Background: For patients with a first unprovoked venous thromboembolism (VTE), the optimal durati... more Background: For patients with a first unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulant therapy (AT) is a crucial clinical dilemma which has yet to be resolved . Choosing short-term (3-6 months) or indefinite AT, requires balancing the long-term risk of recurrent VTE when AT is discontinued, with the long-term risk of major bleeding (MB) from extended AT. Current guidelines suggest considering indefinite AT in all unprovoked VTE patients with non-high bleeding risk. This however, is a weak-evidence recommendation based on limited data, and no precise risk thresholds have been established to help guide treatment duration in this patient population. From an economic perspective, we aimed to identify thresholds of the risk of MB and recurrent VTE for which indefinite AT, as compared to stopping AT after initial short-term treatment, may be warranted. Methods: We constructed a Markov decision model of patients with a first unprovoked VTE who had completed at least 3-6 months of initial AT. The model adopted a lifetime horizon and a publicly-funded healthcare system perspective. Using a cycle length of one year, the model tracked recurrent VTE (DVT and/or PE), MB, and death from any cause [ Figure 1 ]. For the base case, we considered patients aged 57 years, having a life expectancy of 30 years, annual risk of MB on Vitamin K Antagonists of 1.5%, annual recurrent VTE risk of 5% per year off therapy, case-fatality-rate (CFR) for MB of 11.3%, and CFR for recurrent VTE of 3.6%. We expressed our results as Incremental Net Benefit (INB) which incorporates costs, life-expectancy, quality-adjusted life-years (QALYs), and a willingness to pay (WTP) value. INB is the incremental benefit, expressed in monetary terms ($), of offering a patient treatment (indefinite AT) rather than the comparator (stopping AT). An INB > 0 favours the treatment, whereas an INB Results: For the base case analysis with assuming a decision-maker9s WTP threshold of $50,000/QALY, indefinite AT was not justified (i.e. INB Figure 2 ], or when the annual risk of MB exceeded 2.4% [ Figure 3 ]. Furthermore, in a two-way sensitivity analysis [ Figure 4 ], as the MB risk increased, so did the recurrent VTE risk threshold for which indefinite AT would be warranted. As illustrated through three hypothetical situations outlined in Figure 4; for a patient with an annual MB risk of 3.5% [scenario A ], a recurrence risk of >15% would be required for indefinite AT to be favorable (i.e. INB > 0). Similarly, using a base case annual MB risk of 1.5% [scenario B ], from an economic standpoint, the decision to offer indefinite AT would not be preferred for a patient in whom the risk of recurrence is 3%, but may be supported for a patient in whom the risk of recurrence is 10%. Lastly, for a patient with an annual recurrent VTE risk of C ], continuing AT indefinitely would never be justified, irrespective of the risk of MB. Conclusions/Implications: To the best of our knowledge, this is the first decision analysis of a hypothetical cohort of unprovoked VTE patients that identifies risk thresholds of MB and recurrent VTE to guide treatment duration. From an economic viewpoint, our analysis demonstrates that choosing indefinite AT in such patients may not be justified at the proposed risk thresholds. Furthermore, long-term follow up demonstrates that VTE recurs in less than 50% of such patients after stopping AT;thus, considering indefinite AT in all unprovoked VTE patients is an inefficient use of resources, and exposes a large proportion of patients to the unnecessary risks, burdens and costs of lifelong AT. Establishing risk thresholds, as achieved through our decision model, allows individualized treatment and helps guide patient-centered decision making. If validated and further optimized (as planned prior to the ASH), findings from our study could change clinical practice. Disclosures No relevant conflicts of interest to declare.
