137 results on '"Daniel Knott"'
Search Results
2. Syrian hamster convalescence from prototype SARS-CoV-2 confers measurable protection against the attenuated disease caused by the Omicron variant.
- Author
-
Kathryn A Ryan, Kevin R Bewley, Robert J Watson, Christopher Burton, Oliver Carnell, Breeze E Cavell, Amy Challis, Naomi S Coombes, Elizabeth R Davies, Jack Edun-Huges, Kirsty Emery, Rachel Fell, Susan A Fotheringham, Karen E Gooch, Kathryn Gowan, Alastair Handley, Debbie J Harris, Richard Hesp, Laura Hunter, Richard Humphreys, Rachel Johnson, Chelsea Kennard, Daniel Knott, Sian Lister, Daniel Morley, Didier Ngabo, Karen L Osman, Jemma Paterson, Elizabeth J Penn, Steven T Pullan, Kevin S Richards, Sian Summers, Stephen R Thomas, Thomas Weldon, Nathan R Wiblin, Emma L Rayner, Richard T Vipond, Bassam Hallis, Francisco J Salguero, Simon G P Funnell, and Yper Hall more...
- Subjects
Immunologic diseases. Allergy ,RC581-607 ,Biology (General) ,QH301-705.5 - Abstract
The mutation profile of the SARS-CoV-2 Omicron (lineage BA.1) variant posed a concern for naturally acquired and vaccine-induced immunity. We investigated the ability of prior infection with an early SARS-CoV-2 ancestral isolate (Australia/VIC01/2020, VIC01) to protect against disease caused by BA.1. We established that BA.1 infection in naïve Syrian hamsters resulted in a less severe disease than a comparable dose of the ancestral virus, with fewer clinical signs including less weight loss. We present data to show that these clinical observations were almost absent in convalescent hamsters challenged with the same dose of BA.1 50 days after an initial infection with ancestral virus. These data provide evidence that convalescent immunity against ancestral SARS-CoV-2 is protective against BA.1 in the Syrian hamster model of infection. Comparison with published pre-clinical and clinical data supports consistency of the model and its predictive value for the outcome in humans. Further, the ability to detect protection against the less severe disease caused by BA.1 demonstrates continued value of the Syrian hamster model for evaluation of BA.1-specific countermeasures. more...
- Published
- 2023
- Full Text
- View/download PDF
Catalog
3. A potent SARS-CoV-2 neutralising nanobody shows therapeutic efficacy in the Syrian golden hamster model of COVID-19
- Author
-
Jiandong Huo, Halina Mikolajek, Audrey Le Bas, Jordan J. Clark, Parul Sharma, Anja Kipar, Joshua Dormon, Chelsea Norman, Miriam Weckener, Daniel K. Clare, Peter J. Harrison, Julia A. Tree, Karen R. Buttigieg, Francisco J. Salguero, Robert Watson, Daniel Knott, Oliver Carnell, Didier Ngabo, Michael J. Elmore, Susan Fotheringham, Adam Harding, Lucile Moynié, Philip N. Ward, Maud Dumoux, Tessa Prince, Yper Hall, Julian A. Hiscox, Andrew Owen, William James, Miles W. Carroll, James P. Stewart, James H. Naismith, and Raymond J. Owens more...
- Subjects
Science - Abstract
Neutralizing nanobodies (Nb) are of considerable interest as therapeutic agents for COVID-19 treatment. Here, the authors functionally and structurally characterize Nbs that bind with high affinity to the receptor binding domain of the SARS-CoV-2 spike protein and show that an engineered homotrimeric Nb prevents disease progression in a Syrian hamster model of COVID-19 when administered intranasally. more...
- Published
- 2021
- Full Text
- View/download PDF
4. Comparison of rhesus and cynomolgus macaques as an infection model for COVID-19
- Author
-
Francisco J. Salguero, Andrew D. White, Gillian S. Slack, Susan A. Fotheringham, Kevin R. Bewley, Karen E. Gooch, Stephanie Longet, Holly E. Humphries, Robert J. Watson, Laura Hunter, Kathryn A. Ryan, Yper Hall, Laura Sibley, Charlotte Sarfas, Lauren Allen, Marilyn Aram, Emily Brunt, Phillip Brown, Karen R. Buttigieg, Breeze E. Cavell, Rebecca Cobb, Naomi S. Coombes, Alistair Darby, Owen Daykin-Pont, Michael J. Elmore, Isabel Garcia-Dorival, Konstantinos Gkolfinos, Kerry J. Godwin, Jade Gouriet, Rachel Halkerston, Debbie J. Harris, Thomas Hender, Catherine M. K. Ho, Chelsea L. Kennard, Daniel Knott, Stephanie Leung, Vanessa Lucas, Adam Mabbutt, Alexandra L. Morrison, Charlotte Nelson, Didier Ngabo, Jemma Paterson, Elizabeth J. Penn, Steve Pullan, Irene Taylor, Tom Tipton, Stephen Thomas, Julia A. Tree, Carrie Turner, Edith Vamos, Nadina Wand, Nathan R. Wiblin, Sue Charlton, Xiaofeng Dong, Bassam Hallis, Geoffrey Pearson, Emma L. Rayner, Andrew G. Nicholson, Simon G. Funnell, Julian A. Hiscox, Mike J. Dennis, Fergus V. Gleeson, Sally Sharpe, and Miles W. Carroll more...
