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Mehta BK, Chauhan HS, Basu S, Anand A, Baveja A, Zunjare RU, Muthusamy V, Singh AK, Hossain F. Mutant crtRB1 gene negates the unfavourable effects of opaque2 gene on germination and seed vigour among shrunken2-based biofortified sweet corn genotypes. Funct Plant Biol 2024; 51:FP23179. [PMID: 38326234 DOI: 10.1071/fp23179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024]
Abstract
Sweet corn is one of the most popular vegetables worldwide. However, traditional shrunken2 (sh2 )-based sweet corn varieties are poor in nutritional quality. Here, we analysed the effect of (1) β-carotene hydroxylase1 (crtRB1 ), (2) opaque2 (o2 ) and (3) o2+crtRB1 genes on nutritional quality, germination, seed vigour and physico-biochemical traits in a set of 27 biofortified sh2 -based sweet corn inbreds. The biofortified sweet corn inbreds recorded significantly higher concentrations of proA (16.47μg g-1 ), lysine (0.36%) and tryptophan (0.09%) over original inbreds (proA: 3.14μg g-1 , lysine: 0.18%, tryptophan: 0.04%). The crtRB1 -based inbreds had the lowest electrical conductivity (EC), whereas o2 -based inbreds possessed the highest EC. The o2 +crtRB1 -based inbreds showed similar EC to the original inbreds. Interestingly, o2 -based inbreds also had the lowest germination and seed vigour compared to original inbreds, whereas crtRB1 and o2 +crtRB1 introgressed sweet corn inbreds showed similar germination and seed vigour traits to their original versions. This suggested that the negative effect of o2 on germination, seed vigour and EC is nullified by crtRB1 in the double mutant sweet corn. Overall, o2 +crtRB1 -based sweet corn inbreds were found the most desirable over crtRB1 - and o2 -based inbreds alone.
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Affiliation(s)
- Brijesh K Mehta
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India; and Present address: ICAR-Indian Grassland and Fodder Research Institute, Jhansi 284003, India
| | - Hema S Chauhan
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - Sudipta Basu
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - Anjali Anand
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - Aanchal Baveja
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | | | - Vignesh Muthusamy
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - Ashok K Singh
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
| | - Firoz Hossain
- ICAR-Indian Agricultural Research Institute, New Delhi 110012, India
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2
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Devender M, Sebastian P, Maurya VK, Kumar K, Anand A, Namdeo M, Maurya R. Immunogenicity and protective efficacy of tuzin protein as a vaccine candidate in Leishmania donovani-infected BALB/c mice. Front Immunol 2024; 14:1294397. [PMID: 38274802 PMCID: PMC10808571 DOI: 10.3389/fimmu.2023.1294397] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Visceral leishmaniasis (VL) is referred to as the most severe and fatal type of leishmaniasis basically caused by Leishmania donovani and L. infantum. The most effective method for preventing the spread of the disease is vaccination. Till today, there is no promising licensed vaccination for human VL. Hence, investigation for vaccines is necessary to enrich the therapeutic repertoire against leishmaniasis. Tuzin is a rare trans-membrane protein that has been reported in Trypanosoma cruzi with unknown function. However, tuzin is not characterized in Leishmania parasites. In this study, we for the first time demonstrated that tuzin protein was expressed in both stages (promastigote and amastigote) of L. donovani parasites. In-silico studies revealed that tuzin has potent antigenic properties. Therefore, we analyzed the immunogenicity of tuzin protein and immune response in BALB/c mice challenged with the L. donovani parasite. We observed that tuzin-vaccinated mice have significantly reduced parasite burden in the spleen and liver compared with the control. The number of granulomas in the liver was also significantly decreased compared with the control groups. We further measured the IgG2a antibody level, a marker of Th1 immune response in VL, which was significantly higher in the serum of immunized mice when compared with the control. Splenocytes stimulated with soluble Leishmania antigen (SLA) displayed a significant increase in NO and ROS levels compared with the control groups. Tuzin-immunized and parasite-challenged mice exhibit a notable rise in the IFN-γ/IL-10 ratio by significantly suppressing IL-10 expression level, an immunosuppressive cytokine that inhibits leishmanicidal immune function and encourages disease progression. In conclusion, tuzin immunizations substantially increase the protective immune response in L. donovani-challenged mice groups compared with control.
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Gupta A, Mathew R, Anand A, Bhardwaj T, Singh A, Singh K, Kumar A, Mishra PR, Sharma TK. A DNA aptamer-based assay for the detection of soluble ST2, a prognostic biomarker for monitoring heart failure. Int J Biol Macromol 2024; 256:128295. [PMID: 37992929 DOI: 10.1016/j.ijbiomac.2023.128295] [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: 06/30/2023] [Revised: 11/18/2023] [Accepted: 11/18/2023] [Indexed: 11/24/2023]
Abstract
Heart failure (HF) is emerging as a leading cause of death worldwide. Estimation of BNP levels is a routine diagnosis in these patients. However, in patients having high body-mass index (BMI), renal disease or in geriatric patients, BNP level is reported to be noisy and leads to incongruous conclusion. Thus, for better risk stratification among heart failure patients, it is imperative to look for a superior biomarker. In recent times, sST2 has shown promise as a biomarker. Identifying such biomarkers in peripheral blood of HF patients, need an affine and selective molecular recognition element. Thus, in the current study an aptamer (sS9_P) against sST2 was identified from an aptamer library. Systematic Evolution of Ligands through Exponential enrichment (SELEX) derived aptamer evinced role of its primer binding domains in maintaining its selectivity. This aptamer candidate demonstrated dissociation constant (Kd) in low nanomolar range, and the Limit of Detection (LOD) was ~4 ng. Circular dichroism confirms the formation of complex stem-loop like structure. The well characterized sS9_P aptamer was used in an Aptamer Linked Immobilized Sorbent Assay (ALISA) to detect sST2 level in patients' serum (n = 99). Aptamer sS9_P has shown significant discrimination to differentiate HF patients and healthy volunteers with a reasonable specificity (~83 %) with a modest sensitivity of ~64 %. While sST-2 antibody has shown poor specificity of ~44% but good sensitivity (~87%). The insight obtained from this study indicates that a combination of aptamer and antibody-based assay can be used to design a point-of-care assay for the rapid detection of HF patients in emergency settings.
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Affiliation(s)
- Ankit Gupta
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Roshan Mathew
- All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi 110029, India
| | - Anjali Anand
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Tanu Bhardwaj
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India; Department of Medical Biotechnology, Gujarat Biotechnology University, GIFT-City, Gandhinagar, Gujarat 382355, India
| | - Aakriti Singh
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
| | - Krishna Singh
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
| | - Amit Kumar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
| | | | - Tarun Kumar Sharma
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India; Department of Medical Biotechnology, Gujarat Biotechnology University, GIFT-City, Gandhinagar, Gujarat 382355, India.
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Das G, Anand A, Vedhanarayanan B, Padmakumar A, Praveen VK, Ajayaghosh A. Controlling the Morphological Features, Aspect Ratio and Emission Patterns of Supramolecular Copolymers by Restricted Dimensional Growth. Chemistry 2023; 29:e202301819. [PMID: 37498316 DOI: 10.1002/chem.202301819] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 07/28/2023]
Abstract
One of the bottlenecks associated with supramolecular polymerization of functional π-systems is the spontaneous assembly of monomers leading to one- or two-dimensional (1D or 2D) polymers without control over chain length and optical properties. In the case of supramolecular copolymerization of monomers that are structurally too diverse, preferential self-sorting occurs unless they are closely interacting donor-acceptor pairs. Herein, it is established that the spontaneous 1D polymerization of a phenyleneethynylene (PE) derivative and the 2D polymerization of a Bodipy derivative (BODIPY) can be controlled by copolymerizing them in different ratios, leading to unusual spindle-shaped structures with controlled aspect ratio, as evident by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and confocal laser scanning microscopy (CLSM) studies. For example, when the content of BODIPY is 50 % in the BODIPY-PE mixture, the 1D polymerization of PE is significantly restricted to form elongated spindle-like structures having an aspect ratio of 4-6. The addition of 75 % of BODIPY to PE resulted in circular spindles having an aspect ratio of 1-2.5, thereby completely restricting the 1D polymerization of PE monomers. Moreover, the resultant supramolecular copolymers exhibited morphology and aspect ratio dependent emission features as observed by the time-resolved emission studies.
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Affiliation(s)
- Gourab Das
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Anjali Anand
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Balaraman Vedhanarayanan
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
| | - Akhil Padmakumar
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Vakayil K Praveen
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Ayyappanpillai Ajayaghosh
- Photosciences and Photonics Section, Chemical Sciences and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology (CSIR-NIIST), Thiruvananthapuram, Kerala, 695019, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
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Bartoli E, Devara E, Dang HQ, Rabinovich R, Mathura RK, Anand A, Pascuzzi BR, Adkinson J, Bijanki KR, Sheth SA, Shofty B. Default mode network spatio-temporal electrophysiological signature and causal role in creativity. bioRxiv 2023:2023.09.13.557639. [PMID: 37786678 PMCID: PMC10541614 DOI: 10.1101/2023.09.13.557639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The default mode network (DMN) is a widely distributed, intrinsic brain network thought to play a crucial role in internally-directed cognition. It subserves self-referential thinking, recollection of the past, mind wandering, and creativity. Knowledge about the electrophysiology underlying DMN activity is scarce, due to the difficulty to simultaneously record from multiple distant cortical areas with commonly-used techniques. The present study employs stereo-electroencephalography depth electrodes in 13 human patients undergoing monitoring for epilepsy, obtaining high spatiotemporal resolution neural recordings across multiple canonical DMN regions. Our results offer a rare insight into the temporal evolution and spatial origin of theta (4-8Hz) and gamma signals (30-70Hz) during two DMN-associated higher cognitive functions: mind-wandering and alternate uses. During the performance of these tasks, DMN activity is defined by a specific pattern of decreased theta coupled with increased gamma power. Critically, creativity and mind wandering engage the DMN with different dynamics: creativity recruits the DMN strongly during the covert search of ideas, while mind wandering displays the strongest modulation of DMN during the later recall of the train of thoughts. Theta band power modulations, predominantly occurring during mind wandering, do not show a predominant spatial origin within the DMN. In contrast, gamma power effects were similar for mind wandering and creativity and more strongly associated to lateral temporal nodes. Interfering with DMN activity through direct cortical stimulation within several DMN nodes caused a decrease in creativity, specifically reducing the originality of the alternate uses, without affecting creative fluency or mind wandering. These results suggest that DMN activity is flexibly modulated as a function of specific cognitive processes and supports its causal role in creative thinking. Our findings shed light on the neural constructs supporting creative cognition and provide causal evidence for the role of DMN in the generation of original connections among concepts.
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Affiliation(s)
- E Bartoli
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - E Devara
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - H Q Dang
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - R Rabinovich
- Department of Neurosurgery, University of Utah, USA
| | - R K Mathura
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - A Anand
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - B R Pascuzzi
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - J Adkinson
- Department of Neurosurgery, Baylor College of Medicine, USA
| | - K R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, USA
- Department of Neuroscience, Baylor College of Medicine, USA
| | - S A Sheth
- Department of Neurosurgery, Baylor College of Medicine, USA
- Department of Neuroscience, Baylor College of Medicine, USA
| | - B Shofty
- Department of Neurosurgery, University of Utah, USA
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Anand A, Garg VK, Agrawal A, Mangla S, Pathak A. Distribution and concentration pathway of particulate pollution during pandemic-induced lockdown in metropolitan cities in India. Int J Environ Sci Technol (Tehran) 2023:1-14. [PMID: 37360554 PMCID: PMC10258753 DOI: 10.1007/s13762-023-05025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/23/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023]
Abstract
To characterize the pollutant dispersal across major metropolitan cities in India, daily particulate matter (PM10 and PM2.5) data for the study areas were collected from the National Air Quality Monitoring stations database provided by the Central Pollution Control Board (CPCB) of India. The data were analysed for three temporal ranges, i.e. before the pandemic-induced lockdown, during the lockdown, and after the upliftment of lockdown restrictions. For the purpose, the time scale ranged from 1st April to 31st May for the years 2019 (pre), 2020, and 2021 (post). Statistical distributions (lognormal, Weibull, and Gamma), aerosol optical thickness, and back trajectories were assessed for all three time periods. Most cities followed the lognormal distribution for PM2.5 during the lockdown period except Mumbai and Hyderabad. For PM10, all the regions followed the lognormal distribution. Delhi and Kolkata observed a maximum decline in particulate pollution of 41% and 52% for PM2.5 and 49% and 53% for PM10, respectively. Air mass back trajectory suggests local transmission of air mass during the lockdown period, and an undeniable decline in aerosol optical thickness was observed from the MODIS sensor. It can be concluded that statistical distribution analysis coupled with pollution models can be a counterpart in studying the dispersal and developing pollution abatement policies for specific sites. Moreover, incorporating remote sensing in pollution study can enhance the knowledge about the origin and movement of air parcels and can be helpful in taking decisions beforehand.
