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Article: Automatic algorithmic driven monitoring of atrioventricular nodal re-entrant tachycardia ablation to improve procedural safety.

Tam, Tsz Kin / Lai, Angel / Chan, Joseph Y S / Au, Alex C K / Chan, Chin Pang / Cheng, Yuet Wong / Yan, Bryan P

2023 Volume 10, Page(s) 1212837

Abstract: Background: During slow pathway modification for atrioventricular nodal reentrant tachycardia, heart block may occur if ablation cannot be stopped in time in response to high risk electrogram features (HREF).: Objectives: To develop an automatic ... ...

Abstract	Background: During slow pathway modification for atrioventricular nodal reentrant tachycardia, heart block may occur if ablation cannot be stopped in time in response to high risk electrogram features (HREF). Objectives: To develop an automatic algorithm to monitor HREF and terminate ablation earlier than human reaction. Methods: Digital electrogram data from 332 ablation runs from February 2020 to June 2022 were included. They were divided into training and validation sets which contained 126 and 206 ablation runs respectively. HREF in training set was measured. Then a program was developed with cutoff values decided from training set to capture all these HREF. Simulation ablation videos were rendered using validation set electrogram data. The videos were played to three independent electrophysiologists who each determined when to stop ablation. Timing of ablation termination, sensitivity, and specificity were compared between human and program. Results: Reasons for ablation termination in the training set include short AA time, short VV time, AV block and VA block. Cutoffs for the program were set to maximize program sensitivity. Sensitivity and specificity for the program in the validation set were 95.2% and 91.1% respectively, which were comparable to that of human performance at 93.5% and 95.4%. If HREF were recognized by both human and program, ablations were terminated earlier by the program 90.2% of times, by a median of 574 ms (interquartile range 412-807 ms, Conclusion: Algorithmic-driven monitoring of slow pathway modification can supplement human judgement to improve ablation safety.
Language	English
Publishing date	2023-07-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1212837
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Article ; Online: Aveir VR real-world performance and chronic pacing threshold prediction using mapping and fixation electrical data.

Tam, Mark T K / Cheng, Yuet-Wong / Chan, Joseph Y S / Chan, Chin-Pang / Au, Alex C K / Fan, Katie W S / Chim, Thomas M Y / Kwok, Wan-Ying / Fong, Fuk-Kei / Lai, Angel / Tan, Guang-Ming / Yan, Bryan P

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2024 Volume 26, Issue 3

Abstract: Aims: Aveir VR performance and predictors for its pacing threshold (PCT) in a real-world cohort were investigated.: Methods: Electrical measurements at various stages of an Aveir VR implant were prospectively collected. Predictors for 3-month PCT ... ...

Abstract	Aims: Aveir VR performance and predictors for its pacing threshold (PCT) in a real-world cohort were investigated. Methods: Electrical measurements at various stages of an Aveir VR implant were prospectively collected. Predictors for 3-month PCT were studied. A retrospective cohort of consecutive 139 Micra implants was used to compare the PCT evolution. High PCT was defined as ≥1.5 V, using a pulse width of 0.4 ms for Aveir and 0.24 ms for Micra. Excellent PCT was defined as ≤0.5 V at the respective pulse width. Results: Among the 123 consecutive Aveir VR implant attempts, 122 (99.2%) were successful. The majority were of advanced age (mean 79.7) and small body size (mean BSA 1.60). Two patients (1.6%) experienced complications, including one pericardial effusion after device reposition and one intraoperative device dislodgement. Eighty-eight patients reached a 3-month follow-up. Aveir 3-month PCT was correlated with impedance at mapping (P = 0.015), tether mode (P < 0.001), end-of-procedure (P < 0.001), and mapping PCT (P = 0.035), but not with PCTs after fixation (P > 0.05). Tether mode impedance >470 ohms had 88% sensitivity and 71% specificity in predicting excellent 3-month PCT. Although it is more common for Aveir to have high PCT at end of procedure (11.5% for Aveir and 2.2% for Micra, P = 0.004), the rate at 3 months was similar (2.3% for Aveir and 3.1% for Micra, P = 1.000). Conclusion: Aveir VR demonstrated satisfactory performance in this high-risk cohort. Pacing thresholds tend to improve to a greater extent than Micra after implantation. The PCT after fixation, even after a waiting period, has limited predictive value for the chronic threshold. Low-mapping PCT and high intraoperative impedance predict chronic low PCT.
MeSH term(s)	Humans ; Pacemaker, Artificial ; Treatment Outcome ; Retrospective Studies ; Equipment Design ; Virtual Reality ; Cardiac Pacing, Artificial/adverse effects ; Cardiac Pacing, Artificial/methods
Language	English
Publishing date	2024-03-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1449879-0
ISSN	1532-2092 ; 1099-5129
ISSN (online)	1532-2092
ISSN	1099-5129
DOI	10.1093/europace/euae051
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Article ; Online: Emergency Open-source Three-dimensional Printable Ventilator Circuit Splitter and Flow Regulator during the COVID-19 Pandemic.