This is the replication material related to the following paper submitted for TSE. Faizan Khan, B... more This is the replication material related to the following paper submitted for TSE. Faizan Khan, Boqi Chen, Daniel Varro, and Shane McIntosh. An Empirical Study ofType-Related Defects in Python Projects.IEEE Transactions on Software Engineering,2021(under review)
BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initi... more BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initial 3 to 6 months) anticoagulant therapy for a first unprovoked venous thromboembolism (VTE) is uncertain. PURPOSE To determine the incidence of major bleeding during extended anticoagulation of up to 5 years among patients with a first unprovoked VTE, overall, and in clinically important subgroups. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to 23 July 2021. STUDY SELECTION Randomized controlled trials (RCTs) and prospective cohort studies reporting major bleeding among patients with a first unprovoked VTE who were to receive oral anticoagulation for a minimum of 6 additional months after completing at least 3 months of initial anticoagulant treatment. DATA EXTRACTION Two reviewers independently abstracted data and assessed study quality. Unpublished data required for analyses were obtained from authors of included studies. DATA SYNTHESIS Among the 14 RCTs and 13 cohort studies included in the analysis, 9982 patients received a vitamin K antagonist (VKA) and 7220 received a direct oral anticoagulant (DOAC). The incidence of major bleeding per 100 person-years was 1.74 events (95% CI, 1.34 to 2.20 events) with VKAs and 1.12 events (CI, 0.72 to 1.62 events) with DOACs. The 5-year cumulative incidence of major bleeding with VKAs was 6.3% (CI, 3.6% to 10.0%). Among patients receiving either a VKA or a DOAC, the incidence of major bleeding was statistically significantly higher among those who were older than 65 years or had creatinine clearance less than 50 mL/min, a history of bleeding, concomitant use of antiplatelet therapy, or a hemoglobin level less than 100 g/L. The case-fatality rate of major bleeding was 8.3% (CI, 5.1% to 12.2%) with VKAs and 9.7% (CI, 3.2% to 19.2%) with DOACs. LIMITATION Data were insufficient to estimate incidence of major bleeding beyond 1 year of extended anticoagulation with DOACs. CONCLUSION In patients with a first unprovoked VTE, the long-term risks and consequences of anticoagulant-related major bleeding are considerable. This information will help inform patient prognosis and guide decision making about treatment duration for unprovoked VTE. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research. (PROSPERO: CRD42019128597).
Introduction: Chronic pain remains an important public health problem as it continues to increase... more Introduction: Chronic pain remains an important public health problem as it continues to increase healthcare-related cost. Comorbidities like obesity have been associated with efficacy of spinal cord stimulator (SCS) therapy and worse outcomes. The goal of this study is to investigate the trends of obesity amongst hospitalized patients with SCS therapy as well as healthcare utilization outcomes. Methods: Using the International Classification of Diseases (ICD) ninth and tenth procedure and diagnosis code, we investigated the National Inpatient Sample (NIS) for patients with SCS implants between 2011 and 2015. Patients received a diagnosis of obesity based on the following categories: class I, II and III Digital Features To view digital features for this article go to
Introduction To summarize and compare the effectiveness of pharmacological thromboprophylaxis to ... more Introduction To summarize and compare the effectiveness of pharmacological thromboprophylaxis to pneumatic compression devices (PCD) for the prevention of venous thromboembolism in patients with acute intracerebral hemorrhage. Methods MEDLINE, PUBMED, EMBASE, and CENTRAL were systematically searched to identify randomized and non-randomized studies that compared each intervention directly to each other or against a common control (hydration, anti-platelet agents, stockings) in adults with acute spontaneous intracerebral hemorrhage. Two investigators independently screened the studies, extracted data, and appraised risk of bias. Studies with a high risk of bias were excluded from our final analysis. The primary outcome was the occurrence of venous thromboembolism (proximal deep vein thrombosis or pulmonary embolism) in the first 30 days. Results 8,739 articles were screened; four articles, all randomized control trials, met eligibility criteria. Bayesian network meta-analysis was performed to calculate risk estimates using both fixed and random effects analyses. 607 patients were included in the network analysis. PCD were associated with a significant decrease in venous thromboembolism compared to control (OR: 0.43, 95% Credible Limits [CrI]: 0.23-0.80). We did not find evidence of statistically significant differences between pharmacological thromboprophylaxis and control (OR: 0.93, 95% CrI: 0.19-4.37) or between PCD and pharmacological thromboprophylaxis (OR: 0.47, 95% CrI: 0.09-2.54).
Poly-crystalline Ge (pc-Ge) thin films were prepared on a SiO2/Si substrate using Au-induced crys... more Poly-crystalline Ge (pc-Ge) thin films were prepared on a SiO2/Si substrate using Au-induced crystallization (GIC) of amorphous Ge (a-Ge) with an annealing temperature around the eutectic point of Au-Ge alloy system (361ºC) in order to shorten the annealing time. Bilayer thin films of Au (20 nm)/a-Ge (100 nm) were used as a precursor material and annealed at 300, 400, and 500 ºC for 60 min, which successfully leads to the formation of pc-Ge layers. Characterizing the prepared Ge layers, the crystallographic properties indicated that the metal catalyst Au plays a notable role of enhancing both the crystallization and the island formation of Ge layers. It was also shown that the pc-Ge hardly contains Au atoms. Therefore, the Seebeck coefficient was hardly influenced by Au atoms since they do not act as a carrier source. In addition, the thermal conductivity of the pc-Ge film prepared by the GIC method was higher than that formed without Au, which is not due to the Au catalyst itself...