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Affiliation(s)
- A. Anand
- Department of Environmental Sciences and Technology, Central University of Punjab, Ghudda, Bathinda, Punjab India
| | - V. K. Garg
- Department of Environmental Sciences and Technology, Central University of Punjab, Ghudda, Bathinda, Punjab India
| | - A. Agrawal
- Department of Mathematics and Statistics, Central University of Punjab, Ghudda, Bathinda, Punjab India
| | - S. Mangla
- International Institute for Population Sciences, Mumbai, India
| | - A. Pathak
- Department of Statistics, Ramjas College, University of Delhi, Delhi, India
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Raza A, Charagh S, Abbas S, Hassan MU, Saeed F, Haider S, Sharif R, Anand A, Corpas FJ, Jin W, Varshney RK. Assessment of proline function in higher plants under extreme temperatures. Plant Biol (Stuttg) 2023; 25:379-395. [PMID: 36748909 DOI: 10.1111/plb.13510] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Climate change and abiotic stress factors are key players in crop losses worldwide. Among which, extreme temperatures (heat and cold) disturb plant growth and development, reduce productivity and, in severe cases, lead to plant death. Plants have developed numerous strategies to mitigate the detrimental impact of temperature stress. Exposure to stress leads to the accumulation of various metabolites, e.g. sugars, sugar alcohols, organic acids and amino acids. Plants accumulate the amino acid 'proline' in response to several abiotic stresses, including temperature stress. Proline abundance may result from de novo synthesis, hydrolysis of proteins, reduced utilization or degradation. Proline also leads to stress tolerance by maintaining the osmotic balance (still controversial), cell turgidity and indirectly modulating metabolism of reactive oxygen species. Furthermore, the crosstalk of proline with other osmoprotectants and signalling molecules, e.g. glycine betaine, abscisic acid, nitric oxide, hydrogen sulfide, soluble sugars, helps to strengthen protective mechanisms in stressful environments. Development of less temperature-responsive cultivars can be achieved by manipulating the biosynthesis of proline through genetic engineering. This review presents an overview of plant responses to extreme temperatures and an outline of proline metabolism under such temperatures. The exogenous application of proline as a protective molecule under extreme temperatures is also presented. Proline crosstalk and interaction with other molecules is also discussed. Finally, the potential of genetic engineering of proline-related genes is explained to develop 'temperature-smart' plants. In short, exogenous application of proline and genetic engineering of proline genes promise ways forward for developing 'temperature-smart' future crop plants.
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Affiliation(s)
- A Raza
- College of Agriculture, Fujian Agriculture and Forestry University (FAFU), Fuzhou, China
| | - S Charagh
- State Key Laboratory of Rice Biology, China National Rice Research Institute, Chinese Academy of Agricultural Sciences (CAAS), Hangzhou, China
| | - S Abbas
- Department of Botany, Faculty of Life Sciences, Government College University, Faisalabad, Pakistan
| | - M U Hassan
- Research Center on Ecological Sciences, Jiangxi Agricultural University, Nanchang, China
| | - F Saeed
- Department of Agricultural Genetic Engineering, Faculty of Agricultural Sciences and Technologies, Nigde Omer Halisdemir University, Nigde, Turkey
| | - S Haider
- Plant Biochemistry and Molecular Biology Lab, Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - R Sharif
- Department of Horticulture, School of Horticulture and Landscape, Yangzhou University, Yangzhou, China
| | - A Anand
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, Pusa, New Delhi, India
| | - F J Corpas
- Group of Antioxidants, Free Radicals and Nitric Oxide in Biotechnology, Food and Agriculture, Department of Stress, Development and Signaling in Plants, Estación Experimental del Zaidín, Spanish National Research Council, CSIC, Granada, Spain
| | - W Jin
- Key Laboratory of Biology and Genetic Improvement of Horticultural Crops (North China), Institute of Forestry and Pomology, Beijing Academy of Agriculture and Forestry Sciences, Beijing, China
| | - R K Varshney
- State Agricultural Biotechnology Centre, Centre for Crop and Food Innovation, Murdoch University, Murdoch, WA, Australia
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8
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Zabeeulla M, Sharma C, Anand A. Early Detection of Heart Disease Using Machine Learning Approach. CM 2023. [DOI: 10.18137/cardiometry.2023.26.342347] [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: 03/18/2023] Open
Abstract
Heart attack is one of the leading causes of morbidity in the worldwide population. Cardiovascular disease is one of the major diseases involved in clinical data analysis or one of the most important part for forecasting. Early detection of cardiovascular diseases can help to reduce high-risk condition for heart patients to make individual decisions for their lifestyle adjustments, mitigating the challenges. Early detection of heart disease has been explored in this study using a machine-learning approach. Additionally, we used sampling strategies to deal with disparate datasets. The overall risk is estimated using a variety of machine-learning techniques. On Kaggle, the Heart Disease dataset is accessible and open for all. In present study testing set used this dataset. The ultimate objective is to determine whether the patient has a “10-year risk of developing coronary heart disease” (CHD). The dataset contained thirteen features that provided patient data, and the authors used machine learning algorithms to diagnose cardiac problems with 98.8% accuracy.
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Chauhan NK, Anand A, Sharma A, Dhiman K, Gosain TP, Singh P, Singh P, Khan E, Chattopadhyay G, Kumar A, Sharma D, Ashish, Sharma TK, Singh R. Structural and Functional Characterization of Rv0792c from Mycobacterium tuberculosis: Identifying Small Molecule Inhibitor against HutC Protein. Microbiol Spectr 2023; 11:e0197322. [PMID: 36507689 PMCID: PMC9927256 DOI: 10.1128/spectrum.01973-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In order to adapt in host tissues, microbial pathogens regulate their gene expression through a variety of transcription factors. Here, we have functionally characterized Rv0792c, a HutC homolog from Mycobacterium tuberculosis. In comparison to the parental strain, a strain of M. tuberculosis with a Rv0792c mutant was compromised for survival upon exposure to oxidative stress and infection in guinea pigs. RNA sequencing analysis revealed that Rv0792c regulates the expression of genes involved in stress adaptation and virulence of M. tuberculosis. Solution small-angle X-ray scattering (SAXS) data-steered model building confirmed that the C-terminal region plays a pivotal role in dimer formation. Systematic evolution of ligands by exponential enrichment (SELEX) resulted in the identification of single-strand DNA (ssDNA) aptamers that can be used as a tool to identify small-molecule inhibitors targeting Rv0792c. Using SELEX and SAXS data-based modeling, we identified residues essential for Rv0792c's aptamer binding activity. In this study, we also identified I-OMe-Tyrphostin as an inhibitor of Rv0792c's aptamer and DNA binding activity. The identified small molecule reduced the growth of intracellular M. tuberculosis in macrophages. The present study thus provides a detailed shape-function characterization of a HutC family of transcription factor from M. tuberculosis. IMPORTANCE Prokaryotes encode a large number of GntR family transcription factors that are involved in various fundamental biological processes, including stress adaptation and pathogenesis. Here, we investigated the structural and functional role of Rv0792c, a HutC homolog from M. tuberculosis. We demonstrated that Rv0792c is essential for M. tuberculosis to adapt to oxidative stress and establish disease in guinea pigs. Using a systematic evolution of ligands by exponential enrichment (SELEX) approach, we identified ssDNA aptamers from a random ssDNA library that bound to Rv0792c protein. These aptamers were thoroughly characterized using biochemical and biophysical assays. Using SAXS, we determined the structural model of Rv0792c in both the presence and absence of the aptamers. Further, using a combination of SELEX and SAXS methodologies, we identified I-OMe-Tyrphostin as a potential inhibitor of Rv0792c. Here we provide a detailed functional characterization of a transcription factor belonging to the HutC family from M. tuberculosis.
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Affiliation(s)
- Neeraj Kumar Chauhan
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Anjali Anand
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Arun Sharma
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Kanika Dhiman
- Institute of Microbial Technologygrid.417641.1, Council of Scientific and Industrial Research, Chandigarh, India
| | - Tannu Priya Gosain
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Prashant Singh
- Institute of Microbial Technologygrid.417641.1, Council of Scientific and Industrial Research, Chandigarh, India
| | - Padam Singh
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Eshan Khan
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indoregrid.450280.b, Indore, India
| | | | - Amit Kumar
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indoregrid.450280.b, Indore, India
| | - Deepak Sharma
- Institute of Microbial Technologygrid.417641.1, Council of Scientific and Industrial Research, Chandigarh, India
| | - Ashish
- Institute of Microbial Technologygrid.417641.1, Council of Scientific and Industrial Research, Chandigarh, India
| | - Tarun Kumar Sharma
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
| | - Ramandeep Singh
- Translational Health Science and Technology Institutegrid.464764.3, Faridabad, Haryana, India
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Gomez Zapata D, Joshi P, Fogaing C, Anand A, Rajenderan R, Bhadranavar S, Toribio-Vázquez C, Kulkarni S. Redo panurethral stricture: A challenge in reconstructive urology. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00496-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Zioupos L, Kirkpatrick J, Anand A. 1272 A PILOT ROUTINE ELECTRONIC HEALTH RECORD FUNCTIONAL TRACKING SCORE FOR OLDER PATIENTS IN HOSPITAL. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.025] [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: 01/18/2023] Open
Abstract
Abstract
Introduction
Approximately one-third of older patients leave hospital with a new functional impairment. Tracking rehabilitation progress following acute illness could improve recognition and understanding of hospital-acquired disability. However, traditional mobility and functional scores include measures that are not part of routine rehabilitation therapy, adding a time burden for staff to report. Capturing data already recorded in routine electronic records could provide an efficient patient tracking measure of rehabilitation success.
Methods
A scoping literature review appraised existing scores of mobility and functional status. Analysis of 15 admissions through the Royal Infirmary of Edinburgh identified mobility and functional domains which were reliably recorded in free text electronic health records. A pilot score was drafted, comprising admission and discharge scores (0-30 points), medical progress (0-10), physiotherapy and occupational therapy tracking (0-30). Higher scores indicate greater functional independence. Expert feedback was obtained through focus group discussion with physiotherapists and occupational therapists. The approach was tested in a fresh set of six case studies. Two independent scorers applied the scoring schema and agreement was assessed using Cohen’s weighted-kappa coefficient.
Results
The selected electronic health records contained 438 medical, 352 nursing and 183 therapist entries. Existing measures such as the Barthel Index were not recorded for any patient. Focus group discussion identified value in the overall approach and informed item-weighting. The pilot functional score allowed visualisation of rehabilitation trajectories over the course of each admission. Excellent inter-rater reliability was demonstrated for the medical (Cohen’s Kappa 0.99, 95% confidence interval [CI] 0.96–1.00) and physiotherapy (Kappa 0.96, 95% CI 0.93–0.99) components.
Conclusions
A functional tracking score generated from routine health records proved feasible and reproducible in this pilot. Future development should assess validity, reliability and prognostic power in larger populations, exploring automation using natural language processing. Development of graphic visualisations may aid communication within multidisciplinary teams.
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Affiliation(s)
- L Zioupos
- University of Edinburgh Medical School
| | | | - A Anand
- University of Edinburgh Centre for Cardiovascular Science,
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12
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Ramaclus JV, Anand A. 4-[4-(4-methoxyphenyl)-1,3-butadienyl] 1methylpyridinium 4-chlorobenzene sulphonate (MBMPCBS) – An efficient nonlinear optical crystal with superior thermal stability. CrystEngComm 2023. [DOI: 10.1039/d3ce00090g] [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: 03/17/2023]
Abstract
Organic crystals are considered to be one of the best THz emitters due to its high nonlinear optical susceptibility but are thermally fragile and vulnerable to damage when exposed to...
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Gupta N, Jain SK, Tomar BS, Anand A, Singh J, Sagar V, Kumar R, Singh V, Chaubey T, Abd-Elsalam KA, Singh AK. Impact of Foliar Application of ZnO and Fe 3O 4 Nanoparticles on Seed Yield and Physio-Biochemical Parameters of Cucumber ( Cucumis sativus L.) Seed under Open Field and Protected Environment vis a vis during Seed Germination. Plants (Basel) 2022; 11:3211. [PMID: 36501251 PMCID: PMC9738616 DOI: 10.3390/plants11233211] [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: 10/17/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
Nutritionally rich cucumber seeds remain in demand in the agricultural, health and cosmetic sectors as they are essential for a successful crop stand establishment and seed-based products. However, the production of cucumber seeds is impeded by source limitation and nutrient deficiency. The foliar application of micronutrients can supplement this deficiency and overcome the physiological setback. An experiment was undertaken to compare the impacts of the foliar application of Fe and Zn, as nanoparticles and fertilizers, on the yield and seed quality of cucumber under open and protected environments. A foliar spray of nano-ZnO (ZnNPs) and nano-Fe3O4 (FeNPs) at 100, 200 and 300 mg L-1, as well as ZnSO4 and FeSO4 as fertilizer (0.5%), was conducted at the vegetative stage and pre- and post-flowering stages. The NPs had a greater efficacy in an open field than in the protected (naturally ventilated poly house) environment. The application of both NPs increased seed yield (51.7-52.2%), total chlorophyll content (15.9-17.3%) and concentration of Zn and Fe in the fruit and the seed, by 2.0-58.5% and 5.0-30.5%, respectively. A significant increase in starch, soluble proteins, soluble sugars and oil content was observed in the seeds from the NP treated plants. NP treatment also enhanced the germination-related parameters, such as percent germination (16.8-17.0%), rate of germination (18.0-22.2%) and seedling vigor (59.8-72.6%). The biochemical characterization showed a significant improvement in the seed water uptake and the activity of hydrolytic enzymes (amylase and protease) in the germinating seed. The involvement of reactive oxygen species (superoxide anion and hydrogen peroxide) and antioxidant enzymes (Superoxide dismutase, Catalase and Peroxidase) in the germination process was indicated by an increase in their activities in the seeds from NP treated plants. Hence, the study proposes the potential benefit of the foliar application of 300 mg L-1 ZnNPs and 200 mg L-1 FeNPs at crucial stages of plant growth to improve the yield and seed quality in cucumbers.