- Subjects
Science - Abstract
Non-human primates are important animal models for studying SARS-CoV-2 infection. Here, Salguero et al. directly compare rhesus and cynomolgus macaques and show that both species represent COVID-19 disease of mild clinical cases, and provide a lung histopathology scoring system. more...
- Published
- 2021
- Full Text
- View/download PDF
5. Use of a Preclinical Natural Transmission Model to Study Antiviral Effects of a Carbohydrate-Binding Module Therapy against SARS-CoV-2 in Hamsters
- Author
-
Daniel Knott, Rachel Fell, Jane A. Potter, Samantha Yuille, Franscisco J. Salguero, Victoria A. Graham, Roger Hewson, David Howat, and Stuart D. Dowall
- Subjects
coronavirus ,broad spectrum ,efficacy ,prophylaxis ,Microbiology ,QR1-502 - Abstract
The emergence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) and its expansion to a worldwide pandemic resulted in efforts to assess and develop interventions to reduce the disease burden. Despite the introduction of vaccine programmes against SARS-CoV-2, global incidence levels in early 2022 remained high, demonstrating a need for the development of physiologically relevant models, which are essential for the identification of alternative antiviral strategies. The hamster model of SARS-CoV-2 infection has been widely adopted due to similarities with humans in terms of host cell entry mechanism (via ACE2), and aspects of symptomology and virus shedding. We have previously described a natural transmission hamster model that better represents the natural course of infection. In the present study, we have conducted further testing of the model using the first-in-class antiviral Neumifil, which has previously shown promise against SARS-CoV-2 after a direct intranasal challenge. Neumifil is an intranasally delivered carbohydrate-binding module (CBM) which reduces the binding of viruses to their cellular receptor. By targeting the host cell, Neumifil has the potential to provide broad protection against multiple pathogens and variants. This study demonstrates that using a combination of a prophylactic and therapeutic delivery of Neumifil significantly reduces the severity of clinical signs in animals infected via a natural route of transmission and indicates a reduction of viral loads in the upper respiratory tract. Further refinements of the model are required in order to ensure the adequate transmission of the virus. However, our results provide additional data to the evidence base of Neumifil efficacy against respiratory virus infection and demonstrate that the transmission model is a potentially valuable tool for testing antiviral compounds against SARS-CoV-2. more...
- Published
- 2023
- Full Text
- View/download PDF
6. Josephson Supercurrent through the Topological Surface States of Strained Bulk HgTe
- Author
-
Jeroen B. Oostinga, Luis Maier, Peter Schüffelgen, Daniel Knott, Christopher Ames, Christoph Brüne, Grigory Tkachov, Hartmut Buhmann, and Laurens W. Molenkamp
- Subjects
Physics ,QC1-999 - Abstract
Strained bulk HgTe is a three-dimensional topological insulator, whose surface electrons have a high mobility (∼30 000 cm^{2}/Vs), while its bulk is effectively free of mobile charge carriers. These properties enable a study of transport through its unconventional surface states without being hindered by a parallel bulk conductance. Here, we show transport experiments on HgTe-based Josephson junctions to investigate the appearance of the predicted Majorana states at the interface between a topological insulator and a superconductor. Interestingly, we observe a dissipationless supercurrent flow through the topological surface states of HgTe. The current-voltage characteristics are hysteretic at temperatures below 1 K, with critical supercurrents of several microamperes. Moreover, we observe a magnetic-field-induced Fraunhofer pattern of the critical supercurrent, indicating a dominant 2π-periodic Josephson effect in the unconventional surface states. Our results show that strained bulk HgTe is a promising material system to get a better understanding of the Josephson effect in topological surface states, and to search for the manifestation of zero-energy Majorana states in transport experiments. more...
- Published
- 2013
- Full Text
- View/download PDF
7. Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications
- Author
-
Abel P. David, Aaron L. Zebolsky, Andrea M. Park, Chase M. Heaton, P. Daniel Knott, and Rahul Seth
- Subjects
anterolateral thigh free flap ,hemostasis ,microporous polysaccharide hemospheres ,microvascular reconstruction ,randomized controlled trial ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Background Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting. Methods Prospective, single‐blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1–3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection. Results Twenty‐nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1–3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation. Level of Evidence 2 more...