Background: When a journal receives a duplicate publication the ability to identify the submitted... more Background: When a journal receives a duplicate publication the ability to identify the submitted work as previously published, and reject it, is an assay to publication ethics best practices. The aim of this study was to evaluate how three different types of journals, namely open access (OA) journals, subscription-based journals, and presumed predatory journals, responded to receiving a previously published manuscript for review. Methods: We performed a quasi-experimental study in which we submitted a previously published article to a random sample of 602 biomedical journals, roughly 200 journals from each journal type sampled: OA journals, subscription-based journals, and presumed predatory journals. Three hundred and three journals received a Word version in manuscript format, while 299 journals received the formatted publisher’s PDF version of the published article. We then recorded responses to the submission received after approximately 1 month. Responses were reviewed, extrac...
Conclusion: high quality studies in support of endoscopic therapy in the management of PDiv are l... more Conclusion: high quality studies in support of endoscopic therapy in the management of PDiv are lacking. Available studies are mainly case series and of low quality. Based on currently available evidence, the estimated effi cacy of endoscopic therapy is 58% but this estimate is neither robust nor precision due to poor quality of available studies and signifi cant heterogeneity.
S1324 testinal tract, 10-20% of cases will require endoscopic retrieval. We present an unusual ca... more S1324 testinal tract, 10-20% of cases will require endoscopic retrieval. We present an unusual case of foreign body ingestion involving a patient presenting with abdominal pain and melena. A 68 year-old man with a history of coronary artery disease presented to the hospital with a 3 day history of unremitting, burning epigastric pain associated with 1 episode of melenic stool. He denied hematochezia and weakness but did endorse a history of non-steroidal anti-infl ammatory use. Upon admission he was found to be hemodynamically stable. Laboratory values including complete blood count, basic metabolic panel, and protime were unremarkable. Plain abdominal fi lm on admission revealed an elongated radiopaque object concerning for foreign body in the antrum. Th e patient denied ingestion of any known non-food items. Upper endoscopy was performed. An elongated Forrest 2c 7mm x 2cm pyloric ulcer was discovered (fi gure 1). On retrofl exion in the stomach, a quarter was visible in the greater curvature (fi gure 2). Closer inspection revealed a dime underneath the fi rst coin (fi gure 3). Both coins were successfully retrieved with the Roth retrieval net. Biopsies for Helicobacter Pylori were negative. Th e patient was started on 40mg esomeprazole daily and was soon discharged with a plan for repeat upper endoscopy in 3 months. While the majority of ingestions can be managed with conservative measures, cases with airway compromise or peritoneal signs oft en call for urgent endoscopic or surgical evaluation. Concerning ingestions include sharp objects, disk batteries, magnets, or items with diameter greater than 25mm as they are less likely to pass through the pylorus. Ingestion of foreign non-food objects is more commonly encountered in the pediatric population with coins representing the majority of cases. When seen in adults, there is usually concomitant alcoholism or cognitive and psychiatric disorders. In our patient's case, there was a history of excessive alcohol abuse. It is likely that the coins were ingested while intoxicated. Th e patient's use of non-steroidal anti-infl ammatory drugs likely lead to ulcer development; however, it is possible that the coins may also have contributed as ulcers have been reported with similar blunt objects.
View the article online for updates and enhancements. Content from this work may be used under th... more View the article online for updates and enhancements. Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Objectives To determine the rate of a first recurrent venous thromboembolism (VTE) event after di... more Objectives To determine the rate of a first recurrent venous thromboembolism (VTE) event after discontinuation of anticoagulant treatment in patients with a first episode of unprovoked VTE, and the cumulative incidence for recurrent VTE up to 10 years. Design Systematic review and meta-analysis. Data sources Medline, Embase, and the Cochrane Central Register of Controlled Trials (from inception to 15 March 2019). Study selection Randomised controlled trials and prospective cohort studies reporting symptomatic recurrent VTE after discontinuation of anticoagulant treatment in patients with a first unprovoked VTE event who had completed at least three months of treatment. Data extraction and synthesis Two investigators independently screened studies, extracted data, and appraised risk of bias. Data clarifications were sought from authors of eligible studies. Recurrent VTE events and person years of follow-up after discontinuation of anticoagulant treatment were used to calculate rates ...