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Affiliation(s)
- Nakul Gupta
- ICAR—Indian Institute of Vegetable Research, PB-01, Po-Jakhini (Sahanshahpur), Varanasi 221305, India
- ICAR—Indian Agricultural Research Institute, New Delhi 110012, India
| | - Sudhir Kumar Jain
- ICAR—Indian Agricultural Research Institute, New Delhi 110012, India
| | | | - Anjali Anand
- ICAR—Indian Agricultural Research Institute, New Delhi 110012, India
| | - Jogendra Singh
- ICAR—Indian Agricultural Research Institute, New Delhi 110012, India
| | - Vidya Sagar
- ICAR—Indian Institute of Vegetable Research, PB-01, Po-Jakhini (Sahanshahpur), Varanasi 221305, India
| | - Rajesh Kumar
- ICAR—Indian Institute of Vegetable Research, PB-01, Po-Jakhini (Sahanshahpur), Varanasi 221305, India
| | - Vikas Singh
- ICAR—Indian Institute of Vegetable Research, PB-01, Po-Jakhini (Sahanshahpur), Varanasi 221305, India
| | - Tribhuvan Chaubey
- ICAR—Indian Institute of Vegetable Research, PB-01, Po-Jakhini (Sahanshahpur), Varanasi 221305, India
| | - Kamel A. Abd-Elsalam
- Plant Pathology Research Institute, Agricultural Research Center, Giza 12619, Egypt
| | - Awani Kumar Singh
- ICAR—Indian Agricultural Research Institute, New Delhi 110012, India
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Parveen S, Rudra SG, Singh B, Anand A. Impact of High Night Temperature on Yield and Pasting Properties of Flour in Early and Late-Maturing Wheat Genotypes. Plants (Basel) 2022; 11:plants11223096. [PMID: 36432825 PMCID: PMC9693585 DOI: 10.3390/plants11223096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 05/27/2023]
Abstract
The inexorable process of climate change in terms of the rise in minimum (nighttime) temperature delineates its huge impact on crop plants. It can affect the yield and quality of various crops. We investigated the effect of high night temperature (HNT) (+2.3 °C over ambient) from booting to physiological maturity on the yield parameters, grain growth rate (GGR), starch content, composition, and flour rheological properties in early (HI 1544, HI 1563) and late-maturing (HD 2932) wheat genotypes. The change in yield under HNT was highly correlated with grain number per plant (r = 0.740 ***) and hundred-grain weight (r = 0.628 **), although the reduction in grain weight was not significantly different. This was also reflected as an insignificant change in starch content (except in HI 1544). Under HNT, late-sown genotypes (HI 1563 and HD 2932) maintained high GGR compared to the timely sown (HI 1544) genotype during the early period of grain growth (5 to 10 days after anthesis), which declined during the later phase of grain development. The increased rheological properties under HNT can be attributed to a significant reduction in the amylose to amylopectin (AMY/AMP) ratio in early-maturity genotypes (HI 1544 and HI 1563). The AMY/AMP ratio was positively correlated to flour rheological parameters (except setback from peak) under HNT. Our study reports the HNT-induced change in the amylose/amylopectin ratio in early maturing wheat genotypes, which determines the stability of flour starches for specific end-use products.
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Affiliation(s)
- Shamima Parveen
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India
| | - Shalini Gaur Rudra
- Division of Post Harvest Technology, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India
| | - Bhupinder Singh
- Division of Environment Science, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India
| | - Anjali Anand
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi 110 012, India
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Gundewadi G, Rudra SG, Prasanna R, Banerjee T, Singh SK, Dhakate SR, Gupta A, Anand A. Palladium encapsulated nanofibres for scavenging ethylene from sapota fruits. Front Nutr 2022; 9:994813. [DOI: 10.3389/fnut.2022.994813] [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] [Received: 07/15/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
Scavenging ethylene is a useful intervention during the transportation and storage of tropical climacteric fruits like sapota. Sapota (Manilkara achras Mill.) is a delicious tropical fruit with a very high respiration rate and poor shelf life. To prolong its post-harvest shelf life, the use of palladium chloride in electrospun nanomats was evaluated at a concentration varying from 1 to 4% levels. Encapsulation of 1–2% PdCl2 in nanomats increased the ethylene scavenging capacity (ESC) by 47–68%. Although, upon encapsulation, both PdCl2 and potassium permanganate showed significantly the same ethylene scavenging activity, the efficacy of PdCl2 was found better in presence of sapota fruits. The PdCl2 nanomats were brighter (L* > 73) in colour compared to the potassium permanganate mat. The placement of nanomats (2 cm2 × 9 cm2) in corrugated fibre board boxes in which the sapota was packed showed higher quality indices (firmness, TSS, ascorbic acid, and phenolics) along with lower PLW and respiration rate during the 8 days of storage period. Compared to control (8.35%), physiological loss in weight of 4.47% was recorded in fruits stored with ethylene scavenging nanomats. PdCl2 encapsulated PVA nanomats can emerge as a promising option for the retention of quality in fruits during storage and transit.
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16
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Hobbis D, Yaddanapudi S, Brooks J, Pafundi D, Jackson A, Tryggestad E, Moseley D, Routman D, Stish B, Lucido J, Ma J, Fatyga M, Anand A, Rong Y, Foote R, Patel S. Comparisons of Clinical and Reference Standard Contours to AI Auto-Segmentation: An Evaluation of 5 Commercial Models in Head and Neck Organ at Risk Delineation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.888] [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]
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17
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Laughlin B, DeWees T, Rule W, Sio T, Ashman J, Ridgway A, Heinzerling D, Lara P, Tinnon K, Archuleta J, Korte S, Bues M, Liu W, Anand A. Evaluation of Planning Techniques Involving Inverse Optimization in SBPT to Assess for Organs at Risk in Anal Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Lucido J, DeWees T, Leavitt T, Anand A, Beltran C, Brooke M, Buroker J, Foote R, Foss O, Hughes C, Hunzeker A, Laack N, Lenz T, Morigami M, Moseley D, Patel Y, Tryggestad E, Wilson M, Zverovitch A, Patel S. A Prospective Observational Study of Clinical Acceptability of Deep Learning Model for the Automated Segmentation of Organs at Risk for Head and Neck Radiotherapy Treatment Planning. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.940] [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: 10/31/2022]
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Balakrishnan A, Jah A, Lesurtel M, Andersson B, Gibbs P, Harper SJF, Huguet EL, Kosmoliaptsis V, Liau SS, Praseedom RK, Ramia JM, Branes A, Lendoire J, Maithel S, Serrablo A, Achalandabaso M, Adham M, Ahmet A, Al-Sarireh B, Albiol Quer M, Alconchel F, Alejandro R, Alsammani M, Alseidi A, Anand A, Anselmo A, Antonakis P, Arabadzhieva E, de Aretxabala X, Aroori S, Ashley S, Ausania F, Banerjee A, Barabino M, Bartlett A, Bartsch F, Belli A, Beristain-Hernandez J, Berrevoet F, Bhatti A, Bhojwani R, Bjornsson B, Blaz T, Byrne M, Calvo M, Castellanos J, Castro M, Cavallucci D, Chang D, Christodoulis G, Ciacio O, Clavien P, Coker A, Conde-Rodriguez M, D'Amico F, D'Hondt M, Daams F, Dasari B, De Beillis M, de Meijer V, Dede K, Deiro G, Delgado F, Desai G, Di Gioia A, Di Martino M, Dixon M, Dorovinis P, Dumitrascu T, Ebata T, Eilard M, Erdmann J, Erkan M, Famularo S, Felli E, Fergadi M, Fernandez G, Fox A, Galodha S, Galun D, Ganandha S, Garcia R, Gemenetzis G, Giannone F, Gil L, Giorgakis E, Giovinazzo F, Giuffrida M, Giuliani T, Giuliante F, Gkekas I, Goel M, Goh B, Gomes A, Gruenberger T, Guevara O, Gulla A, Gupta A, Gupta R, Hakeem A, Hamid H, Heinrich S, Helton S, Heumann A, Higuchi R, Hughes D, Inarejos B, Ivanecz A, Iwao Y, Iype S, Jaen I, Jie M, Jones R, Kacirek K, Kalayarasan R, Kaldarov A, Kaman L, Kanhere H, Kapoor V, Karanicolas P, Karayiannakis A, Kausar A, Khan Z, Kim DS, Klose J, Knowles B, Koh P, Kolodziejczyk P, Komorowski A, Koong J, Kozyrin I, Krishna A, Kron P, Kumar N, van Laarhoven S, Lakhey P, Lanari J, Laurenzi A, Leow V, Limbu Y, Liu YB, Lob S, Lolis E, Lopez-Lopez V, Lozano R, Lundgren L, Machairas M, Magouliotis D, Mahamid A, Malde D, Malek A, Malik H, Malleo G, Marino M, Mayo S, Mazzola M, Memeo R, Menon K, Menzulin R, Mohan R, Morgul H, Moris D, Mulita F, Muttillo E, Nahm C, Nandasena M, Nashidengo P, Nickkholgh A, Nikov A, Noel C, O'Reilly D, O'Rourke T, Ohtsuka M, Omoshoro-Jones J, Pandanaboyana S, Pararas N, Patel R, Patkar S, Peng J, Perfecto A, Perinel J, Perivoliotis K, Perra T, Phan M, Piccolo G, Porcu A, Primavesi F, Primrose J, Pueyo-Periz E, Radenkovic D, Rammohan A, Rowcroft A, Sakata J, Saladino E, Schena C, Scholer A, Schwarz C, Serrano P, Silva M, Soreide K, Sparrelid E, Stattner S, Sturesson C, Sugiura T, Sumo M, Sutcliffe R, Teh C, Teo J, Tepetes K, Thapa P, Thepbunchonchai A, Torres J, Torres O, Torzili G, Tovikkai C, Troncoso A, Tsoulfas G, Tuzuher A, Tzimas G, Umar G, Urbani L, Vanagas T, Varga, Velayutham V, Vigano L, Wakai T, Yang Z, Yip V, Zacharoulis D, Zakharov E, Zimmitti G. Heterogeneity of management practices surrounding operable gallbladder cancer - results of the OMEGA-S international HPB surgical survey. HPB (Oxford) 2022; 24:2006-2012. [PMID: 35922277 DOI: 10.1016/j.hpb.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. METHODS A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia-Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. RESULTS Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. CONCLUSION Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.
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Affiliation(s)
- Anita Balakrishnan
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom.
| | - Asif Jah
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Mickael Lesurtel
- Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, University of Paris Cité, 100 Bd du Général Leclerc, 92110, Clichy, France
| | - Bodil Andersson
- Department of Surgery, Lund University, Skane University Hospital, Lund, Sweden
| | - Paul Gibbs
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Simon J F Harper
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Emmanuel L Huguet
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Vasilis Kosmoliaptsis
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Siong S Liau
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Raaj K Praseedom
- Department of HPB Surgery, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Jose M Ramia
- Department of Surgery, Hospital General Universitario de Alicante, Avenida Pintor Baeza, 12 03010 Alicante, Spain
| | - Alejandro Branes
- Department of HPB Surgery, Hospital Sotero del Rio, Av. Concha y Toro 3459, Puente Alto, Región Metropolitana, Chile
| | - Javier Lendoire
- Department of Surgery, University of Buenos Aires, Hospital Dr Cosme Argerich, Buenos Aires, Argentina
| | - Shishir Maithel
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, 30322 USA
| | - Alejandro Serrablo
- Department of HPB Surgery, Miguel Servet University Hospital, Zaragoza, Spain
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Agrawal MK, Kumar A, Fanai MH, Pal A, Anand A, Pahwa HS, Sonkar AA. P-065 PROSPECTIVE STUDY OF QUALITY OF LIFE OUTCOMES OF TOTALLY TRANSFASCIAL SUTURE FIXATION OF MESH WITH CLOSURE OF DEFECT IN LAPAROSCOPIC VENTRAL HERNIA REPAIR. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.163] [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: 11/12/2022]
Abstract
Abstract
Aim
To study the Quality of life Outcome in totally transfacial suture fixation of mesh with primary closure of defect in laparoscopic ventral hernia repair with regards to:
Materials & Methods
Patients who visited the OPD of General Surgery, KGMU, Lucknow, UP and was diagnosed as a case of symptomatic ventral and incisional hernia fulfilling the inclusion and exclusion criteria were enrolled.
Results
A total of 40 patients from OPD department of General Surgery were enrolled. Maximum numbers of patients in the study i.e. 14(35%) belong to M4. Mean BMI is 28.6. Mean defect size was 3.25 cm (Range- 2cm to 5 cm). Mean duration of hospital stay was 2.85 days. With this procedure the patients were able to resume his/her daily routines very early and a mean of 4.65 days was recorded among the 40 patients involved in the study. Also a mean of 11.6 days was recorded as the time taken to return to office works which was all within two weeks after the operation. Carolina's comfort scale measure quality of life score in pre-op and post-op period on sensation of mesh,pain sensation and limitation of movement . where the scores were added and the mean sensation of mesh at post-operative period was 0.30.
Conclusion
There was significant improvement in dimensions of body pain, physical function, vitality, emotional role, mental health and sensation of mesh in small and medium size hernia, with totally transfascial suture fixation of mesh.
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Affiliation(s)
- M K Agrawal
- General Surgery, King George's Medical University , Lucknow , India
| | - A Kumar
- General Surgery, King George's Medical University , Lucknow , India
| | - M H Fanai
- General Surgery, King George's Medical University , Lucknow , India
| | - A Pal
- General Surgery, King George's Medical University , Lucknow , India
| | - A Anand
- General Surgery, King George's Medical University , Lucknow , India
| | - H S Pahwa
- General Surgery, King George's Medical University , Lucknow , India
| | - A A Sonkar
- General Surgery, King George's Medical University , Lucknow , India
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Anand A, Soon RA, Ho ZX, Shenkin SD, MacLullich AMJ, Mills NL. Automated electronic health record frailty assessment for older cardiac patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Frailty is an established risk factor for poorer outcomes in older hospitalised patients, but most measures require additional clinical review. Such formal frailty assessments are rarely undertaken in acute cardiac patients. However, routine electronic health records increasingly record health and functional deficits that together may represent the frailty phenotype.
Purpose
To report the outcomes of acute cardiac patients in relation to an automated frailty measurement, derived from routine electronic health records.
Methods
This retrospective observational cohort study included consecutive patients aged ≥70 years old who were managed under the specialist care of a consultant cardiologist between April 2016 and August 2020 in three acute hospitals across Edinburgh, Scotland. The Continuous Dynamic Evaluation of Frailty (CODE-f) score was derived from national Care Assurance Standards data that is mandated for older patient hospital care. This includes measures of cognition, functional dependence, nutrition, falls risk, continence, skin health and mobility. A total of 31 data points were included in an unweighted frailty index with scores ranging between 0 (no markers present) and 1 (all present). No CODE-f score was generated if insufficient data was completed (>33% missing). The primary outcome was mortality at 1 year after hospital admission. Secondary outcomes were length of first (index) hospital stay and the number of days spent alive and out of hospital in the year after index admission (“home time”). In a nested cohort study of 318 consecutive patients at one hospital site, the Clinical Frailty Scale (CFS) was determined from manual electronic case note review for comparison with CODE-f scores.