- Published
- 2022
- Full Text
- View/download PDF
8. Outcomes of Vascularized Versus Nonvascularized Adipofascial Grafts for Parotidectomy Reconstruction
- Author
-
Gaelen B. Stanford-Moore, Elaine C. Thompson, Arushi Gulati, Patrick Carpenter, Andrea Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
9. Anterolateral Thigh Free Flap Versus Thigh Split Thickness Skin Graft: Comparison of Morbidity in the First 30 Days
- Author
-
Tania Benjamin, Aaron L. Zebolsky, Alexander F. Haddad, Edgar Ochoa, Karolina A. Plonowska-Hirschfeld, Andrea M. Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
10. Shorter interval between radiation therapy and salvage laryngopharyngeal surgery increases complication rates following microvascular free tissue transfer
- Author
-
Formeister, Eric J., Sean Alemi, A., El-Sayed, Ivan, George, Jonathan R., Ha, Patrick, Daniel Knott, P., Ryan, William R., Seth, Rahul, Tamplen, Matthew L., and Heaton, Chase M.
- Published
- 2018
- Full Text
- View/download PDF
11. Gender-affirming facial surgery: Anatomy and fundamentals of care
- Author
-
Tania Benjamin, P. Daniel Knott, and Rahul Seth
- Subjects
Otorhinolaryngology ,Surgery - Published
- 2023
- Full Text
- View/download PDF
12. Facial masculinization surgery
- Author
-
Neil N. Patel, Arushi Gulati, P. Daniel Knott, and Rahul Seth
- Subjects
Otorhinolaryngology ,Surgery - Published
- 2023
- Full Text
- View/download PDF
13. Chondrolaryngoplasty
- Author
-
VyVy N. Young, Rahul Seth, P. Daniel Knott, and Clark A. Rosen
- Subjects
Otorhinolaryngology ,Surgery - Published
- 2023
- Full Text
- View/download PDF
14. Glucocorticoids cause mandibular bone fragility and suppress osteocyte perilacunar-canalicular remodeling
- Author
-
A. Sean Alemi, Courtney M. Mazur, Tristan W. Fowler, Jonathon J. Woo, P. Daniel Knott, and Tamara Alliston
- Subjects
Diseases of the musculoskeletal system ,RC925-935 - Abstract
Osteocytes support dynamic, cell-intrinsic resorption and deposition of bone matrix through a process called perilacunar/canalicular remodeling (PLR). In long bones, PLR depends on MMP13 and is tightly regulated by PTH, sclerostin, TGFβ, and glucocorticoids. However, PLR is regulated differently in the cochlea, suggesting a mechanism that is anatomically distinct. Unlike long bones, the mandible derives from neural crest and exhibits unique susceptibility to medication and radiation induced osteonecrosis. Therefore, we sought to determine if PLR in the mandible is suppressed by glucocorticoids, as it is in long bone. Hemimandibles were collected from mice subcutaneously implanted with prednisolone or vehicle containing pellets for 7, 21, or 55 days (n = 8/group) for radiographic and histological analyses. Within 21 days, micro-computed tomography revealed a glucocorticoid-dependent reduction in bone volume/total volume and trabecular thickness and a significant decrease in bone mineral density after 55 days. Within 7 days, glucocorticoids strongly and persistently repressed osteocytic expression of the key PLR enzyme MMP13 in both trabecular and cortical bone of the mandible. Cathepsin K expression was significantly reduced only after 55 days of glucocorticoid treatment, at which point histological analysis revealed a glucocorticoid-dependent reduction in the lacunocanalicular surface area. In addition to reducing bone mass and suppressing PLR, glucocorticoids also reduced the stiffness of mandibular bone in flexural tests. Thus, osteocyte PLR in the neural crest-derived mandible is susceptible to glucocorticoids, just as it is in the mesodermally-derived femur, highlighting the need to further study PLR as a target of drugs, and radiation in mandibular osteonecrosis. Keywords: Osteocyte, Perilacunar/canalicular remodeling, Mandible, Glucocorticoids more...
- Published
- 2018
- Full Text
- View/download PDF
15. High-Yield Purification, Preservation, and Serial Transplantation of Human Satellite Cells
- Author
-
Steven M. Garcia, Stanley Tamaki, Solomon Lee, Alvin Wong, Anthony Jose, Joanna Dreux, Gayle Kouklis, Hani Sbitany, Rahul Seth, P. Daniel Knott, Chase Heaton, William R. Ryan, Esther A. Kim, Scott L. Hansen, William Y. Hoffman, and Jason H. Pomerantz more...
- Subjects
Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Summary: Investigation of human muscle regeneration requires robust methods to purify and transplant muscle stem and progenitor cells that collectively constitute the human satellite cell (HuSC) pool. Existing approaches have yet to make HuSCs widely accessible for researchers, and as a result human muscle stem cell research has advanced slowly. Here, we describe a robust and predictable HuSC purification process that is effective for each human skeletal muscle tested and the development of storage protocols and transplantation models in dystrophin-deficient and wild-type recipients. Enzymatic digestion, magnetic column depletion, and 6-marker flow-cytometric purification enable separation of 104 highly enriched HuSCs per gram of muscle. Cryostorage of HuSCs preserves viability, phenotype, and transplantation potential. Development of enhanced and species-specific transplantation protocols enabled serial HuSC xenotransplantation and recovery. These protocols and models provide an accessible system for basic and translational investigation and clinical development of HuSCs. : Garcia and colleagues report methods for efficient purification of satellite cells from human skeletal muscle. They use their approaches to demonstrate stem cell functions of endogenous satellite cells and to make human satellite cells accessible for sharing among researchers. Keywords: human satellite cell purification, serial transplantation, satellite cell cryopreservation more...