Research and Practice in Thrombosis and Haemostasis, 2017
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The escalation in open-access publishing has fueled the rise of questionable businesses, namely, ... more The escalation in open-access publishing has fueled the rise of questionable businesses, namely, ‘predatory’ journals. Predatory journals and their publishers seek manuscripts through aggressive electronic solicitation and execute flawed peer-review practices, consequently undermining the scholarly record and current research cultures, globally. As these journals are not indexed in any legitimate databases, the research they publish is often undiscoverable and fails to be disseminated to a worldwide readership. Acknowledging this threat to the credibility of science, this article aims to alert researchers at various levels of their career of the increasing global issue of predatory journals, and offer helpful advice and resources for identifying and avoiding them. RésuméL’essor de la publication en accès libre a alimenté l’expansion d’entreprises douteuses, à savoir des revues « prédatrices ». Les revues prédatrices et leurs éditeurs recherchent des manuscrits au moyen de requ...
Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths... more Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths and recurrences associated with endometrial cancer. Small-cell carcinoma of the endometrium is relatively rare but aggressive, and often presents a component of endometrioid carcinoma, and is not generally associated with serous carcinoma. Herein, we report a case of 74-year-old African-American female, who presented with intermittent postmenopausal bleeding for N1-month. She underwent robotic-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node mapping, and pelvic-and-aortic lymphadenectomy. Final pathology was consistent with serous carcinoma of the endometrium in combination with neuroendocrine small-cell carcinoma. This extremely rare combination of tumors presents a challenge for treatment. The mainstay of treatment seems to be surgery followed by chemotherapy ± radiation therapy. To our knowledge, it represents an under-reported area of gynecological medicine.
Background: For patients with a first unprovoked venous thromboembolism (VTE), the optimal durati... more Background: For patients with a first unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulant therapy (AT) is a crucial clinical dilemma which has yet to be resolved . Choosing short-term (3-6 months) or indefinite AT, requires balancing the long-term risk of recurrent VTE when AT is discontinued, with the long-term risk of major bleeding (MB) from extended AT. Current guidelines suggest considering indefinite AT in all unprovoked VTE patients with non-high bleeding risk. This however, is a weak-evidence recommendation based on limited data, and no precise risk thresholds have been established to help guide treatment duration in this patient population. From an economic perspective, we aimed to identify thresholds of the risk of MB and recurrent VTE for which indefinite AT, as compared to stopping AT after initial short-term treatment, may be warranted. Methods: We constructed a Markov decision model of patients with a first unprovoked VTE who had completed at least 3-6 months of initial AT. The model adopted a lifetime horizon and a publicly-funded healthcare system perspective. Using a cycle length of one year, the model tracked recurrent VTE (DVT and/or PE), MB, and death from any cause [ Figure 1 ]. For the base case, we considered patients aged 57 years, having a life expectancy of 30 years, annual risk of MB on Vitamin K Antagonists of 1.5%, annual recurrent VTE risk of 5% per year off therapy, case-fatality-rate (CFR) for MB of 11.3%, and CFR for recurrent VTE of 3.6%. We expressed our results as Incremental Net Benefit (INB) which incorporates costs, life-expectancy, quality-adjusted life-years (QALYs), and a willingness to pay (WTP) value. INB is the incremental benefit, expressed in monetary terms ($), of offering a patient treatment (indefinite AT) rather than the comparator (stopping AT). An INB > 0 favours the treatment, whereas an INB Results: For the base case analysis with assuming a decision-maker9s WTP threshold of $50,000/QALY, indefinite AT was not justified (i.e. INB Figure 2 ], or when the annual risk of MB exceeded 2.4% [ Figure 3 ]. Furthermore, in a two-way sensitivity analysis [ Figure 4 ], as the MB risk increased, so