Results
A total of 2,406 patients were included (mean age 79±6 years, 60% male). The CODE-f could be generated in 2,158 (90%) patients, with a mean score of 0.20±0.21. The primary outcome occurred in 352 (15%) patients. Those in the highest scoring CODE-f quartile (>0.35) had greater than 3-fold increased risk of death at 1 year compared to patients in the lowest quartile (<0.07), after adjustment for age and sex (27% versus 9%, adjusted odds ratio 3.44, 95% confidence intervals [CI] 2.47 to 4.82, p<0.001). Increasing median length of index hospital stay was observed at CODE-f scores above 0.3 (Figure A). In the highest CODE-f quartile, nearly one third of patients experienced less than 9 months home time in the following year, compared to fewer than 1 in 10 in the lowest two quartiles (Figure B). In the nested cohort study, CODE-f scores were well correlated with the CFS (r=0.50, 95% CI 0.41 to 0.58, p<0.001).
Conclusion
An automated electronic health record measure can identify frail older adults at risk of poorer recovery and death after acute cardiac illness. This could inform complex treatment decisions and future care planning for this patient group.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Chief Scientist Office
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Affiliation(s)
- A Anand
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - R A Soon
- University of Edinburgh , Edinburgh , United Kingdom
| | - Z X Ho
- University of Edinburgh , Edinburgh , United Kingdom
| | - S D Shenkin
- University of Edinburgh, Ageing and Health Research Group , Edinburgh , United Kingdom
| | - A M J MacLullich
- University of Edinburgh, Ageing and Health Research Group , Edinburgh , United Kingdom
| | - N L Mills
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
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Ferry AV, Wereski R, Marshall L, Strachan FE, Schulberg SD, Bularga A, Chapman AR, Lee KK, Anand A, Mills NL. Exploring adherence to an early rule-out pathway for myocardial infarction in the emergency department using mixed-methods. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Incorporating a high-sensitivity cardiac troponin assay into a care pathway for the assessment of suspected acute coronary syndrome has enabled myocardial infarction to be ruled out earlier.
Purpose
Using mixed methods, we explored adherence to an early rule-out pathway in the HiSTORIC (High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction) randomised controlled trial.
Methods
In 16,972 consecutive patients we evaluated clinician adherence to an early rule-out pathway for the assessment of suspected acute coronary syndrome. Adherence was defined in patients with presentation cardiac troponin I concentrations <5ng/L and symptom onset >2 hours from presentation without serial troponin testing (type 1 adherence); presentation troponin <5ng/L and symptom onset ≤2 hours from presentation with serial testing (type 2 adherence); or presentation troponin between 5ng/L and sex-specific 99th centile with serial testing (type 3 adherence). Semi-structured interviews were conducted with 23 clinicians to aid interpretation of the quantitative analysis. Qualitative data were coded and organized into themes.
Results
In patients with troponin <5ng/L presenting >2hr from symptom onset, adherence was achieved in 81% of patients. In patients presenting ≤2hr from symptom onset, 35% of patients had a second troponin test. In patients with an initial troponin concentration between 5ng/L and the 99th centile, 65% of patients had a second troponin test. Compared to patients managed by clinicians who were adherent to the pathway, patients with troponin over-testing (type 1 non-adherence) were more likely to be older (mean age 52±16 years versus 58±14, P<0.001) and have a history of coronary disease (11% versus 27%, P<0.001). In contrast, patients with under testing (type 2 non-adherence) tended to be younger (mean age 49±16 versus 63±15, P<0.001), female (50% versus 37%, P<0.001) and have lower presentation troponin levels (median concentration 1.0ng/L IQR 1.0 to 2.0, versus 5.0ng/L IQR 2.0–10.0) compared to those in whom testing was performed according to pathway recommendations. Semi-structured interview data revealed how pathway adherence was influenced by five main themes: guideline characteristics, patient characteristics, the healthcare practitioner, the healthcare system and scientific evidence. Clear visual pathway layout was fundamental in achieving optimal adherence. Strong clinical suspicion of acute coronary syndrome promoted repeat troponin testing and deviation from the pathway was felt to be justifiable by more senior clinicians.
Conclusion
This analysis revealed successful implementation of the early rule-out pathway with interview data aiding interpretation of trial data. Younger patients with lower troponin concentrations were less likely to receive pathway recommended serial troponin testing. Clinical judgement is one of the main reasons for discontinuation of pathway recommendations.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation
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Affiliation(s)
- A V Ferry
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - R Wereski
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - L Marshall
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - F E Strachan
- Usher Institute of Population Health Sciences and Informatics , Edinburgh , United Kingdom
| | - S D Schulberg
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - A Bularga
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - A R Chapman
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - K K Lee
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - A Anand
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
| | - N L Mills
- University of Edinburgh, Centre for Cardiovascular Science , Edinburgh , United Kingdom
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23
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Lowry M, Doudesis D, Kimenai D, Bularga A, Taggart C, Wereski R, Ferry A, Stewart S, Tuck C, Lee K, Chapman A, Shah A, Newby D, Anand A, Mills N. Impact of time from symptom onset on the diagnostic performance of high-sensitivity cardiac troponin for type 1 myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High-sensitivity cardiac troponin has enabled the rapid rule-out and rule-in of myocardial infarction at presentation. However, increases in cardiac troponin may not be detectable early after symptom onset, and uncertainty remains as to how time of symptom onset influences diagnostic performance.
Purpose
To evaluate the impact of time from symptom onset on the diagnostic performance of high-sensitivity cardiac troponin for type 1 myocardial infarction.
Methods
In a secondary analysis of a prospective multicentre randomised controlled trial of consecutive patients with suspected acute coronary syndrome, we evaluated the diagnostic performance of high-sensitivity cardiac troponin I measurements at presentation stratified by time of symptom onset to blood sampling. Diagnostic performance was evaluated in four groups (≤3 hours, 4–6 hours, 7–12 hours and >12 hours from symptom onset) for recommended thresholds to rule-out (sex-specific 99th centile and optimised threshold [64 ng/L]) type 1 myocardial infarction.
Results
This analysis included 41,104 patients (median 60 [interquartile range 49–74] years, 46% female) of which 12,595 (31%), 10,298 (25%), 7,171 (17%) and 11,040 (27%) presented ≤3 hours, 4–6 hours, 7–12 hours and >12 hours, respectively. Type 1 myocardial infarction was the adjudicated diagnosis in 3,692 (9%) patients. For the rule-out of type 1 myocardial infarction, sensitivity was highest in those tested 7–12 hours from symptom onset and lowest in those tested ≤3 hours. In early presenters, a threshold of <2 ng/L had greater sensitivity and negative predictive value (99.4% [95% CI 98.9 to 99.7%] and 99.7% [95% CI 99.5 to 99.9%]) compared to <5 ng/L (96.7% [95% CI 95.7 to 97.6%] and 99.3% [95% CI 99.1 to 99.5%], respectively). In those tested >3 hrs from symptom onset, the sensitivity and negative predictive value for both thresholds were similar, but a threshold of <5 ng/L correctly ruled out more patients (60% [17,056/28,506] versus 29% [8,316/28,506]). For the rule-in of myocardial infarction, the sensitivity of the 99th centile and 64 ng/L was lowest in patients tested within 3 hours (71.7% [95% CI 69.3 to 74.1%] and 46.5% [95% CI 44.1 to 49.2%], respectively), and increased in those tested later from symptom onset. The specificity and positive predictive value were highest when testing was performed 7–12 hours from symptom onset for the sex-specific 99th centile (92.4% [95% CI 91.8 to 93.0%] and 51.3% [95% CI 48.2–54.5%]) and 64 ng/L (96.2% [95% CI 95.7 to 96.7%] and 61.2% [95% CI 57.3 to 65.2%]).
Conclusions
The diagnostic performance of cardiac troponin for myocardial infarction is strongly influenced by the time from symptom onset to testing. In early presenters the limit of detection may facilitate immediate rule-out of myocardial infarction, but otherwise testing at least 3 hours from symptom onset is needed with the optimal time to rule-in myocardial infarction being 7–12 hours from the onset of symptoms.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation (BHF)Medical Research council UK (MRC)
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Affiliation(s)
- M Lowry
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Doudesis
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Kimenai
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Bularga
- University of Edinburgh , Edinburgh , United Kingdom
| | - C Taggart
- University of Edinburgh , Edinburgh , United Kingdom
| | - R Wereski
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Ferry
- University of Edinburgh , Edinburgh , United Kingdom
| | - S Stewart
- University of Edinburgh , Edinburgh , United Kingdom
| | - C Tuck
- University of Edinburgh , Edinburgh , United Kingdom
| | - K Lee
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Chapman
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Shah
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Newby
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Anand
- University of Edinburgh , Edinburgh , United Kingdom
| | - N Mills
- University of Edinburgh , Edinburgh , United Kingdom
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24
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Lee K, Doudesis D, Bing R, Astengo F, Perez J, Anand A, McIntyre S, Bloor N, Sandler B, Lister S, Pollock K, Qureshi A, McAllister D, Shah A, Mills N. Sex-differences in oral anticoagulation therapy in patients hospitalised with atrial fibrillation: a nationwide cohort study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Important disparities in the treatment and outcomes of women and men with atrial fibrillation are well recognized. Whether introduction of direct oral anticoagulants has reduced disparities in treatment is uncertain.
Methods
All patients who had an incident hospitalization from 2010 to 2019 with non-valvular atrial fibrillation in Scotland were included in this cohort study. Community drug dispensing data were used to determine prescribed oral anticoagulation therapy and comorbidity status. Logistic regression modelling was used to evaluate patient factors associated with treatment with vitamin K antagonists and direct oral anticoagulants.
Results
A total of 172,989 patients (48% women [82,833/172,989]) had an incident hospitalization with non-valvular atrial fibrillation in Scotland between 2010 and 2019. The proportion of patients with thromboembolic risk factors (CHA2DS2VASc score >0 in men and >1 in women) treated with oral anticoagulation therapy increased from 36.8% to 66.3% over this 10-year period. By 2019, factor Xa inhibitors accounted for 83.6% of all oral anticoagulants prescribed, while treatment with vitamin K antagonists and direct thrombin inhibitors declined to 15.9% and 0.6%, respectively. Women were less likely to be prescribed any oral anticoagulation therapy compared to men (adjusted odds ratio, aOR 0.68 [95% CI, CI 0.67–0.70]). This disparity was mainly attributed to vitamin K antagonists (aOR 0.68 [95% CI 0.66–0.70]), whilst there was less disparity in use of factor Xa inhibitors between women and men (aOR 0.92 [95% CI 0.90–0.95]). At 1 year following hospitalization with atrial fibrillation, patients not prescribed oral anticoagulation therapy were more likely to have subsequent major adverse cardiovascular events compared to those prescribed with oral anticoagulation therapy (38.8% [15,380/39,608] versus 17.0% [6,761/39,671] in women and 35.2% [12,977/36,868] versus 16.4% [7,395/45,093] in men).
Conclusions
Women with non-valvular atrial fibrillation were significantly less likely to be prescribed vitamin K antagonists compared to men. Most patients admitted to hospital in Scotland with incident non-valvular atrial fibrillation are now treated with factor Xa inhibitors and this is associated with less treatment disparities between women and men.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): This study was supported by the British Heart Foundation through a Clinical Research Training Fellowship (FS/18/25/33454), Intermediate Clinical Research Fellowship (FS/19/17/34172), Senior Clinical Research Fellowship (FS/16/14/32023) and a Research Excellence Award (RE/18/5/34216), and a research grant to NHS Lothian from Bristol Myers Squibb Pharmaceuticals Ltd and Pfizer UK Ltd.
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Affiliation(s)
- K Lee
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Doudesis
- University of Edinburgh , Edinburgh , United Kingdom
| | - R Bing
- University of Edinburgh , Edinburgh , United Kingdom
| | - F Astengo
- University of Edinburgh , Edinburgh , United Kingdom
| | - J Perez
- University of Glasgow , Glasgow , United Kingdom
| | - A Anand
- University of Edinburgh , Edinburgh , United Kingdom
| | - S McIntyre
- Bristol Myers Squibb Pharmaceuticals Ltd , London , United Kingdom
| | - N Bloor
- Pfizer Ltd , Tadworth , United Kingdom
| | - B Sandler
- Bristol Myers Squibb Pharmaceuticals Ltd , London , United Kingdom
| | - S Lister
- Bristol Myers Squibb Pharmaceuticals Ltd , London , United Kingdom
| | - K Pollock
- Bristol Myers Squibb Pharmaceuticals Ltd , London , United Kingdom
| | - A Qureshi
- Bristol Myers Squibb Pharmaceuticals Ltd , London , United Kingdom
| | - D McAllister
- University of Glasgow , Glasgow , United Kingdom
| | - A Shah
- London School of Hygiene and Tropical Medicine , London , United Kingdom
| | - N Mills
- University of Edinburgh , Edinburgh , United Kingdom
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25
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Doudesis D, Lee KK, Bularga A, Ferry AV, Tuck C, Anand A, Boeddinghaus J, Mueller C, Greenslade JH, Pickering JW, Than MP, Cullen L, Mills NL. Machine learning to optimise use of cardiac troponin in the diagnosis of acute myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Guidelines recommend fixed cardiac troponin thresholds for the assessment of patients with suspected acute coronary syndrome, however, performance varies in important patient groups as concentrations are influenced by age, sex and comorbidities. This limitation can be addressed using machine learning algorithms.
Methods
Machine learning algorithms were developed that integrate cardiac troponin concentrations at presentation or on serial testing with age, sex and clinical features in 10,038 consecutive emergency patients with suspected acute coronary syndrome. The primary outcome was an adjudicated diagnosis of type 1, type 4b or type 4c myocardial infarction. The best performing algorithm was selected for the CoDE-ACS (Collaboration for the Diagnosis and Evaluation of Acute Coronary Syndrome) decision-support tool, and performance was externally validated in 3,035 patients pooled from three prospective studies.