- Published
- 2018
- Full Text
- View/download PDF
16. Restarting Therapeutic Antibiotics Following Postoperative Prophylaxis in Head and Neck Microvascular Free Tissue Transfer
- Author
-
Karolina A, Plonowska-Hirschfeld, Aaron L, Zebolsky, Michael M, Lindeborg, Christian, McNeill, P Daniel, Knott, Rahul, Seth, Andrea M, Park, and Chase M, Heaton
- Subjects
Otorhinolaryngology ,Surgery - Abstract
To determine factors associated with restarting therapeutic antibiotics within 30 days of head and neck microvascular free tissue transfer (HN-MFTT).Retrospective study of consecutive HN-MFTTs performed from January 2015 to July 2020.Tertiary academic medical center.Thirty-day postoperative antibiotic use and post-HN-MFTT surgical and medical complications were assessed. Univariable analyses and multivariable logistic regression were used to evaluate risk factors associated with restarting antibiotics.overall 482 patients with 501 HN-MFTTs were stratified by duration of prophylaxis: ≤24 hours (n = 136, 27.1%), 25-72 hours (n = 54, 10.8%), and72 hours (n = 311, 62.1%). Antibiotics were restarted in 199 patients (209 procedures, 42%). The most common indications for antibiotic reinitiation were flap recipient site infection (n = 59, 28%); hospital-acquired pneumonia (n = 44, 21%); and wound dehiscence, fluctuance, or change in quality of drain output (n = 44, 21%). Shorter antibiotic prophylaxis (≤24 hours) (odds ratio [OR], 1.95; 95% CI, 1.2-3.0;Aerodigestive reconstruction, 24-hour postoperative antimicrobial prophylaxis, American Society of Anesthesiologists class 3 and 4, prior chemotherapy/immunotherapy, cardiovascular disease, and osteocutaneous flaps are associated with reinitiation of antibiotics within 30 days of HN-MFTT. more...
- Published
- 2022
- Full Text
- View/download PDF
17. Hepatitis C as a Potential Risk Factor for Adverse Surgical Outcomes in Head and Neck Free Tissue Transfer Reconstruction
- Author
-
Phillip Daniel Knott, Madeleine P. Strohl, Rahul Seth, Jacquelyn K. Callander, Chase M. Heaton, and Andrea M. Park
- Subjects
Oncology ,medicine.medical_specialty ,Hepatitis C virus ,Hepacivirus ,medicine.disease_cause ,Postoperative Complications ,Risk Factors ,Internal medicine ,medicine ,Humans ,Head and neck ,Retrospective Studies ,Potential risk ,business.industry ,Head and neck cancer ,food and beverages ,Hepatitis C ,Plastic Surgery Procedures ,medicine.disease ,Tissue transfer ,Treatment Outcome ,Increased risk ,Head and Neck Neoplasms ,Surgery ,business - Abstract
Background: Infection with hepatitis C virus (HCV) is associated with an increased risk of developing head and neck cancer (HNC), and negatively impacts cancer-specific survival. Objective: To meas... more...
- Published
- 2022
- Full Text
- View/download PDF
18. Utility of Microporous Polysaccharide Hemosphere on Anterolateral Thigh Free Flap Donor Site Complications
- Author
-
Rahul Seth, Abel P. David, Andrea M. Park, Elizabeth A. Shuman, Chase M. Heaton, P. Daniel Knott, Tania Benjamin, and Aaron L. Zebolsky
- Subjects
medicine.medical_specialty ,Reconstructive surgery ,business.industry ,food and beverages ,Free flap ,Microporous material ,Anterolateral thigh ,Free Tissue Flaps ,Surgery ,Tissue transfer ,Seroma ,Treatment Outcome ,Head and Neck Neoplasms ,Polysaccharides ,medicine ,Humans ,Prospective Studies ,Head and neck ,business ,Retrospective Studies - Abstract
Background: Anterolateral thigh (ALT) microvascular free tissue transfer is an integral part of head and neck reconstructive surgery, but it can be complicated by postoperative donor site fluid col... more...
- Published
- 2022
- Full Text
- View/download PDF
19. Sex-Related Characteristics of the Face
- Author
-
Arushi, Gulati, P Daniel, Knott, and Rahul, Seth
- Subjects
Male ,Otorhinolaryngology ,Face ,Gender Identity ,Humans ,Feminization ,General Medicine - Abstract
The face is central to individual identity and gender presentation. Sex-based differences are seen at nearly every component of the face, from craniofacial structure to skin and soft tissue distribution. This article provides a framework for identification and analysis of sex-based differences in facial anatomy. This can then be used to guide individualized approaches to surgical planning to create greater congruence between patients' existing physical features and goals for gender expression. more...