did the recurrent VTE risk threshold for which indefinite AT would be warranted. As illustrated through three hypothetical situations outlined in Figure 4; for a patient with an annual MB risk of 3.5% [scenario A ], a recurrence risk of >15% would be required for indefinite AT to be favorable (i.e. INB > 0). Similarly, using a base case annual MB risk of 1.5% [scenario B ], from an economic standpoint, the decision to offer indefinite AT would not be preferred for a patient in whom the risk of recurrence is 3%, but may be supported for a patient in whom the risk of recurrence is 10%. Lastly, for a patient with an annual recurrent VTE risk of C ], continuing AT indefinitely would never be justified, irrespective of the risk of MB. Conclusions/Implications: To the best of our knowledge, this is the first decision analysis of a hypothetical cohort of unprovoked VTE patients that identifies risk thresholds of MB and recurrent VTE to guide treatment duration. From an economic viewpoint, our analysis demonstrates that choosing indefinite AT in such patients may not be justified at the proposed risk thresholds. Furthermore, long-term follow up demonstrates that VTE recurs in less than 50% of such patients after stopping AT;thus, considering indefinite AT in all unprovoked VTE patients is an inefficient use of resources, and exposes a large proportion of patients to the unnecessary risks, burdens and costs of lifelong AT. Establishing risk thresholds, as achieved through our decision model, allows individualized treatment and helps guide patient-centered decision making. If validated and further optimized (as planned prior to the ASH), findings from our study could change clinical practice. Disclosures No relevant conflicts of interest to declare.
This is the replication material related to the following paper submitted for TSE. Faizan Khan, B... more This is the replication material related to the following paper submitted for TSE. Faizan Khan, Boqi Chen, Daniel Varro, and Shane McIntosh. An Empirical Study ofType-Related Defects in Python Projects.IEEE Transactions on Software Engineering,2021(under review)
BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initi... more BACKGROUND The long-term risk for major bleeding in patients receiving extended (beyond the initial 3 to 6 months) anticoagulant therapy for a first unprovoked venous thromboembolism (VTE) is uncertain. PURPOSE To determine the incidence of major bleeding during extended anticoagulation of up to 5 years among patients with a first unprovoked VTE, overall, and in clinically important subgroups. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to 23 July 2021. STUDY SELECTION Randomized controlled trials (RCTs) and prospective cohort studies reporting major bleeding among patients with a first unprovoked VTE who were to receive oral anticoagulation for a minimum of 6 additional months after completing at least 3 months of initial anticoagulant treatment. DATA EXTRACTION Two reviewers independently abstracted data and assessed study quality. Unpublished data required for analyses were obtained from authors of included studies. DATA SYNTHESIS Among the 14 RCTs and 13 cohort studies included in the analysis, 9982 patients received a vitamin K antagonist (VKA) and 7220 received a direct oral anticoagulant (DOAC). The incidence of major bleeding per 100 person-years was 1.74 events (95% CI, 1.34 to 2.20 events) with VKAs and 1.12 events (CI, 0.72 to 1.62 events) with DOACs. The 5-year cumulative incidence of major bleeding with VKAs was 6.3% (CI, 3.6% to 10.0%). Among patients receiving either a VKA or a DOAC, the incidence of major bleeding was statistically significantly higher among those who were older than 65 years or had creatinine clearance less than 50 mL/min, a history of bleeding, concomitant use of antiplatelet therapy, or a hemoglobin level less than 100 g/L. The case-fatality rate of major bleeding was 8.3% (CI, 5.1% to 12.2%) with VKAs and 9.7% (CI, 3.2% to 19.2%) with DOACs. LIMITATION Data were insufficient to estimate incidence of major bleeding beyond 1 year of extended anticoagulation with DOACs. CONCLUSION In patients with a first unprovoked VTE, the long-term risks and consequences of anticoagulant-related major bleeding are considerable. This information will help inform patient prognosis and guide decision making about treatment duration for unprovoked VTE. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research. (PROSPERO: CRD42019128597).