Lai, Bryan K / Erian, Jennifer L / Pew, Scott H / Eckmann, Maxim S

Anesthesiology

2020 Volume 133, Issue 1, Page(s) 246–248

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/therapy ; Device Approval ; Equipment Design/methods ; Equipment and Supplies, Hospital/supply & distribution ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/therapy ; Printing, Three-Dimensional/instrumentation ; SARS-CoV-2 ; Ventilators, Mechanical/supply & distribution
Keywords	covid19
Language	English
Publishing date	2020-04-14
Publishing country	United States
Document type	Letter
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000003332
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Article: Emergency Open-source Three-dimensional Printable Ventilator Circuit Splitter and Flow Regulator during the COVID-19 Pandemic

Lai, Bryan K / Erian, Jennifer L / Pew, Scott H / Eckmann, Maxim S

Anesthesiology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32287047
Database	COVID19

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Article ; Online: Emergency Open-source Three-dimensional Printable Ventilator Circuit Splitter and Flow Regulator during the COVID-19 Pandemic

Lai, Bryan K. / Erian, Jennifer L. / Pew, Scott H. / Eckmann, Maxim S.

Anesthesiology

2020 Volume 133, Issue 1, Page(s) 246–248

Keywords	Anesthesiology and Pain Medicine ; covid19
Language	English
Publisher	Ovid Technologies (Wolters Kluwer Health)
Publishing country	us
Document type	Article ; Online
ZDB-ID	269-0
ISSN	0003-3022
ISSN	0003-3022
DOI	10.1097/aln.0000000000003332
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Article ; Online: Influence of Income, Education, and Medicaid Expansion on Palliative Care in Acute Myeloid Leukemia Using the National Cancer Database.

Chan, Bryan / Taylor, Allison O / Doucette, Kimberley / Ma, Xiaoyang / Ahn, Jaeil / Lai, Catherine

Journal of pain and symptom management

2024 Volume 67, Issue 4, Page(s) e341–e346

Abstract: Palliative care is integral to symptom management, and we examined its relationship with income, education, and Medicaid expansion in acute myeloid leukemia. This was a retrospective cross-sectional study using the National Cancer Database that included ... ...

Abstract	Palliative care is integral to symptom management, and we examined its relationship with income, education, and Medicaid expansion in acute myeloid leukemia. This was a retrospective cross-sectional study using the National Cancer Database that included patients with acute myeloid and monocytic leukemias > 18 years of age treated at Commission on Cancer facilities from 2004 to 2016. Univariate and multivariate models were adjusted for demographic variables and facility characteristics. There were 124,988 patients, but only 106,495 had palliative care data, and of this 4111 (3%) received palliative care. The most educated had the highest odds of receiving palliative care (odds ratio, OR 1.23, 95% CI 1.08-1.41; P = 0.002), but the highest income bracket (≥ $63,333) had the lowest odds (OR 0.82, 95% CI 0.72-0.93; P = 0.003). Residence in states with Medicaid expansion (January 2014 onward) had greater palliative care utilization. Palliative care use was associated with higher education but underutilized with higher incomes. Increased access with Medicaid expansion suggests the importance of public insurance.
MeSH term(s)	United States ; Humans ; Medicaid ; Palliative Care ; Cross-Sectional Studies ; Retrospective Studies ; Leukemia, Myeloid, Acute/therapy
Language	English
Publishing date	2024-01-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	639142-4
ISSN	1873-6513 ; 0885-3924
ISSN (online)	1873-6513
ISSN	0885-3924
DOI	10.1016/j.jpainsymman.2024.01.005
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Article ; Online: Enabling, Decagram-Scale Synthesis of Macrocyclic MCL-1 Inhibitor ABBV-467.

Brady, Patrick B / Sorensen, Bryan K / Risi, Roberto M / Curtin, Michael L / Mantei, Robert A / Florjancic, Alan S / Mastracchio, Anthony / Ji, Cheng / Kunzer, Aaron R / Lai, Chunqiu / Storer, Gregory E / Chan, Vincent S / Henry, Rodger F / Souers, Andrew J / Michaelides, Michael R / Judd, Andrew S / Hansen, T Matthew

The Journal of organic chemistry

2023 Volume 88, Issue 22, Page(s) 15562–15568

Abstract: ABBV-467 is a highly potent and selective MCL-1 inhibitor that was advanced to a phase I clinical trial for the treatment of multiple myeloma. Due to its large size and structural complexity, ABBV-467 is a challenging synthetic target. Herein, we ... ...