- Published
- 2022
- Full Text
- View/download PDF
20. The Impact of Venous Anastomosis Technique on Outcomes of Free Tissue Transfer to the Head and Neck
- Author
-
Shayan Fakurnejad, Arushi Gulati, Gaelen B. Stanford-Moore, Andrea M. Park, Chase M. Heaton, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
21. Assessing the Prevalence of Burnout Among Female Microvascular Head and Neck Surgeons
- Author
-
Tania Benjamin, Arushi Gulati, Aaron L. Zebolsky, Rahul Seth, P. Daniel Knott, Oluwafunmilola Okuyemi, and Andrea M. Park
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
22. Through a New Lens: Skin-Grafted Free Flaps and Objective Facial Skin Color Matching
- Author
-
Neil N. Patel, Arushi Gulati, Aaron Lee Zebolsky, Andrea M. Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
23. Outcomes Associated with Multiple Free Tissue Transfers Performed in a Single Day
- Author
-
Arushi Gulati, Chase M. Heaton, Andrea M. Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
24. Patient-Reported Outcomes in Gender-Affirming Facial Surgery: Recommendations from a Multidisciplinary Gender Health Panel
- Author
-
Aaron L. Zebolsky, Arushi Gulati, Ryan K. Badiee, Seth T. Pardo, Madeline B. Deutsch, P. Daniel Knott, Andrea M. Park, Jason H. Pomerantz, William Y. Hoffman, and Rahul Seth
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
25. Patterns of Postoperative Trismus Following Mandibulectomy and Fibula Free Flap Reconstruction
- Author
-
Rex H. Lee, Cara Evans, Joey Laus, Cristina Sanchez, Katherine C. Wai, P. Daniel Knott, Rahul Seth, Ivan H. El-Sayed, Jonathan R. George, William R. Ryan, Chase M. Heaton, Andrea M. Park, and Patrick K. Ha more...
- Subjects
Cancer Research ,Oncology ,trismus ,mouth opening ,mandibulectomy ,fibula free flap ,postoperative ,ramus ,MIO ,interincisal opening ,head and neck ,survivorship - Abstract
The factors that contribute to postoperative trismus after mandibulectomy and fibula free flap reconstruction (FFFR) are undefined. We retrospectively assessed postoperative trismus (defined as a maximum interincisal opening ≤35 mm) in 106 patients undergoing mandibulectomy with FFFR, employing logistic regression to identify risk factors associated with this sequela. The surgical indication was primary ablation in 64%, salvage for recurrence in 24%, and osteonecrosis in 12%. Forty-five percent of patients had existing preoperative trismus, and 58% of patients received adjuvant radiation/chemoradiation following surgery. The overall rates of postoperative trismus were 76% in the early postoperative period (≤3 months after surgery) and 67% in the late postoperative period (>6 months after surgery). Late postoperative trismus occurred more frequently in patients with ramus-involving vs. ramus-preserving posterior mandibulotomies (82% vs. 46%, p = 0.004). A ramus-involving mandibulotomy was the only variable significantly associated with trismus >6 months postoperatively on multivariable logistic regression (OR, 7.94; 95% CI, 1.85–33.97; p = 0.005). This work demonstrates that trismus is common after mandibulectomy and FFFR, and suggests that posterior mandibulotomies that involve or remove the ramus may predispose to a higher risk of persistent postoperative trismus. more...
- Published
- 2023
- Full Text
- View/download PDF
26. Satisfaction and Quality of Life Following Gender-Affirming Facial Surgery
- Author
-
Arushi Gulati, Aaron L. Zebolsky, Neil Patel, Seth Pardo, Madeline B. Deutsch, Andrea M. Park, P. Daniel Knott, and Rahul Seth
- Subjects
Surgery - Published
- 2023
- Full Text
- View/download PDF
27. Skin Color Match in Head and Neck Reconstructive Surgery
- Author
-
Philip Daniel Knott, Sean A. Alemi, Mary Han, Rahul Seth, Andrea M. Park, Chase M. Heaton, Roy C. Grekin, Sarah T. Arron, Isaac Neuhaus, Siegrid S. Yu, Drew K. Saylor, and Bovey Z. Zhu
- Subjects
Adult ,Cross-Sectional Studies ,Otorhinolaryngology ,Humans ,Skin Pigmentation ,Skin Transplantation ,Plastic Surgery Procedures ,Free Tissue Flaps - Abstract
To quantify the degree of color match achieved during microvascular facial reconstruction, and to describe a novel technique for improving reconstructive skin color match. We hypothesize that split-thickness skin grafts (STSG) placed atop de-epithelialized free tissue produces better facial skin color match than free tissue with intact epithelium.Cross sectional photographic study of reconstructed facial skin color match.Sixty-eight adults, who underwent head and neck reconstructive surgery, were divided into six categories based on cutaneous reconstructive technique: cervicofacial flap, radial forearm free flap (RFFF), fibula free flap, anterolateral thigh free flap (ALT), STSG over adiopofascial flap (STAFF), and STSG over myogenous flap (STMF). Averaged color samplings of the reconstructed defect and adjacent normal skin were taken from digital photographs. The color difference was calculated using the delta-E calculation. Blinded expert observers also rated the degree of color match. Nonparametric cohort contrast and correlation statistical analyses were performed.The mean delta-E's and 10-point Likert ratings for the ALT, fibula, RFFF, STAFF, STMF, and cervicofacial flaps were 11.6, 10.0, 7.7, 6.3, 8.8, and 4.7, and 5.1, 6.4, 2.4, 3.2, 2.7, and 1.1, respectively. Likert scale inter-rater correlation was strong, with coefficient = 0.80.On average, STSG over de-epithelialized myogenous and adipofascial free tissue transfers produced a better color match than the skin paddles of donor sites, with the exception of the radial forearm donor site. Delta-E values obtained from photos correlated well with expert ratings of color match. This reliable technique for quantifying color match may be used in future studies.3 Laryngoscope, 132:1753-1759, 2022. more...