Introduction: Chronic pain remains an important public health problem as it continues to increase... more Introduction: Chronic pain remains an important public health problem as it continues to increase healthcare-related cost. Comorbidities like obesity have been associated with efficacy of spinal cord stimulator (SCS) therapy and worse outcomes. The goal of this study is to investigate the trends of obesity amongst hospitalized patients with SCS therapy as well as healthcare utilization outcomes. Methods: Using the International Classification of Diseases (ICD) ninth and tenth procedure and diagnosis code, we investigated the National Inpatient Sample (NIS) for patients with SCS implants between 2011 and 2015. Patients received a diagnosis of obesity based on the following categories: class I, II and III Digital Features To view digital features for this article go to
Introduction To summarize and compare the effectiveness of pharmacological thromboprophylaxis to ... more Introduction To summarize and compare the effectiveness of pharmacological thromboprophylaxis to pneumatic compression devices (PCD) for the prevention of venous thromboembolism in patients with acute intracerebral hemorrhage. Methods MEDLINE, PUBMED, EMBASE, and CENTRAL were systematically searched to identify randomized and non-randomized studies that compared each intervention directly to each other or against a common control (hydration, anti-platelet agents, stockings) in adults with acute spontaneous intracerebral hemorrhage. Two investigators independently screened the studies, extracted data, and appraised risk of bias. Studies with a high risk of bias were excluded from our final analysis. The primary outcome was the occurrence of venous thromboembolism (proximal deep vein thrombosis or pulmonary embolism) in the first 30 days. Results 8,739 articles were screened; four articles, all randomized control trials, met eligibility criteria. Bayesian network meta-analysis was performed to calculate risk estimates using both fixed and random effects analyses. 607 patients were included in the network analysis. PCD were associated with a significant decrease in venous thromboembolism compared to control (OR: 0.43, 95% Credible Limits [CrI]: 0.23-0.80). We did not find evidence of statistically significant differences between pharmacological thromboprophylaxis and control (OR: 0.93, 95% CrI: 0.19-4.37) or between PCD and pharmacological thromboprophylaxis (OR: 0.47, 95% CrI: 0.09-2.54).
Poly-crystalline Ge (pc-Ge) thin films were prepared on a SiO2/Si substrate using Au-induced crys... more Poly-crystalline Ge (pc-Ge) thin films were prepared on a SiO2/Si substrate using Au-induced crystallization (GIC) of amorphous Ge (a-Ge) with an annealing temperature around the eutectic point of Au-Ge alloy system (361ºC) in order to shorten the annealing time. Bilayer thin films of Au (20 nm)/a-Ge (100 nm) were used as a precursor material and annealed at 300, 400, and 500 ºC for 60 min, which successfully leads to the formation of pc-Ge layers. Characterizing the prepared Ge layers, the crystallographic properties indicated that the metal catalyst Au plays a notable role of enhancing both the crystallization and the island formation of Ge layers. It was also shown that the pc-Ge hardly contains Au atoms. Therefore, the Seebeck coefficient was hardly influenced by Au atoms since they do not act as a carrier source. In addition, the thermal conductivity of the pc-Ge film prepared by the GIC method was higher than that formed without Au, which is not due to the Au catalyst itself...
Background: When a journal receives a duplicate publication the ability to identify the submitted... more Background: When a journal receives a duplicate publication the ability to identify the submitted work as previously published, and reject it, is an assay to publication ethics best practices. The aim of this study was to evaluate how three different types of journals, namely open access (OA) journals, subscription-based journals, and presumed predatory journals, responded to receiving a previously published manuscript for review. Methods: We performed a quasi-experimental study in which we submitted a previously published article to a random sample of 602 biomedical journals, roughly 200 journals from each journal type sampled: OA journals, subscription-based journals, and presumed predatory journals. Three hundred and three journals received a Word version in manuscript format, while 299 journals received the formatted publisher’s PDF version of the published article. We then recorded responses to the submission received after approximately 1 month. Responses were reviewed, extrac...
Conclusion: high quality studies in support of endoscopic therapy in the management of PDiv are l... more Conclusion: high quality studies in support of endoscopic therapy in the management of PDiv are lacking. Available studies are mainly case series and of low quality. Based on currently available evidence, the estimated effi cacy of endoscopic therapy is 58% but this estimate is neither robust nor precision due to poor quality of available studies and signifi cant heterogeneity.