Findings
CoDE-ACS had excellent discrimination and calibration using cardiac troponin at presentation (area under curve [AUC] 0.959, 95% confidence interval 0.948–0.971, Brier score 0.040), in the pooled external validation cohort. At presentation, the rule-out score identified 62.1% (1,885/3,035) of all patients as low-probability of myocardial infarction with a 99.5% (99.1–99.7%) negative predictive value and 97.0% (96.3–97.6%) sensitivity. The rule-in score identified 8.3% (252/3,035) of patients as high-probability with an 83.7% (82.4–85.0%) positive predictive value and 98.5% (98.0–98.9%) specificity. Performance of the rule-out and rule-in scores was consistent across patient subgroups (Figure 1 and Figure 2). CoDE-ACS incorporating a second cardiac troponin measurement also had excellent discrimination and calibration (AUC 0.971 [0.962–0.980], Brier score 0.039) and refined the individualised probabilities in the 29.5% (898/3,035) of patients neither ruled-out or ruled-in at presentation to guide further investigation.
Conclusions
We developed and externally validated the CoDE-ACS decision-support tool using machine learning to aid in the diagnosis of myocardial infarction. CoDE-ACS had excellent diagnostic performance to rule-out and rule-in myocardial infarction at presentation, performed consistently across patient subgroups, and provided individualised probabilities to guide further care in those who require serial troponin measurements.
Conclusions
We developed and externally validated the CoDE-ACS decision-support tool using machine learning to aid in the diagnosis of myocardial infarction. CoDE-ACS had excellent diagnostic performance to rule-out and rule-in myocardial infarction at presentation, performed consistently across patient subgroups, and provided individualised probabilities to guide further care in those who require serial troponin measurements.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): National Institute for Health ResearchBritish Heart Foundation
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Affiliation(s)
- D Doudesis
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - K K Lee
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - A Bularga
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - A V Ferry
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - C Tuck
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - A Anand
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
| | - J Boeddinghaus
- University of Basel, Cardiovascular Research Institute Basel and Department of Cardiology , Basel , Switzerland
| | - C Mueller
- University of Basel, Cardiovascular Research Institute Basel and Department of Cardiology , Basel , Switzerland
| | - J H Greenslade
- University of Queensland, School of Medicine , Brisbane , Australia
| | - J W Pickering
- University of Otago, Christchurch Heart Institute , Christchurch , New Zealand
| | - M P Than
- Christchurch Hospital , Christchurch , New Zealand
| | - L Cullen
- University of Queensland, School of Medicine , Brisbane , Australia
| | - N L Mills
- University of Edinburgh, Centre for Cardiovascular Sciences , Edinburgh , United Kingdom
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26
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Lee K, Doudesis D, Ferry AV, Chapman AR, Kimenai D, Tuck C, Strachan FE, Newby DE, Anand A, Shah ASV, Mills NL. Implementation of high-sensitivity cardiac troponin and risk of myocardial infarction or death at 5 years: a stepped-wedge cluster-randomised controlled trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Implementation of a high-sensitivity cardiac troponin I assay with the sex-specific 99th centile as the diagnostic threshold identifies more patients with myocardial injury and infarction, but whether this impacts on long-term clinical outcomes is unknown.
Purpose
In a prespecified analysis of a stepped-wedge cluster-randomised controlled trial performed across ten hospitals in Scotland, we evaluated the impact of implementing a high-sensitivity cardiac troponin I assay on outcomes at 5 years in consecutive patients with suspected acute coronary syndrome.
Methods
Throughout the trial, all 48,282 patients had cardiac troponin I concentrations measured using both a contemporary (standard care) and high-sensitivity (implementation) assay. During standard care, results from the high-sensitivity assay were concealed and the contemporary assay was used to guide care. Hospitals were randomly allocated to early (n=5) or late (n=5) implementation of the high-sensitivity assay using the sex-specific 99th centile to guide care and results from the contemporary assay were concealed. Patients reclassified by the high-sensitivity assay were defined as those with cardiac troponin concentrations above the sex-specific 99th centile but below the contemporary assay diagnostic threshold. Subsequent myocardial infarction or all-cause death at 5 years was compared before and after implementation using an adjusted Cox proportional hazards model in those reclassified by the high-sensitivity assay and stratified by index diagnosis.
Results
Overall, 10,360 patients had cardiac troponin concentrations greater than the sex-specific 99th centile of whom 1,771 (17%) were reclassified by the high-sensitivity assay. Compared to those identified as having elevated cardiac troponin by the contemporary assay, patients reclassified by the high-sensitivity assay were more likely to have non-ischemic myocardial injury (54% versus 28%) and less likely to have type 1 myocardial infarction (33% versus 59%; P<0.001 for both). In those reclassified, the 5-year incidence of subsequent myocardial infarction or all-cause death was 63% (456/720) before and 54% (567/1051) after implementation of the high-sensitivity assay (adjusted hazard ratio [aHR] 0.75 [95% CI 0.57–0.98]) (Figure 1). Following implementation, subsequent myocardial infarction or all-cause death at 5 years was reduced in patients with non-ischemic myocardial injury (aHR 0.66 [0.51–0.86]) but not type 1 or type 2 myocardial infarction (aHR 0.90 [0.78–1.03] and 0.81 [0.55–1.20], respectively).
Conclusions
In patients with suspected acute coronary syndrome, implementation of a high-sensitivity cardiac troponin assay was associated with a lower risk of subsequent myocardial infarction or death at 5 years. Improvements in outcome were greater in those with a diagnosis of non-ischemic myocardial injury rather than infarction.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation
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Affiliation(s)
- K Lee
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Doudesis
- University of Edinburgh , Edinburgh , United Kingdom
| | - A V Ferry
- University of Edinburgh , Edinburgh , United Kingdom
| | - A R Chapman
- University of Edinburgh , Edinburgh , United Kingdom
| | - D Kimenai
- University of Edinburgh , Edinburgh , United Kingdom
| | - C Tuck
- University of Edinburgh , Edinburgh , United Kingdom
| | - F E Strachan
- University of Edinburgh , Edinburgh , United Kingdom
| | - D E Newby
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Anand
- University of Edinburgh , Edinburgh , United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine , London , United Kingdom
| | - N L Mills
- University of Edinburgh , Edinburgh , United Kingdom
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27
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Bularga A, Kimenai DM, Taggart C, Lowry M, Wereski R, McCance K, Lee KK, Anand A, Strachan FE, Tuck C, Shah ASV, Chapman AR, Newby DE, Jenks S, Mills NL. Impact of patient selection on performance of an early rule-out pathway for myocardial infarction: from research to the real world. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1344] [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
Early rule-out pathways for myocardial infarction using high-sensitivity cardiac troponin are widely recommended in the assessment of patients with suspected acute coronary syndrome. Although developed in selected patients participating in research studies, these pathways are applied more widely in clinical practice where the diagnostic performance and effectiveness of these pathways may differ.
Purpose
To evaluate the performance of an early rule-out pathway for myocardial infarction using high-sensitivity cardiac troponin in selected and consecutive unselected patients with suspected acute coronary syndrome.
Methods
Presentation and serial high-sensitivity cardiac troponin I concentrations were measured in two cohorts of patients with suspected acute coronary syndrome presenting to the Emergency Departments across three acute care hospitals in Scotland. In the unselected cohort, electronic health record data were collected on consecutive patients in whom the usual care clinician measured cardiac troponin for suspected acute coronary syndrome. In the selected cohort, patients with suspected acute coronary syndrome were approached between 8am and 8pm by research staff and written informed consent obtained. In both cohorts, the performance of the High-STEACS early rule-out pathway was evaluated for an adjudicated diagnosis of myocardial infarction (type 1, type 4b or type 4c) during the index hospital admission.
Results
The unselected and selected patient cohorts comprised of 1,242 (median age 60 [interquartile range 47–75] years, 46% women) and 1,695 (median age 61 [52–73] years, 40% women) patients respectively. Myocardial infarction was diagnosed in 6% (74/1,242) and 14% (232/1,695) of patients in the unselected and selected patient cohorts respectively. More patients had myocardial infarction ruled-out in the unselected (74% [828/1,112] versus 66% [1,102/1,678]; P<0.001), with similar negative predictive value (99.9% [95% CI 99.7%-100%] versus 99.7% [95% CI 99.4%-99.0%) and sensitivity (99.3% [95% CI 97.4%-100%] versus 98.9% [95% CI 97.6%-99.9%]; Figure 1). In the selected cohort, more patients had intermediate troponin concentrations requiring serial testing (36% versus 29%) or had myocardial infarction diagnosed (34% versus 26%; P<0.001 for both). In contrast, the positive predictive value for myocardial infarction was lower in unselected patients (26.1% [95% CI 21.2%-31.4%] versus 39.9% [95% CI 35.9%-44.0%]).
Conclusion
The prevalence of myocardial infarction is lower in patients with suspected acute coronary syndrome evaluated in routine practice compared to those selected to participate in a research study. Whilst more patients have myocardial infarction accurately ruled out, the positive-predictive value in those ruled in is lower resulting in more hospital admissions with elevated cardiac troponin due to other conditions.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart FoundationMedical Research Council
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Affiliation(s)
- A Bularga
- University of Edinburgh , Edinburgh , United Kingdom
| | - D M Kimenai
- University of Edinburgh , Edinburgh , United Kingdom
| | - C Taggart
- University of Edinburgh , Edinburgh , United Kingdom
| | - M Lowry
- University of Edinburgh , Edinburgh , United Kingdom
| | - R Wereski
- University of Edinburgh , Edinburgh , United Kingdom
| | - K McCance
- University of Edinburgh, Department Clinical Biochemistry, , Edinburgh , United Kingdom
| | - K K Lee
- University of Edinburgh , Edinburgh , United Kingdom
| | - A Anand
- University of Edinburgh , Edinburgh , United Kingdom
| | - F E Strachan
- University of Edinburgh , Edinburgh , United Kingdom
| | - C Tuck
- University of Edinburgh , Edinburgh , United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine, Department of Cardiology , London , United Kingdom
| | - A R Chapman
- University of Edinburgh , Edinburgh , United Kingdom
| | - D E Newby
- University of Edinburgh , Edinburgh , United Kingdom
| | - S Jenks
- Royal Infirmary of Edinburgh, Department of Clinical Biochemistry , Edinburgh , United Kingdom
| | - N L Mills
- University of Edinburgh , Edinburgh , United Kingdom
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28
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Lier S, Rein I, Lund S, Lång A, Lång E, Meyer N, Dutta A, Anand S, Nesse G, Johansen R, Klungland A, Rinholm J, Bøe S, Anand A, Pollard S, Lerdrup M, Pandey D. P10.12.A CDK12/CDK13 inhibition disrupts a transcriptional program critical for glioblastoma survival. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.177] [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
Glioblastoma multiforme (GBM) is the most prevalent and aggressive malignant tumor of the central nervous system. With a median survival of only one year, GBM patients have a particularly poor prognosis, highlighting a clear need for novel therapeutic strategies to target this disease. Transcriptional cyclin-dependent kinases (CDK), which phosphorylate key residues of RNA polymerase II (RNAPII) C-terminal domain (CTD), play a major role in sustaining aberrant transcriptional programs that are key to development and maintenance of cancer cells.
Material and Methods
We used pharmacological inhibition and genetic ablation to study effects of CDK12/CDK13 depletion on the proliferatory and migratory capacity of GBM cells and mouse xenografts. SLAM-seq, CUT&RUN and cell cycle assays were used to study the mechanistic effects of CDK12/CDK13 depletion in GBM cells.
Results
CDK12/CDK13 depletion markedly reduced the proliferatory and migratory capacity of GBM cells, as well as in vivo growth. CDK12/CDK13 inhibition potentiated existing chemotherapeutic treatments. Mechanistically, inhibition of CDK12/CDK13 leads to a genome-wide abrogation of RNAPII CTD phosphorylation, which in turn disrupts transcription and cell cycle progression in GBM cells.
Conclusion
These results provide proof-of-concept for the potential of CDK12 and CDK13 as therapeutic targets for GBM.
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Affiliation(s)
- S Lier
- Institute of Basic Medical Sciences, University of Oslo , Oslo , Norway
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - I Rein
- Dept. of Radiation Biology, Oslo University Hospital , Oslo , Norway
| | - S Lund
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - A Lång
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - E Lång
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - N Meyer
- Institute of Basic Medical Sciences, University of Oslo , Oslo , Norway
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - A Dutta
- Dept. of Computer Science and Engineering, Indian Institute of Technology, Guwahati , Assam , India
| | - S Anand
- Department of Informatics, Systems and Communications, University of Milano-Bicocca , Milan , Italy
| | - G Nesse
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - R Johansen
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - A Klungland
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
- Dept. of Biosciences, University of Oslo , Oslo , Norway
| | - J Rinholm
- Institute of Basic Medical Sciences, University of Oslo , Oslo , Norway
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - S Bøe
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
| | - A Anand
- Dept. of Computer Science and Engineering, Indian Institute of Technology, Guwahati , Assam , India
| | - S Pollard
- MRC Centre for Regenerative Medicine, SCRM Building, University of Edinburgh , Edinburgh , United Kingdom
| | - M Lerdrup
- Center for Chromosome Stability (CCS), Department of Cellular and Molecular Medicine, University of Copenhagen , Copenhagen , Denmark
| | - D Pandey
- Dept. of Microbiology, Oslo University Hospital , Oslo , Norway
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29
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Anand A, Harwood DS, Bishop C, Todd K, Ellis R, Ellis R, Poulsen FR, Kristensen BW. P12.08.A Uncovering the glioblastoma tumor-microenvironment by high-end multiplexing with imaging mass cytometry. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.273] [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: 11/12/2022] Open
Abstract
Abstract
Background
Glioblastoma is one of the most aggressive cancers, and hypoxia plays an essential role in its tumor- microenvironment. Tumor-associated microglia and macrophages (TAMs) have been reported to constitute up to 30 % of the cells, a fraction that is even higher in hypoxic areas. Single-cell mRNA sequencing of glioblastoma tumors has revealed vast heterogeneity, but the spatial aspects are not entirely defined yet. The aim of this study was to uncover differences between the hypoxic and normoxic tumor-microenvironment of human glioblastoma by high-end multiplexing with imaging mass cytometry.