- Published
- 2021
- Full Text
- View/download PDF
28. Human Satellite Cell Transplantation and Regeneration from Diverse Skeletal Muscles
- Author
-
Xiaoti Xu, Karlijn J. Wilschut, Gayle Kouklis, Hua Tian, Robert Hesse, Catharine Garland, Hani Sbitany, Scott Hansen, Rahul Seth, P. Daniel Knott, William Y. Hoffman, and Jason H. Pomerantz
- Subjects
Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Identification of human satellite cells that fulfill muscle stem cell criteria is an unmet need in regenerative medicine. This hurdle limits understanding how closely muscle stem cell properties are conserved among mice and humans and hampers translational efforts in muscle regeneration. Here, we report that PAX7 satellite cells exist at a consistent frequency of 2–4 cells/mm of fiber in muscles of the human trunk, limbs, and head. Xenotransplantation into mice of 50–70 fiber-associated, or 1,000–5,000 FACS-enriched CD56+/CD29+ human satellite cells led to stable engraftment and formation of human-derived myofibers. Human cells with characteristic PAX7, CD56, and CD29 expression patterns populated the satellite cell niche beneath the basal lamina on the periphery of regenerated fibers. After additional injury, transplanted satellite cells robustly regenerated to form hundreds of human-derived fibers. Together, these findings conclusively delineate a source of bona-fide endogenous human muscle stem cells that will aid development of clinical applications. more...
- Published
- 2015
- Full Text
- View/download PDF
29. Objective Outcomes of Trichophytic Brow Lift and Hairline Advancement in Facial Feminization Surgery
- Author
-
Abel P. David, Adrian E. House, Sonia Targ, Andrea M. Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2022
- Full Text
- View/download PDF
30. Long-Term Appearance-Related Outcomes of Facial Reconstruction After Skin Cancer Resection
- Author
-
Arushi Gulati, Roy Grekin, Isaac Neuhaus, Drew Saylor, Siegrid Yu, Andrea Park, Rahul Seth, and P. Daniel Knott
- Subjects
Surgery - Published
- 2022
- Full Text
- View/download PDF
31. A potent SARS-CoV-2 neutralising nanobody shows therapeutic efficacy in the Syrian golden hamster model of COVID-19
- Author
-
Robert J. Watson, Oliver Carnell, Jordan J. Clark, Francisco J. Salguero, Tessa Prince, William James, Michael J. Elmore, Miriam Weckener, Philip N. Ward, Audrey Le Bas, Chelsea Norman, Susan A. Fotheringham, Raymond J. Owens, Yper Hall, Parul Sharma, James H. Naismith, Adam Harding, Karen R. Buttigieg, Andrew Owen, Peter J. Harrison, Lucile Moynié, Jiandong Huo, Anja Kipar, Miles W. Carroll, Daniel K. Clare, James P. Stewart, Didier Ngabo, H. Mikolajek, Daniel Knott, Maud Dumoux, Joshua Dormon, Julia A. Tree, and Julian A. Hiscox more...