S1324 testinal tract, 10-20% of cases will require endoscopic retrieval. We present an unusual ca... more S1324 testinal tract, 10-20% of cases will require endoscopic retrieval. We present an unusual case of foreign body ingestion involving a patient presenting with abdominal pain and melena. A 68 year-old man with a history of coronary artery disease presented to the hospital with a 3 day history of unremitting, burning epigastric pain associated with 1 episode of melenic stool. He denied hematochezia and weakness but did endorse a history of non-steroidal anti-infl ammatory use. Upon admission he was found to be hemodynamically stable. Laboratory values including complete blood count, basic metabolic panel, and protime were unremarkable. Plain abdominal fi lm on admission revealed an elongated radiopaque object concerning for foreign body in the antrum. Th e patient denied ingestion of any known non-food items. Upper endoscopy was performed. An elongated Forrest 2c 7mm x 2cm pyloric ulcer was discovered (fi gure 1). On retrofl exion in the stomach, a quarter was visible in the greater curvature (fi gure 2). Closer inspection revealed a dime underneath the fi rst coin (fi gure 3). Both coins were successfully retrieved with the Roth retrieval net. Biopsies for Helicobacter Pylori were negative. Th e patient was started on 40mg esomeprazole daily and was soon discharged with a plan for repeat upper endoscopy in 3 months. While the majority of ingestions can be managed with conservative measures, cases with airway compromise or peritoneal signs oft en call for urgent endoscopic or surgical evaluation. Concerning ingestions include sharp objects, disk batteries, magnets, or items with diameter greater than 25mm as they are less likely to pass through the pylorus. Ingestion of foreign non-food objects is more commonly encountered in the pediatric population with coins representing the majority of cases. When seen in adults, there is usually concomitant alcoholism or cognitive and psychiatric disorders. In our patient's case, there was a history of excessive alcohol abuse. It is likely that the coins were ingested while intoxicated. Th e patient's use of non-steroidal anti-infl ammatory drugs likely lead to ulcer development; however, it is possible that the coins may also have contributed as ulcers have been reported with similar blunt objects.
View the article online for updates and enhancements. Content from this work may be used under th... more View the article online for updates and enhancements. Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
Objectives To determine the rate of a first recurrent venous thromboembolism (VTE) event after di... more Objectives To determine the rate of a first recurrent venous thromboembolism (VTE) event after discontinuation of anticoagulant treatment in patients with a first episode of unprovoked VTE, and the cumulative incidence for recurrent VTE up to 10 years. Design Systematic review and meta-analysis. Data sources Medline, Embase, and the Cochrane Central Register of Controlled Trials (from inception to 15 March 2019). Study selection Randomised controlled trials and prospective cohort studies reporting symptomatic recurrent VTE after discontinuation of anticoagulant treatment in patients with a first unprovoked VTE event who had completed at least three months of treatment. Data extraction and synthesis Two investigators independently screened studies, extracted data, and appraised risk of bias. Data clarifications were sought from authors of eligible studies. Recurrent VTE events and person years of follow-up after discontinuation of anticoagulant treatment were used to calculate rates ...
Research and Practice in Thrombosis and Haemostasis, 2017
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The escalation in open-access publishing has fueled the rise of questionable businesses, namely, ... more The escalation in open-access publishing has fueled the rise of questionable businesses, namely, ‘predatory’ journals. Predatory journals and their publishers seek manuscripts through aggressive electronic solicitation and execute flawed peer-review practices, consequently undermining the scholarly record and current research cultures, globally. As these journals are not indexed in any legitimate databases, the research they publish is often undiscoverable and fails to be disseminated to a worldwide readership. Acknowledging this threat to the credibility of science, this article aims to alert researchers at various levels of their career of the increasing global issue of predatory journals, and offer helpful advice and resources for identifying and avoiding them. RésuméL’essor de la publication en accès libre a alimenté l’expansion d’entreprises douteuses, à savoir des revues « prédatrices ». Les revues prédatrices et leurs éditeurs recherchent des manuscrits au moyen de requ...
Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths... more Endometrial serous carcinomas are very clinically aggressive, which constitutes 40% of all deaths and recurrences associated with endometrial cancer. Small-cell carcinoma of the endometrium is relatively rare but aggressive, and often presents a component of endometrioid carcinoma, and is not generally associated with serous carcinoma. Herein, we report a case of 74-year-old African-American female, who presented with intermittent postmenopausal bleeding for N1-month. She underwent robotic-assisted laparoscopic hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node mapping, and pelvic-and-aortic lymphadenectomy. Final pathology was consistent with serous carcinoma of the endometrium in combination with neuroendocrine small-cell carcinoma. This extremely rare combination of tumors presents a challenge for treatment. The mainstay of treatment seems to be surgery followed by chemotherapy ± radiation therapy. To our knowledge, it represents an under-reported area of gynecological medicine.
Uploads
Papers by Faizan khan