Material and Methods
A tissue microarray (TMA) with normoxic and hypoxic areas from 4 IDH-wildtype glioblastomas was prepared based on the hypoxia marker hypoxia-inducing factor 1 alpha (HIF1 alpha). The TMA was stained with 18 metal-tagged antibodies covering TAMs, lymphocytes, immune checkpoints, vessels, tumor cells and proliferation. The Hyperion-CYTOF technology was used to ablate the samples and the images were analyzed by MCD viewer, Visiopharm software, and customized R scripts.
Results
Single-cell analysis of 160 fields covering around 45,000 cells in the glioblastoma microenvironment revealed multiple cellular phenotypes. It was revealed that proliferating TAMs (IBA1+, Ki67+) were more frequent in hypoxia, whereas proliferating vessels (CD34+, Ki67+) were more frequent in normoxia. Additionally, proliferating stem-like tumor cells (OLIG-2+, Ki67+) were more frequent in normoxia regions.
Conclusion
Our study revealed multiple cellular phenotypes in the glioblastoma microenvironment. The TAMs, endothelial and tumor cell phenotypes revealed may play a critical role in glioblastoma biology however this needs to be elucidated in future studies.
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Affiliation(s)
- A Anand
- Department of Pathology, The Bartholin Institute, Rigshospitalet , Copenhagen , Denmark
- Department of Pathology, The Bartholin Institute, Rigshospitalet , Copenhagen , Denmark
| | - D S Harwood
- Department of Pathology, The Bartholin Institute, Rigshospitalet , Copenhagen , Denmark
| | - C Bishop
- NIHR Guy's and St Thomas' Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London , London , United Kingdom
| | - K Todd
- NIHR Guy's and St Thomas' Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London , London , United Kingdom
| | - R Ellis
- NIHR Guy's and St Thomas' Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London , London , United Kingdom
| | - R Ellis
- NIHR Guy's and St Thomas' Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London , London , United Kingdom
| | - F R Poulsen
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark, OUH , Odense , Denmark
| | - B W Kristensen
- Department of Pathology, The Bartholin Institute, Rigshospitalet , Copenhagen , Denmark
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30
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Tryggestad E, Anand A, Beltran C, Brooks J, Cimmiyotti J, Grimaldi N, Hodge T, Hunzeker A, Lucido JJ, Laack NN, Momoh R, Moseley DJ, Patel SH, Ridgway A, Seetamsetty S, Shiraishi S, Undahl L, Foote RL. Scalable radiotherapy data curation infrastructure for deep-learning based autosegmentation of organs-at-risk: A case study in head and neck cancer. Front Oncol 2022; 12:936134. [PMID: 36106100 PMCID: PMC9464982 DOI: 10.3389/fonc.2022.936134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022] Open
Abstract
In this era of patient-centered, outcomes-driven and adaptive radiotherapy, deep learning is now being successfully applied to tackle imaging-related workflow bottlenecks such as autosegmentation and dose planning. These applications typically require supervised learning approaches enabled by relatively large, curated radiotherapy datasets which are highly reflective of the contemporary standard of care. However, little has been previously published describing technical infrastructure, recommendations, methods or standards for radiotherapy dataset curation in a holistic fashion. Our radiation oncology department has recently embarked on a large-scale project in partnership with an external partner to develop deep-learning-based tools to assist with our radiotherapy workflow, beginning with autosegmentation of organs-at-risk. This project will require thousands of carefully curated radiotherapy datasets comprising all body sites we routinely treat with radiotherapy. Given such a large project scope, we have approached the need for dataset curation rigorously, with an aim towards building infrastructure that is compatible with efficiency, automation and scalability. Focusing on our first use-case pertaining to head and neck cancer, we describe our developed infrastructure and novel methods applied to radiotherapy dataset curation, inclusive of personnel and workflow organization, dataset selection, expert organ-at-risk segmentation, quality assurance, patient de-identification, data archival and transfer. Over the course of approximately 13 months, our expert multidisciplinary team generated 490 curated head and neck radiotherapy datasets. This task required approximately 6000 human-expert hours in total (not including planning and infrastructure development time). This infrastructure continues to evolve and will support ongoing and future project efforts.
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Affiliation(s)
- E. Tryggestad
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
- *Correspondence: E. Tryggestad,
| | - A. Anand
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - C. Beltran
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL, United States
| | - J. Brooks
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - J. Cimmiyotti
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - N. Grimaldi
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - T. Hodge
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - A. Hunzeker
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - J. J. Lucido
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - N. N. Laack
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - R. Momoh
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - D. J. Moseley
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - S. H. Patel
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - A. Ridgway
- Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - S. Seetamsetty
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - S. Shiraishi
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - L. Undahl
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
| | - R. L. Foote
- Department of Radiation Oncology, Mayo Clinic Rochester, Rochester, MN, United States
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31
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Burman RR, Mahra GS, Singh AK, Mallick S, Anand A, Vashisth A, Mishra G, Shekhawat K, Somvanshi V, Rudra SG, Sangwan S, Kumar B, Das AK. ‘Pusa Samachar’: an innovative multimedia-based extension advisory model. CURR SCI INDIA 2022. [DOI: 10.18520/cs/v123/i4/574-582] [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: 11/15/2022]
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32
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Chauhan HS, Muthusamy V, Rashmi T, Basu S, Anand A, Mehta BK, Gain N, Zunjare RU, Singh AK, Gupta HS, Hossain F. Characterization of crtRB1- and vte4-based biofortified sweet corn inbreds for seed vigour and physico-biochemical traits. J Appl Genet 2022; 63:651-662. [PMID: 35972676 DOI: 10.1007/s13353-022-00715-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 10/15/2022]
Abstract
Sweet corn possessing recessive shrunken2 (sh2) gene is popular worldwide. Traditional sweet corn is poor in vitamin A and vitamin E. Plant breeders during the selection of sweet corn genotypes mainly emphasize on plant architecture and yield. Seed germination and seedling vigour play important role for early establishment in field, thereby increasing yield and income. Here, we analysed a set of 15 sh2-based biofortified sweet corn inbreds with crtRB1 (β-carotene hydroxylase1) and vte4 (γ-tocopherol methyltransferase) genes and three traditional sh2-based sweet corn inbreds for nutritional quality, seed vigour and various physico-biochemical traits. The newly developed inbreds possessed significantly higher provitamin A (proA: 15.60 µg/g) and vitamin E [α-tocopherol (α-T): 20.42 µg/g] than the traditional sweet corn inbreds (proA: 2.51 µg/g, α-T: 11.16 µg/g). The biofortified sweet corn inbreds showed wide variation for germination (80.67-87.33%), vigour index-I (2097.17-2925.28 cm), vigour index-II (134.27-216.19 mg) and electrical conductivity (10.19-13.21 μS cm-1 g-1). Wide variation was also observed for dehydrogenase (1.29-1.59 OD g-1 ml-1), super oxide dismutase (4.01-9.82 g-1), peroxidase (11.66-16.47 μM min-1 g-1), esterase (22.98-34.76 nM min-1 g-1) and α-amylase (5.91-8.15 OD g-1 ml-1). Enrichment of proA and vitamin E in sweet corn did not affect seed vigour and physico-biochemical traits. Correlation analysis revealed that electrical conductivity and α-amylase activity was the reliable indicator for assessing seed germination and vigour. The study identified superior biofortified sweet corn genotypes that would contribute to better vigour and establishment in field. This is the first report of analysis of biofortified sweet corn genotypes for seed vigour and physico-biochemical traits.
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Affiliation(s)
- Hema S Chauhan
- ICAR-Indian Agricultural Research Institute, New Delhi, India.,Amity Institute of Biotechnology, Amity University, Noida, India
| | | | - Tuhin Rashmi
- Amity Institute of Biotechnology, Amity University, Noida, India
| | - Sudipta Basu
- ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Anjali Anand
- ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Brijesh K Mehta
- ICAR-Indian Agricultural Research Institute, New Delhi, India.,ICAR-Indian Grassland and Fodder Research Institute, Jhansi, India
| | - Nisrita Gain
- ICAR-Indian Agricultural Research Institute, New Delhi, India
| | | | - Ashok K Singh
- ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Hari S Gupta
- ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Firoz Hossain
- ICAR-Indian Agricultural Research Institute, New Delhi, India.
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Mondal D, Awana M, Aggarwal S, Das D, Thomas B, Singh S, Satyavathi C T, Sundaram RM, Anand A, Singh A, Sachdev A, Praveen S, Krishnan V. Microstructure, matrix interactions, and molecular structure are the key determinants of inherent glycemic potential in pearl millet (Pennisetum glaucum). Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2022.107481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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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34
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Murthy V, Chilukuri S, Mallick I, Maitre P, Agarwal A, Moses A, James F, Narang K, Kataria T, Anand A, Dutta D, Mitra S, Pavamani S, Mallick S, Mahale N, Chandra M, Narayan A, Shahid T, Sairam M, Kannan V, Mohanty S, Basu T, Hotwani C, G B. OC-0606 Multi-institutional outcomes of Gleason grade group 5 prostate cancers treated with EBRT and ADT. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02628-7] [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: 10/18/2022]
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35
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Jones HE, Morrison I, Hurding S, Wild S, Anand A, Shenkin SD. 709 IMPACT ON HEALTHCARE UTILISATION OF A GENERAL PRACTITIONER-LED MODEL OF CARE FOR PATIENTS WITH FRAILTY. Age Ageing 2022. [DOI: 10.1093/ageing/afac035.709] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Primary care has a significant role to play in the identification and management of frailty. MidMed is a new dedicated GP-led service developed by a large practice in Midlothian for patients living at home with moderate or severe frailty. MidMed comprises a full-time GP performing a comprehensive geriatric assessment (CGA) adapted for primary care. Patients receive direct access to all appointments with the named GP. The aim of this study was to assess the impact of MidMed on healthcare utilisation in this patient group.
Methods
Patients with moderate or severe frailty at the MidMed practice were identified by the electronic Frailty Index (>0.24). After 16 months, patients who had been accepted into MidMed (MidMed group) were compared with those yet to be enrolled and who continued to receive usual care (non-MidMed group). Routinely collected data were used to identify outcomes including unscheduled hospital admissions, primary care consultations, continuity of care, outpatient attendances and mortality. Adjusted rate ratios were estimated using regression models.
Results
510 patients with moderate or severe frailty were identified (290 in MidMed, 220 in non-MidMed). Patients in each group were just as likely to have at least one hospital admission per year but those in MidMed had a reduced risk of further hospital admission compared to the non-MidMed group (adjusted RR 0.46 [95%CI 0.30–0.71]). MidMed was also associated with statistically significant higher usage of primary care (adjusted RR 1.52, [95%CI, 1.30–1.75]) and better continuity of care. There was no difference in mortality or the number of outpatient appointments when adjusted for co-variates.
Conclusion
A GP-led service for frailty is associated with lower risk of hospital readmission and improved continuity of care. Further studies are now required to better understand why use of such primary care services increase and whether this changes over time.
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Affiliation(s)
| | | | | | - S Wild
- The Usher Institute, University of Edinburgh
| | - A Anand
- The Centre for Cardiovascular Science, University of Edinburgh
| | - S D Shenkin
- The Usher Institute, University of Edinburgh
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36
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Vardy ERLC, Anand A, Cheng M, Ibitoye T, MacLullich AMJ. 795 A POSITIVE 4AT DELIRIUM ASSESSMENT TOOL SCORE ON HOSPITAL ADMISSION IS LINKED TO MORTALITY, LENGTH OF STAY AND ‘HOME TIME’: A STUDY OF 82,770 HOSPITAL ADMISSIONS IN EDINBURGH AND SALFORD. Age Ageing 2022. [DOI: 10.1093/ageing/afac037.795] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Delirium is linked with poor outcomes but studies using large-scale routine data are scarce. The 4AT (www.the4AT.com) is a brief (~2 minutes), well-validated tool for detection of delirium and cognitive impairment. We performed a two-centre study (Edinburgh and Salford) of Electronic Health Record (EHR) 4AT scores and outcomes in 82,770 non-elective hospital admissions in patients aged ≥65. We determined relationships between 4AT scores 0 (no impairment), 1–3 (cognitive impairment but no delirium) and ≥ 4 (delirium), in relation to 30-day inpatient mortality, length of stay, and time at home (‘home time’) in the year following index admission.
Methods
We analysed EHR 4AT scores recorded within 24 hours of admission, and outcomes data were also derived from the EHR. The study period was between April 2016 (Edinburgh)/September 2017 (Salford) and April 2020 (both centres).
Results
4AT scores suggestive of delirium (≥4) were present in 25% in Salford, and 18% in Edinburgh. After adjustment for age and sex, 30-day inpatient mortality with 4AT ≥4 was 5.5-fold greater than the 4AT 0 group in Edinburgh (aOR 5.53, 95% confidence interval [CI] 4.99–6.13) and 3.4-fold greater in Salford (aOR 3.39, 95% CI 2.98–3.87). Length of stay was more than double in patients with any abnormal 4AT score compared to a 4AT score of 0. The median ‘home time’ at 1 year was reduced by 112 days (Edinburgh) and 61 days (Salford) in the 4AT ≥4 compared to 4AT 0 days.
Conclusions
This large study using routine clinical data confirms the relationships between delirium and poor outcomes previously reported in smaller research studies. Further, the results demonstrate the feasibility and value of using a brief clinical tool to identify delirium as a strong marker of adverse outcomes, and will be helpful in guiding policy development around patient safety including better treatment of delirium.