Abstract	ABBV-467 is a highly potent and selective MCL-1 inhibitor that was advanced to a phase I clinical trial for the treatment of multiple myeloma. Due to its large size and structural complexity, ABBV-467 is a challenging synthetic target. Herein, we describe the synthesis of ABBV-467 on a decagram scale, which enabled preclinical characterization. The strategy is convergent and stereoselective, featuring a hindered biaryl cross coupling, enantioselective hydrogenation, and conformationally preorganized macrocyclization by C-O bond formation as key steps.
MeSH term(s)	Antineoplastic Agents/pharmacology ; Hydrogenation ; Myeloid Cell Leukemia Sequence 1 Protein/antagonists & inhibitors
Chemical Substances	Antineoplastic Agents ; Myeloid Cell Leukemia Sequence 1 Protein
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	123490-0
ISSN	1520-6904 ; 0022-3263
ISSN (online)	1520-6904
ISSN	0022-3263
DOI	10.1021/acs.joc.3c00939
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Article ; Online: Deleterious genetic changes in AGTPBP1 result in teratozoospermia with sperm head and flagella defects.

Lin, Yu-Hua / Wang, Ya-Yun / Lai, Tsung-Hsuan / Teng, Jih-Lung / Lin, Chi-Wei / Ke, Chih-Chun / Yu, I-Shing / Lee, Hui-Ling / Chan, Chying-Chyuan / Tung, Chi-Hua / Conrad, Donald F / O'Bryan, Moira K / Lin, Ying-Hung

Journal of cellular and molecular medicine

2023 Volume 28, Issue 2, Page(s) e18031

Abstract: Approximately 10%-15% of couples worldwide are infertile, and male factors account for approximately half of these cases. Teratozoospermia is a major cause of male infertility. Although various mutations have been identified in teratozoospermia, these ... ...

Abstract	Approximately 10%-15% of couples worldwide are infertile, and male factors account for approximately half of these cases. Teratozoospermia is a major cause of male infertility. Although various mutations have been identified in teratozoospermia, these can vary among ethnic groups. In this study, we performed whole-exome sequencing to identify genetic changes potentially causative of teratozoospermia. Out of seven genes identified, one, ATP/GTP Binding Protein 1 (AGTPBP1), was characterized, and three missense changes were identified in two patients (Affected A: p.Glu423Asp and p.Pro631Leu; Affected B: p.Arg811His). In those two cases, severe sperm head and tail defects were observed. Moreover, AGTPBP1 localization showed a fragmented pattern compared to control participants, with specific localization in the neck and annulus regions. Using murine models, we found that AGTPBP1 is localized in the manchette structure, which is essential for sperm structure formation. Additionally, in Agtpbp1-null mice, we observed sperm head and tail defects similar to those in sperm from AGTPBP1-mutated cases, along with abnormal polyglutamylation tubulin and decreasing △-2 tubulin levels. In this study, we established a link between genetic changes in AGTPBP1 and human teratozoospermia for the first time and identified the role of AGTPBP1 in deglutamination, which is crucial for sperm formation.
MeSH term(s)	Humans ; Male ; Animals ; Mice ; Teratozoospermia/genetics ; Teratozoospermia/metabolism ; Tubulin/metabolism ; Semen/metabolism ; Spermatozoa/metabolism ; Sperm Head/metabolism ; Flagella/metabolism ; Infertility, Male/genetics ; Infertility, Male/metabolism ; Mutation ; GTP-Binding Proteins/metabolism ; Serine-Type D-Ala-D-Ala Carboxypeptidase/genetics ; Serine-Type D-Ala-D-Ala Carboxypeptidase/metabolism
Chemical Substances	Tubulin ; AGTPBP1 protein, human (EC 3.4.16.4) ; GTP-Binding Proteins (EC 3.6.1.-) ; Serine-Type D-Ala-D-Ala Carboxypeptidase (EC 3.4.16.4) ; Agtpbp1 protein, mouse (EC 3.4.17.-)
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article
ZDB-ID	2074559-X
ISSN	1582-4934 ; 1582-4934 ; 1582-1838
ISSN (online)	1582-4934
ISSN	1582-4934 ; 1582-1838
DOI	10.1111/jcmm.18031
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Article ; Online: Thermal Radiofrequency Ablation of the Articular Branch of the Lateral Pectoral Nerve: A Case Report and Novel Technique.