- Subjects
Male ,medicine.medical_treatment ,Science ,Mutant ,Intraperitoneal injection ,Dose-Response Relationship, Immunologic ,General Physics and Astronomy ,Hamster ,Alpha (ethology) ,Crystallography, X-Ray ,Article ,General Biochemistry, Genetics and Molecular Biology ,Epitope ,Epitopes ,Neutralization Tests ,medicine ,Antibody fragment therapy ,Animals ,Administration, Intranasal ,X-ray crystallography ,Multidisciplinary ,Mesocricetus ,biology ,SARS-CoV-2 ,Chemistry ,Cryoelectron Microscopy ,General Chemistry ,Single-Domain Antibodies ,biology.organism_classification ,Antibodies, Neutralizing ,Virology ,COVID-19 Drug Treatment ,Disease Models, Animal ,Spike Glycoprotein, Coronavirus ,biology.protein ,Female ,Antibody ,Golden hamster - Abstract
SARS-CoV-2 remains a global threat to human health particularly as escape mutants emerge. There is an unmet need for effective treatments against COVID-19 for which neutralizing single domain antibodies (nanobodies) have significant potential. Their small size and stability mean that nanobodies are compatible with respiratory administration. We report four nanobodies (C5, H3, C1, F2) engineered as homotrimers with pmolar affinity for the receptor binding domain (RBD) of the SARS-CoV-2 spike protein. Crystal structures show C5 and H3 overlap the ACE2 epitope, whilst C1 and F2 bind to a different epitope. Cryo Electron Microscopy shows C5 binding results in an all down arrangement of the Spike protein. C1, H3 and C5 all neutralize the Victoria strain, and the highly transmissible Alpha (B.1.1.7 first identified in Kent, UK) strain and C1 also neutralizes the Beta (B.1.35, first identified in South Africa). Administration of C5-trimer via the respiratory route showed potent therapeutic efficacy in the Syrian hamster model of COVID-19 and separately, effective prophylaxis. The molecule was similarly potent by intraperitoneal injection., Neutralizing nanobodies (Nb) are of considerable interest as therapeutic agents for COVID-19 treatment. Here, the authors functionally and structurally characterize Nbs that bind with high affinity to the receptor binding domain of the SARS-CoV-2 spike protein and show that an engineered homotrimeric Nb prevents disease progression in a Syrian hamster model of COVID-19 when administered intranasally. more...
- Published
- 2021
32. Facial Reanimation and Reconstruction of the Radical Parotidectomy
- Author
-
Abel P. David, Philip Daniel Knott, and Rahul Seth
- Subjects
medicine.medical_specialty ,business.industry ,Motor nerve ,Free flap ,Plastic Surgery Procedures ,medicine.disease ,Free Tissue Flaps ,Facial nerve ,Parotid Neoplasms ,Surgery ,body regions ,Radical parotidectomy ,medicine.anatomical_structure ,Atrophy ,Thigh ,Facial reanimation ,Fascia lata ,medicine ,Humans ,Parotid Gland ,Muscle transfer ,business - Abstract
Radical parotidectomy may result from treating advanced parotid malignancies invading the facial nerve. Survival is often enhanced with multimodality treatment protocols, including postoperative radiation therapy. In addition to the reconstructive challenge of restoring facial nerve function, patients may be left with a significant cervicofacial concavity and inadequate skin coverage. This should be addressed with stable vascularized tissue that is resistant to radiation-induced atrophy. This article describes a comprehensive strategy, includes the use of the anterolateral thigh free flap, the temporalis regional muscle transfer, motor nerve to vastus lateralis grafts, nerve to masseter transfer, and fascia lata grafts for static suspension. more...
- Published
- 2021
- Full Text
- View/download PDF
33. Introduction
- Author
-
P. Daniel Knott and Rahul Seth
- Subjects
Otorhinolaryngology ,Surgery - Published
- 2023
- Full Text
- View/download PDF
34. Mentalis Muscle Imbrication Mentoplasty for Chin Cleft Reduction and Chin Narrowing
- Author
-
Abel P. David, P. Daniel Knott, and Rahul Seth
- Subjects
Chin ,Genioplasty ,Facial Muscles ,Humans ,Surgery - Published
- 2022
35. Laryngopharyngeal Repair in Salvage Laryngectomy
- Author
-
Bearelly, Shethal, Heaton, Chase M., Seth, Rahul, and Daniel Knott, P.
- Published
- 2016
- Full Text
- View/download PDF
36. Comparison of rhesus and cynomolgus macaques as an infection model for COVID-19
- Author
-
Nadina Wand, Irene Taylor, Didier Ngabo, Vanessa Lucas, Rebecca Cobb, Rachel Halkerston, Susan A. Fotheringham, Stephanie Leung, Alexandra L. Morrison, Tom Tipton, Holly E. Humphries, Bassam Hallis, Phillip Brown, Kerry J Godwin, Stephen Thomas, Isabel García-Dorival, Emily Brunt, Robert J. Watson, Thomas Hender, Charlotte Nelson, Laura Hunter, Andrew White, Gillian S. Slack, Michael J. Elmore, Owen Daykin-Pont, Nathan R Wiblin, Miles W. Carroll, Breeze E. Cavell, Charlotte Sarfas, Simon G. P. Funnell, Francisco J. Salguero, Karen R. Buttigieg, Carrie Turner, Kevin R. Bewley, Jade Gouriet, Yper Hall, Marilyn Aram, Kathryn A. Ryan, Adam Mabbutt, Steve Pullan, Konstantinos Gkolfinos, Julia A. Tree, Geoffrey Pearson, Lauren Allen, Debbie J Harris, Andrew G. Nicholson, Sue Charlton, Alistair C. Darby, Naomi Coombes, Edith Vamos, Daniel Knott, Karen E. Gooch, Catherine M K Ho, Stephanie Longet, Chelsea L Kennard, Julian A. Hiscox, Xiaofeng Dong, Jemma Paterson, Mike Dennis, Emma Rayner, Fergus V. Gleeson, Elizabeth J Penn, Sally Sharpe, and Laura Sibley more...
