoplasms. METHODS We analysed data from 4539 asymptomatic subjects aged 50-70 years who had both colonoscopy and FIT (Hemosure; W.H.P.M., Inc, El Monte, CA, USA) at our bowel cancer screening centre between 2008 and 2012. A total of 572 subjects (12.6%) had a family history of CRC. Our primary outcome was the sensitivity of FIT in detecting advanced neoplasms and cancers in subjects with a family history of CRC. A family history of CRC was defined as any first-degree relative with a history of CRC. RESULTS Among 572 subjects with a family history of CRC, adenoma, advanced neoplasm and cancer were found at screening colonoscopy in 29.4%, 6.5% and 0.7% individuals, respectively. The sensitivity of FIT in detecting adenoma, advanced neoplasm and cancer was 9.5% [95% confidence interval (CI), 5.7-15.3], 35.1% (95% CI, 20.7-52.6) and 25.0% (95% CI, 1.3-78.1), respectively. Among FIT-negative subjects who have a family history of CRC, adenoma was found in 152 (29.6%), advanced neoplasm in 24 (4.7%) and cancer in 3 (0.6%) individuals. CONCLUSION Compared with colonoscopy, FIT is more likely to miss advanced neoplasms or cancers in individuals with a family history of CRC.
Collapse
Affiliation(s)
- S C Ng
- Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|