Eckmann, Maxim S / Lai, Bryan K / Uribe, Marco A / Patel, Samir / Benfield, Jonathan A

A&A practice

2019 Volume 13, Issue 11, Page(s) 415–419

Abstract: The lateral pectoral nerve (LPN) innervates anterior shoulder structures. We report a novel technique for radiofrequency ablation (RFA) of the articular branch of the LPN (abLPN) to treat persistent anterior shoulder pain. Ultrasound and fluoroscopy were ...

Abstract	The lateral pectoral nerve (LPN) innervates anterior shoulder structures. We report a novel technique for radiofrequency ablation (RFA) of the articular branch of the LPN (abLPN) to treat persistent anterior shoulder pain. Ultrasound and fluoroscopy were used to identify bony and vascular landmarks to target the midlateral and superior-lateral coracoid process (CP). Multiple thermal RFA lesions were delivered along this location without complication using a 20-gauge cannula. As a result, the patient has continued substantial relief of resting and dynamic deep anterior shoulder pain beyond 3 months. Ablation of the abLPN may provide anterior shoulder analgesia without causing motor weakness.
MeSH term(s)	Fluoroscopy ; Humans ; Male ; Middle Aged ; Radiofrequency Ablation/instrumentation ; Radiofrequency Ablation/methods ; Shoulder Pain/diagnostic imaging ; Shoulder Pain/surgery ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2019-10-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2575-3126
ISSN (online)	2575-3126
DOI	10.1213/XAA.0000000000001090
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Article ; Online: Protein arginine N-methyltransferase 4 (PRMT4) contributes to lymphopenia in experimental sepsis.

Lai, Yandong / Li, Xiuying / Li, Tiao / Li, Xiaoyun / Nyunoya, Toru / Chen, Kong / Kitsios, Georgios / Nouraie, Mehdi / Zhang, Yingze / McVerry, Bryan J / Lee, Janet S / Mallmapalli, Rama K / Zou, Chunbin

Thorax

2022 Volume 78, Issue 4, Page(s) 383–393

Abstract: Background: One hallmark of sepsis is the reduced number of lymphocytes, termed lymphopenia, that occurs from decreased lymphocyte proliferation or increased cell death contributing to immune suppression. Histone modification enzymes regulate immunity ... ...

Abstract	Background: One hallmark of sepsis is the reduced number of lymphocytes, termed lymphopenia, that occurs from decreased lymphocyte proliferation or increased cell death contributing to immune suppression. Histone modification enzymes regulate immunity by their epigenetic and non-epigenetic functions; however, the role of these enzymes in lymphopenia remains elusive. Methods: We used molecular biological approaches to investigate the high expression and function of a chromatin modulator protein arginine N-methyltransferase 4 (PRMT4)/coactivator-associated arginine methyltransferase 1 in human samples from septic patients and cellular and animal septic models. Results: We identified that PRMT4 is elevated systemically in septic patients and experimental sepsis. Gram-negative bacteria and their derived endotoxin lipopolysaccharide (LPS) increased PRMT4 in B and T lymphocytes and THP-1 monocytes. Single-cell RNA sequencing results indicate an increase of PRMT4 gene expression in activated T lymphocytes. Augmented PRMT4 is crucial for inducing lymphocyte apoptosis but not monocyte THP-1 cells. Ectopic expression of PRMT4 protein caused substantial lymphocyte death via caspase 3-mediated cell death signalling, and knockout of PRMT4 abolished LPS-mediated lymphocyte death. PRMT4 inhibition with a small molecule compound attenuated lymphocyte death in complementary models of sepsis. Conclusions: These findings demonstrate a previously uncharacterised role of a key chromatin modulator in lymphocyte survival that may shed light on devising therapeutic modalities to lessen the severity of septic immunosuppression.
MeSH term(s)	Animals ; Humans ; Arginine/genetics ; Caspase 3/genetics ; Caspase 3/immunology ; Chromatin ; Lipopolysaccharides/pharmacology ; Lymphopenia/etiology ; Lymphopenia/genetics ; Lymphopenia/immunology ; Protein-Arginine N-Methyltransferases/genetics ; Protein-Arginine N-Methyltransferases/metabolism ; Sepsis/complications ; Sepsis/genetics ; Sepsis/immunology
Chemical Substances	Arginine (94ZLA3W45F) ; Caspase 3 (EC 3.4.22.-) ; Chromatin ; coactivator-associated arginine methyltransferase 1 (EC 2.1.1.319) ; Lipopolysaccharides ; Protein-Arginine N-Methyltransferases (EC 2.1.1.319)
Language	English
Publishing date	2022-03-30
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thoraxjnl-2021-217526
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