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Affiliation(s)
- E R L C Vardy
- Salford Royal NHS Foundation trust, Northern Care Alliance, Stott Lane, Salford
| | - A Anand
- Cardiovascular sciences, University of Edinburgh
| | - M Cheng
- Salford Royal NHS Foundation trust, Northern Care Alliance, Stott Lane, Salford
| | - T Ibitoye
- Edinburgh Delirium Research Group, Geriatric Medicine, Usher Institute, University of Edinburgh
| | - A M J MacLullich
- Edinburgh Delirium Research Group, Geriatric Medicine, Usher Institute, University of Edinburgh
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Kumar S, Thakur M, Mitra R, Basu S, Anand A. Sugar metabolism during pre- and post-fertilization events in plants under high temperature stress. Plant Cell Rep 2022; 41:655-673. [PMID: 34628530 DOI: 10.1007/s00299-021-02795-1] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
High temperature challenges global crop production by limiting the growth and development of the reproductive structures and seed. It impairs the developmental stages of male and female gametogenesis, pollination, fertilization, endosperm formation and embryo development. Among these, the male reproductive processes are highly prone to abnormalities under high temperature at various stages of development. The disruption of source-sink balance is the main constraint for satisfactory growth of the reproductive structures which is disturbed at the level of sucrose import and utilization within the tissue. Seed development after fertilization is affected by modulation in the activity of enzymes involved in starch metabolism. In addition, the alteration in the seed-filling rate and its duration affects the seed weight and quality. The present review critically discusses the role of sugar metabolism in influencing the various stages of gamete and seed development under high temperature stress. It also highlights the interaction of the sugars with hormones that mediate the transport of sugars to sink tissues. The role of transcription factors for the regulation of sugar availability under high temperature has also been discussed. Further, the omics-based systematic investigation has been suggested to understand the synergistic or antagonistic interactions between sugars, hormones and reactive oxygen species at various points of sucrose flow from source to sink under high temperature stress.
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Affiliation(s)
- Sunil Kumar
- Division of Seed Science and Technology, ICAR- Indian Agricultural Research Institute, New Delhi, 110012, India
| | - Meenakshi Thakur
- College of Horticulture and Forestry, Dr. Y.S. Parmar University of Horticulture and Forestry, Neri, Hamirpur, 177 001, Himachal Pradesh, India
| | - Raktim Mitra
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Sudipta Basu
- Division of Seed Science and Technology, ICAR- Indian Agricultural Research Institute, New Delhi, 110012, India
| | - Anjali Anand
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
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Thakur M, Praveen S, Divte PR, Mitra R, Kumar M, Gupta CK, Kalidindi U, Bansal R, Roy S, Anand A, Singh B. Metal tolerance in plants: Molecular and physicochemical interface determines the "not so heavy effect" of heavy metals. Chemosphere 2022; 287:131957. [PMID: 34450367 DOI: 10.1016/j.chemosphere.2021.131957] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 05/27/2023]
Abstract
An increase in technological interventions and ruthless urbanization in the name of development has deteriorated our environment over time and caused the buildup of heavy metals (HMs) in the soil and water resources. These heavy metals are gaining increased access into our food chain through the plant and/or animal-based products, to adversely impact human health. The issue of how to restrict the entry of HMs or modulate their response in event of their ingress into the plant system is worrisome. The current knowledge on the interactive-regulatory role and contribution of different physical, biophysical, biochemical, physiological, and molecular factors that determine the heavy metal availability-uptake-partitioning dynamics in the soil-plant-environment needs to be updated. The present review critically analyses the interactive overlaps between different adaptation and tolerance strategies that may be causally related to their cellular localization, conjugation and homeostasis, a relative affinity for the transporters, rhizosphere modifications, activation of efflux pumps and vacuolar sequestration that singly or collectively determine a plant's response to HM stress. Recently postulated role of gaseous pollutants such as SO2 and other secondary metabolites in heavy metal tolerance, which may be regulated at the whole plant and/or tissue/cell is discussed to delineate and work towards a "not so heavy" response of plants to heavy metals present in the contaminated soils.
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Affiliation(s)
- Meenakshi Thakur
- College of Horticulture and Forestry (Dr. Y.S. Parmar University of Horticulture and Forestry), Neri, Hamirpur, 177 001, Himachal Pradesh, India
| | - Shamima Praveen
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Pandurang R Divte
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Raktim Mitra
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Mahesh Kumar
- ICAR-National Institute of Abiotic Stress Management, Baramati, Maharashtra, 413 115, India
| | - Chandan Kumar Gupta
- Division of Plant Physiology and Biochemistry, ICAR-Indian Institute of Sugarcane Research, Lucknow, 226 002, India
| | - Usha Kalidindi
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Ruchi Bansal
- Division of Germplasm Evaluation, ICAR-National Bureau of Plant Genetic Resources, New Delhi, 110 012, India
| | - Suman Roy
- ICAR-Central Research Institute for Jute and Allied Fibres, Barrackpore, Kolkata, 700 120, India
| | - Anjali Anand
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
| | - Bhupinder Singh
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
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Waikhom N, Agarwal N, Jabin Z, Anand A. Antimicrobial effectiveness of Nano Silver Fluoride Varnish in reducing Streptococcus mutans in saliva and plaque biofilm when compared with Chlorhexidine and Sodium Fluoride Varnishes. J Clin Exp Dent 2022; 14:e321-e328. [PMID: 35419182 PMCID: PMC9000386 DOI: 10.4317/jced.59093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
Abstract
Background This in vivo study was done to investigate the antimicrobial effectiveness of Nano Silver fluoride, Sodium fluoride and Chlorhexidine when used as a varnish on Streptococcus mutans (S.mutans) in saliva and plaque biofilm.
Material and Methods 120 caries free subjects, aged 8-10 years were randomly assigned to four different groups (n=30) - group I: Control, group II: Chlorhexidine varnish (CHX), group III: Sodium fluoride varnish (NaF), group IV: Nano Silver fluoride varnish (NSF). Varnish application was done once at baseline. Saliva and plaque samples were collected at baseline (T0), at the end of 1 month (T1) and 3 months (T3) to evaluate S.mutans levels by culture method, optical density and PCR. OHI-S Index was also recorded for clinical evaluation.
Results NSF, CHX and NaF were effective against S.mutans activity. The intragroup comparision of CFU/ml and OD/ml count showed a highly significant reduction from baseline to 3 months for all the 3 varnish groups (p=0.001). PCR result revealed that maximum reduction was seen in NSF and CHX followed by NaF group.
Conclusions NSF reduces S.mutans level in both saliva and plaque biofilm and it is more advantageous than CHX and NaF as it has dual properties of acting as an antibacterial as well as a remineralizing agent. Key words:Chlorhexidine, Nano Silver fluoride, Sodium fluoride, S. mutans, varnish.
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40
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Das S, Jain S, Ilyas M, Anand A, Kumar S, Sharma N, Singh K, Mahlawat R, Sharma TK, Atmakuri K. Development of DNA Aptamers to Visualize Release of Mycobacterial Membrane-Derived Extracellular Vesicles in Infected Macrophages. Pharmaceuticals (Basel) 2021; 15:ph15010045. [PMID: 35056102 PMCID: PMC8779091 DOI: 10.3390/ph15010045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/14/2022] Open
Abstract
Extracellular vesicles (EVs) have emerged into a novel vaccine platform, a biomarker and a nano-carrier for approved drugs. Their accurate detection and visualization are central to their utility in varied biomedical fields. Owing to the limitations of fluorescent dyes and antibodies, here, we describe DNA aptamer as a promising tool for visualizing mycobacterial EVs in vitro. Employing SELEX from a large DNA aptamer library, we identified a best-performing aptamer that is highly specific and binds at nanomolar affinity to EVs derived from three diverse mycobacterial strains (pathogenic, attenuated and avirulent). Confocal microscopy revealed that this aptamer was not only bound to in vitro-enriched mycobacterial EVs but also detected EVs that were internalized by THP-1 macrophages and released by infecting mycobacteria. To the best of our knowledge, this is the first study that detects EVs released by mycobacteria during infection in host macrophages. Within 4 h, most released mycobacterial EVs spread to other parts of the host cell. We predict that this tool will soon hold huge potential in not only delineating mycobacterial EVs-driven pathogenic functions but also in harboring immense propensity to act as a non-invasive diagnostic tool against tuberculosis in general, and extra-pulmonary tuberculosis in particular.
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Affiliation(s)
- Soonjyoti Das
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
| | - Sapna Jain
- Bacterial Pathogenesis Laboratory, Infection and Immunology Group, Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.J.); (M.I.); (S.K.)
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, Delhi, India
| | - Mohd Ilyas
- Bacterial Pathogenesis Laboratory, Infection and Immunology Group, Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.J.); (M.I.); (S.K.)
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, Delhi, India
| | - Anjali Anand
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
| | - Saurabh Kumar
- Bacterial Pathogenesis Laboratory, Infection and Immunology Group, Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.J.); (M.I.); (S.K.)
| | - Nishant Sharma
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
- Department of Biotechnology, Jamia Hamdard, New Delhi 110062, Delhi, India
| | - Kuljit Singh
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
- Clinical Microbiology Division, CSIR-Indian Institute of Integrative Medicine, Jammu 18001, Jammu and Kashmir, India
| | - Rahul Mahlawat
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
| | - Tarun Kumar Sharma
- Aptamer Technology and Diagnostics Laboratory (ATDL), Multidisciplinary Clinical and Translational Research Group (MCTR), Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.D.); (A.A.); (N.S.); (K.S.); (R.M.)
- Correspondence: (T.K.S.); (K.A.)
| | - Krishnamohan Atmakuri
- Bacterial Pathogenesis Laboratory, Infection and Immunology Group, Translational Health Science and Technology Institute, Faridabad 121001, Haryana, India; (S.J.); (M.I.); (S.K.)
- Correspondence: (T.K.S.); (K.A.)
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Gupta A, Anand A, Jain N, Goswami S, Anantharaj A, Patil S, Singh R, Kumar A, Shrivastava T, Bhatnagar S, Medigeshi GR, Sharma TK. A novel G-quadruplex aptamer-based spike trimeric antigen test for the detection of SARS-CoV-2. Mol Ther Nucleic Acids 2021; 26:321-332. [PMID: 34188971 PMCID: PMC8223116 DOI: 10.1016/j.omtn.2021.06.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/09/2021] [Indexed: 12/11/2022]
Abstract
The recent SARS-CoV-2 outbreak has been declared a global health emergency. It will take years to vaccinate the whole population to protect them from this deadly virus, hence the management of SARS-CoV-2 largely depends on the widespread availability of an accurate diagnostic test. Toward addressing the unmet need of a reliable diagnostic test in the current work by utilizing the power of Systematic Evolution of Ligands by EXponential enrichment, a 44-mer G-quadruplex-forming DNA aptamer against spike trimer antigen of SARS-CoV-2 was identified. The lead aptamer candidate (S14) was characterized thoroughly for its binding, selectivity, affinity, structure, and batch-to-batch variability by utilizing various biochemical, biophysical, and in silico techniques. S14 has demonstrated a low nanomolar KD, confirming its tight binding to a spike antigen of SARS-CoV-2. S14 can detect as low as 2 nM of antigen. The clinical evaluation of S14 aptamer on nasopharyngeal swab specimens (n = 232) has displayed a highly discriminatory response between SARS-CoV-2 infected individuals from the non-infected one with a sensitivity and specificity of ∼91% and 98%, respectively. Importantly, S14 aptamer-based test has evinced a comparable performance with that of RT-PCR-based assay. Altogether, this study established the utility of aptamer technology for the detection of SARS-CoV-2.
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Affiliation(s)
- Ankit Gupta
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Anjali Anand
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Neha Jain
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
| | - Sandeep Goswami
- Infection and Immunology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Anbalagan Anantharaj
- Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Sharanabasava Patil
- Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - Rahul Singh
- Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
| | - Amit Kumar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
| | - Tripti Shrivastava
- Infection and Immunology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
| | - Shinjini Bhatnagar
- Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | | | - Tarun Kumar Sharma
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
| | - DBT India Consortium for COVID-19 Research
- Aptamer Technology and Diagnostics Laboratory, Multidisciplinary Clinical and Translational Research, Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Simrol, Madhya Pradesh 453552, India
- Infection and Immunology, Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad, Haryana 121001, India
- Translational Health Science and Technology Institute, Faridabad, Haryana 121001, India
- Raja Ramanna Centre for Advanced Technology, Indore, Madhya Pradesh 452013, India
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Anand A, Jha AK, Kumar M. Comments on "Treatment of anal fistula with FiLaC ®: results of a 10‑year experience with 175 patients". Tech Coloproctol 2021; 26:409-410. [PMID: 34853946 DOI: 10.1007/s10151-021-02553-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/22/2021] [Indexed: 01/19/2023]
Affiliation(s)
- A Anand
- Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar, India
| | - A K Jha
- Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar, India.
| | - M Kumar
- Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar, India
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Naguib WB, Divte PR, Chandra A, Sathee L, Singh B, Mandal PK, Anand A. Raffinose accumulation and preferential allocation of carbon ( 14 C) to developing leaves impart salinity tolerance in sugar beet. Physiol Plant 2021; 173:1421-1433. [PMID: 33837561 DOI: 10.1111/ppl.13420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/05/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Sugar beet is a salt-tolerant crop that can be explored for crop production in degraded saline soils. Seeds of multigerm genotypes LKC-2006 (susceptible) and LKC-HB (tolerant) were grown in 150 mM NaCl, from germination to 60 days after sowing, to decipher the mechanism of salinity tolerance at the vegetative stage. The biomass of the root and leaf were maintained in the tolerant genotype, LKC-HB, under saline conditions. Na+ /K+ ratios were similar in roots and leaves of LKC-HB, with lower values under salinity compared to LKC 2006. Infrared temperatures were 0.96°C lower in LKC-HB than in LKC-2006, which helped regulate the leaf water status under stressed conditions. Pulse-chase experiment showed that 14 C photosynthate was preferentially allocated towards the development of new leaves in the tolerant genotype. The sugar profile of leaves and roots showed accumulation of raffinose in leaves of LKC-HB, indicating a plausible role in imparting salinity tolerance by serving as an osmolyte or scavenger. The molecular analysis of the genes responsible for raffinose synthesis revealed an 18-fold increase in the expression of BvRS2 in the tolerant genotype, suggesting its involvement in raffinose synthesis. Our study accentuated that raffinose accumulation in leaves is vital for inducing salinity tolerance and maintenance of shoot dry weight in sugar beet.
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Affiliation(s)
- Wassem B Naguib
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, India
- Division of Plant Physiology and Biochemistry, ARC-Sugar Crops Research Institute, Giza, Egypt
| | - Pandurang R Divte
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Amaresh Chandra
- Division of Plant Physiology and Biochemistry, ICAR-Indian Institute of Sugarcane Research, Lucknow, India
| | - Lekshmy Sathee
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Bhupinder Singh
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Pranab Kumar Mandal
- ICAR-National Institute for Plant Biotechnology, LBS Centre, New Delhi, India
| | - Anjali Anand
- Division of Plant Physiology, ICAR-Indian Agricultural Research Institute, New Delhi, India
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Kumar P, Sehrawat A, Sundriyal D, Anand A, Sharma A, Agarwal A, Sharma P, Mittal A, Gupta M. Optimal Chemotherapy for Cisplatin-Ineligible Advanced URothelial Cancer: Gemcitabine with CArboplatin vs. Paclitaxel-Prospective Randomized Trial (CAUR CAP TRIAL). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03211-0] [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: 11/27/2022] Open
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Kumar P, Sehrawat A, Sundriyal D, Anand A, Sharma A, Agarwal A, Sharma P, Mittal A, Gupta M. Optimal Chemotherapy for Cisplatin-Ineligible Advanced URothelial Cancer: Gemcitabine with CArboplatin vs. Paclitaxel-Prospective Randomized Trial (CAUR CAP TRIAL). EUR UROL SUPPL 2021. [DOI: https://doi.org/10.1016/s2666-1683(21)03211-0] [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: 11/06/2022] Open
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Lowry MTH, Doudesis D, Kimenai D, Anand A, Mills NL. The impact of age on the diagnosis of type 1 myocardial infarction using high-sensitivity cardiac troponin. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1379] [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
Cardiac troponin concentrations are influenced by age and comorbidities with values above the 99th centile diagnostic threshold more common in older patients without myocardial infarction. Despite this, rule-in thresholds for myocardial infarction are applied universally regardless of age or comorbidities.
Purpose
We sought to evaluate how age and cardiovascular comorbidities influence the diagnostic performance of high-sensitivity cardiac troponin I for myocardial infarction.
Methods
In a secondary analysis of a multi-centre randomised controlled trial, we identified 45,991 consecutive patients with suspected acute coronary syndrome without ST-segment elevation myocardial infarction. The diagnostic performance of high-sensitivity cardiac troponin I measured at presentation for type 1 myocardial infarction was evaluated for the sex-specific 99th centile and thresholds three and five times this value in patients stratified by age (under 50 years, between 50 and 75 years, and over 75 years). The effect of comorbidities on diagnostic accuracy was evaluated using regression modelling.
Results
Of the 45,991 patients, 8,187 (18%) had myocardial injury of which 7,677 (94%) had a presentation troponin above the sex-specific 99th centile. Mean age of those with myocardial injury was 74 years (range 18–108). The positive predictive value (PPV) of the 99th centile was 54.6% (95% confidence interval [CI] 50.6–58.8%), 58.8% (56.9–60.6%) and 36.6% (35.1–38.2%) in patients under 50 years, between 50 and 75 years, and over 75 years, respectively. Rule-in thresholds three and five-times the 99th centile gave a higher PPV in all age groups with a PPV of 45.5% (43.1–47.8%) and 50.4% (47.6–53.2%), respectively in those aged over 75 years (Table 1). Regardless of threshold, specificity and PPV was lowest in patients over 75 years and decreased with advancing age (Figure 1). Across all age groups, the presence of heart failure resulted in the greatest decrease in PPV (36.9% [34.6–39.2%] versus 50.6% [49.3–51.8%]). Adjusting for cardiovascular comorbidities resulted in modest change in the discrimination of cardiac troponin for myocardial infarction (area under curve 0.89 vs 0.90) and did not prevent a decline in diagnostic accuracy in older patients.
Conclusion
The specificity and PPV of high-sensitivity cardiac troponin I for myocardial infarction decreases with advancing age. Cardiovascular comorbidities impact the PPV of troponin, but do not explain the decline in diagnostic accuracy with age. Clinicians should be aware of these important differences in performance by age of the diagnostic and rule-in thresholds for myocardial infarction when interpreting troponin results in older patients.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): University of Edinburgh Figure 1
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Affiliation(s)
- M T H Lowry
- University of Edinburgh, Edinburgh, United Kingdom
| | - D Doudesis
- University of Edinburgh, Edinburgh, United Kingdom
| | - D Kimenai
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, Edinburgh, United Kingdom
| | - N L Mills
- University of Edinburgh, Edinburgh, United Kingdom
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Kimenai DM, Anand A, De Bakker M, Shipley M, Fujisawa T, Strachan F, Shah ASV, Kardys I, Boersma E, Brunner E, Mills NL. Trajectories of high-sensitivity cardiac troponin I in the two decades before cardiovascular death in Whitehall II. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
High-sensitivity cardiac troponin may be a promising biomarker that could be used for personalised cardiovascular risk prediction and monitoring in the general population. Temporal changes in high-sensitivity cardiac troponin before cardiovascular death are largely unexplored.
Purpose
Using the longitudinal Whitehall II cohort, we evaluated whether three serial high-sensitivity cardiac troponin I measurements over 15 years improved prediction of cardiovascular death when compared to a single time point at baseline.
Methods
Whitehall II is an ongoing longitudinal observation cohort study of 10,308 civil servants, and we included participants who had at least one cardiac troponin measurement and outcome data available. We constructed time trajectories to evaluate the temporal pattern of cardiac troponin I in those who died from cardiovascular disease as compared to those who did not. Cox regression and joint models were used to investigate the association of cardiac troponin I in relation to cardiovascular death using single time point (at baseline) and repeated measurements (at baseline, 10 and 15 years), respectively. The discriminative ability was assessed by the concordance index.
Results
In total, we included 7,293 individuals (mean age of 58 years [SD 7] at baseline, 29.4% women). Of these, 5,818 (79.8%) and 4,045 (55.5%) individuals had a second and third cardiac troponin I concentration measured, respectively. Cardiovascular death occurred in 281 (3.9%) individuals during a median follow-up of 21.4 [IQR, 15.8 to 21.8] years. In the 21-year trajectories of cardiac troponin I, we observed higher baseline concentrations in those who died due to cardiovascular disease as compared to those who did not (median 5 [IQR, 2 to 9] ng/L versus 3 [IQR, 2 to 5] ng/L respectively, Figure). Cardiac troponin I was an independent predictor of cardiovascular death, and the hazard ratio (HR) derived from the joint model that included serial cardiac troponin measurements was higher than the HR derived from the single time point model (single time point model: adjusted HR 1.53, 95% Confidence Interval [CI] 1.37 to 1.70 per naturally log transformed unit of cardiac troponin I, versus repeated measurements model: adjusted HR 1.79, 95% CI 1.58 to 2.02). The discriminative ability of the cardiac troponin model improved when using repeated measurements (concordance index of unadjusted cardiac troponin models, single time point: 0.668 versus repeated measurements: 0.724).
Conclusions
Our study shows that cardiac troponin I trajectories were persistently higher among individuals who died from cardiovascular disease. Cardiac troponin I is a strong independent predictor of cardiovascular death, and incorporating repeated measurements of cardiac troponin improves cardiovascular risk prediction in the general population.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Cardiac troponin I measurements and analysis were supported by were supported by Siemens Healthineers. The study was supported by Health Data Research UK which receives its funding from HDR UK Ltd (HDR-5012) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust. NLM is supported by the British Heart Foundation through a Senior Clinical Research Fellowship (FS/16/14/32023), Programme Grant (RG/20/10/34966) and a Research Excellence Award (RE/18/5/34216). The funders had no role in the study and the decision to submit this work to be considered for publication.
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Affiliation(s)
- D M Kimenai
- University of Edinburgh, Usher Institute, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - M De Bakker
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - M Shipley
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - T Fujisawa
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - F Strachan
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine, Department of non-communicable disease, London, United Kingdom
| | - I Kardys
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - E Boersma
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - E Brunner
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - N L Mills
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
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Bularga A, Wereski R, Taggart C, Lowry M, Singh T, Lee KK, Anand A, Shah ASV, Ross DA, Perry MR, Dweck MR, Newby DE, Chapman AR, Mills NL. Mechanisms of myocardial injury and clinical outcomes in patients hospitalised with suspected COVID-19. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Myocardial injury is associated with adverse outcomes in patients with COVID-19. However, the prognostic role of myocardial injury in COVID-19 compared to other acute illnesses and the underlying mechanisms of injury are poorly understood.
Methods
In a prospective, multi-centre, cohort study conducted in secondary and tertiary care hospitals in Scotland, all consecutive patients with suspected COVID-19 underwent cardiac troponin (ARCHITECTSTAT high-sensitive troponin I (hs-cTnI) assay; Abbott Laboratories) testing in plasma that was surplus to clinical requirements. The results were not reported unless required by the attending clinician. We evaluated the prevalence of myocardial injury, mechanisms and outcomes in all patients. In those with any hs-cTnI concentration above the sex-specific 99th centile the diagnosis was adjudicated according to the 4th Universal Definition of Myocardial Infarction. The primary outcome of all-cause mortality was compared in those with and without myocardial injury and COVID-19 by cox regression adjusted for age, sex, renal function and co-morbidities.
Results
A total of 2,916 (median age 69 [interquartile range, IQR 54–79] years, 53% women) consecutive patients with suspected COVID-19 were followed up for 228 [IQR 203–249] days. Myocardial injury occurred in 26% (750/2,916) with a median troponin concentration of 66 [35–178] ng/L; the prevalence was 41% (46/112) and 25% (704/2,804) in those with and without COVID-19, respectively. The most common mechanism was acute non-ischaemic myocardial injury occurring in 80% (37/46) and 71% (502/704) of patients with and without COVID-19, respectively. Type 1 myocardial infarction (2% and 4%), type 2 myocardial infarction (7% and 14%) and chronic myocardial injury (11% and 11%) were less common and only one patient had confirmed myocarditis. In patients with myocardial injury mortality was increased compared to those without (P<0.001 log rank), whether they had COVID-19 (54% [25/46] versus 26% [17/66]) or not (35% [248/704] versus 14% [294/2100]). Myocardial injury was an independent predictor of death in all patients (adjusted hazard ratio [aHR] 2.04, 95% confidence interval [CI] 1.71 to 2.43), but this excess risk was not higher in patients with COVID-19 (aHR 1.58, 95% CI 0.75 to 3.15) compared to those without the condition (aHR 2.01, 95% CI 1.81 to 2.49).
Conclusion
Myocardial injury is common in hospitalised patients with suspected COVID-19 whether or not COVID-19 was the cause of their presentation. The majority of patients had acute non-ischaemic myocardial injury rather than a defined cardiac condition. Despite this the presence of myocardial injury was an independent predictor of death in all hospitalised patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Kaplan-Meier curve for all-cause death
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Affiliation(s)
- A Bularga
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Wereski
- University of Edinburgh, Edinburgh, United Kingdom
| | - C Taggart
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Lowry
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Singh
- University of Edinburgh, Edinburgh, United Kingdom
| | - K K Lee
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, Edinburgh, United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine, Department of Cardiology, London, United Kingdom
| | - D A Ross
- Western General Hospital, Regional Infectious Disease Unit, Edinburgh, United Kingdom
| | - M R Perry
- Western General Hospital, Regional Infectious Disease Unit, Edinburgh, United Kingdom
| | - M R Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D E Newby
- University of Edinburgh, Edinburgh, United Kingdom
| | - A R Chapman
- University of Edinburgh, Edinburgh, United Kingdom
| | - N L Mills
- University of Edinburgh, Edinburgh, United Kingdom
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Tuteja JS, Anand A, Chakrabarti D, Gupta R, Bhatt MLB. Snapshots quiz. Br J Surg 2021; 109:168. [PMID: 34595503 DOI: 10.1093/bjs/znab329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/27/2021] [Indexed: 11/12/2022]
Abstract
A 25-year old gentleman, treated one year previously for a signet ring mid rectal adenocarcinoma, presented with facial swelling and multiple nodular swellings on the neck and back. What is the diagnosis?
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Affiliation(s)
- J S Tuteja
- Department of Radiation Oncology, King George's Medical, Lucknow, India
| | - A Anand
- Department of Radiation Oncology, King George's Medical, Lucknow, India
| | - D Chakrabarti
- Department of Radiation Oncology, King George's Medical, Lucknow, India
| | - R Gupta
- Department of Radiation Oncology, King George's Medical, Lucknow, India
| | - M L B Bhatt
- Department of Radiation Oncology, King George's Medical, Lucknow, India
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Rawoot S, Punatar C, Singh V, Anand A, Shah B, Nagaonkar S, Joshi V. Neutrophil to lymphocyte ratio as a prognostic marker for non-metastatic renal cell carcinoma - does it add to what we already know? Exp Oncol 2021; 43:247-251. [PMID: 34591425 DOI: 10.32471/exp-oncology.2312-8852.vol-43-no-3.16543] [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: 11/18/2022]
Abstract
AIM To study the correlation of pre-operative neutrophil to lymphocyte ratio (NLR) with pathological stage, Fuhrman grade, sarcomatoid differentiation, tumor necrosis and lymph node positivity and its prognostic role in non-metastatic renal cell carcinoma (non-mRCC). MATERIALS AND METHODS This retro-prospective, observational study was done at a tertiary care center in Mumbai, India. All patients with non-mRCC from July 2015 to April 2018 were included. Patients with co-existing systemic infection, prior immunotherapy, and long-term steroids were excluded. NLR closest to surgery, but within one month prior to surgery was used. Patients were stratified as NLR ≥ 3.0 or < 3. NLR was correlated with known prognostic factors by Pearson's correlation. RESULTS 113 patients, aged 18-81 years (83 males and 30 females) were included. 75% had clear cell RCC. 62% had stage 1 disease. 58% patients had Fuhrman Grade 2. 10 patients had lymph node metastasis, 6 had sarcomatoid differentiation, 40 had tumor necrosis. The NLR was < 3 in 72 patients. Statistically significant correlation between NLR and tumor stage (p = 0.0054) as well as NLR and tumor necrosis (p = 0.0128) was shown. CONCLUSIONS NLR correlates significantly with higher T stage and tumor necrosis. NLR may be integrated with well-established prognostic markers to improve the accuracy of prognostic scores.
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Affiliation(s)
- S Rawoot
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - C Punatar
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - V Singh
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - A Anand
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - B Shah
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - S Nagaonkar
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
| | - V Joshi
- P.D. Hinduja National Hospital and Medical Research Centre, Mumbai 400016, India
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