- Subjects
0301 basic medicine ,Male ,Science ,Population ,General Physics and Astronomy ,medicine.disease_cause ,Macaque ,General Biochemistry, Genetics and Molecular Biology ,Article ,Pathogenesis ,03 medical and health sciences ,Interferon-gamma ,0302 clinical medicine ,Immune system ,Immunity ,biology.animal ,Medicine ,Animals ,030212 general & internal medicine ,education ,Lung ,Pandemics ,Coronavirus ,education.field_of_study ,Immunity, Cellular ,Multidisciplinary ,biology ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Chemistry ,Translational research ,Macaca mulatta ,respiratory tract diseases ,Disease Models, Animal ,Macaca fascicularis ,030104 developmental biology ,medicine.anatomical_structure ,Viral infection ,Immunology ,Female ,business ,Respiratory tract - Abstract
A novel coronavirus, SARS-CoV-2, has been identified as the causative agent of the current COVID-19 pandemic. Animal models, and in particular non-human primates, are essential to understand the pathogenesis of emerging diseases and to assess the safety and efficacy of novel vaccines and therapeutics. Here, we show that SARS-CoV-2 replicates in the upper and lower respiratory tract and causes pulmonary lesions in both rhesus and cynomolgus macaques. Immune responses against SARS-CoV-2 are also similar in both species and equivalent to those reported in milder infections and convalescent human patients. This finding is reiterated by our transcriptional analysis of respiratory samples revealing the global response to infection. We describe a new method for lung histopathology scoring that will provide a metric to enable clearer decision making for this key endpoint. In contrast to prior publications, in which rhesus are accepted to be the preferred study species, we provide convincing evidence that both macaque species authentically represent mild to moderate forms of COVID-19 observed in the majority of the human population and both species should be used to evaluate the safety and efficacy of interventions against SARS-CoV-2. Importantly, accessing cynomolgus macaques will greatly alleviate the pressures on current rhesus stocks., Non-human primates are important animal models for studying SARS-CoV-2 infection. Here, Salguero et al. directly compare rhesus and cynomolgus macaques and show that both species represent COVID-19 disease of mild clinical cases, and provide a lung histopathology scoring system. more...
- Published
- 2021
37. Temporalis Tendon Transfer/Lengthening Temporalis Myoplasty for Midfacial Static and Dynamic Reanimation After Head and Neck Oncologic Surgery
- Author
-
Mary Han, P. Daniel Knott, Adrian E House, Andrea M. Park, Rahul Seth, and Madeleine P. Strohl
- Subjects
Temporalis tendon ,medicine.medical_specialty ,Facial Paralysis ,Tendon Transfer ,Video Recording ,Temporal Muscle ,Smiling ,Oncologic surgery ,Postoperative Complications ,Photography ,Paralysis ,medicine ,Humans ,Head and neck ,Aged ,business.industry ,Head and neck cancer ,Sequela ,Plastic Surgery Procedures ,medicine.disease ,Facial nerve ,Surgery ,Facial Expression ,stomatognathic diseases ,Tenotomy ,Head and Neck Neoplasms ,Female ,medicine.symptom ,business - Abstract
Importance: Facial nerve paralysis is an unfortunate, yet relatively common sequela in the treatment of head and neck cancer. Static options for reanimation of the paralyzed midface and oral commis... more...
- Published
- 2021
- Full Text
- View/download PDF
38. Head and neck surgery during the coronavirus‐19 pandemic: The University of California San Francisco experience
- Author
-
P. Daniel Knott, Chase M. Heaton, Rahul Seth, Ivan H. El-Sayed, William R. Ryan, Katherine C. Wai, Patrick K. Ha, Jonathan R. George, Andrea M. Park, Mary Jue Xu, and Rex H. Lee
- Subjects
Adult ,Male ,Reconstructive surgery ,medicine.medical_specialty ,Databases, Factual ,Otorhinolaryngologic Surgical Procedures ,medicine.medical_treatment ,Operative Time ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Parotid Gland ,030223 otorhinolaryngology ,Aged ,Retrospective Studies ,business.industry ,Head and neck cancer ,Thyroidectomy ,COVID-19 ,Neck dissection ,Retrospective cohort study ,Perioperative ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Neck Dissection ,Female ,San Francisco ,Complication ,business - Abstract
Background Guidelines regarding head and neck surgical care have evolved during the coronavirus-19 (COVID-19) pandemic. Data on operative management have been limited. Methods We compared two cohorts of patients undergoing head and neck or reconstructive surgery between March 16, 2019 and April 16, 2019 (pre-COVID-19) and March 16, 2020 and April 16, 2020 (COVID-19) at an academic center. Perioperative, intraoperative, and postoperative outcomes were recorded. Results There were 63 operations during COVID-19 and 84 operations during pre-COVID-19. During COVID-19, a smaller proportion of patients had benign pathology (12% vs 20%, respectively) and underwent thyroid procedures (2% vs 23%) while a greater proportion of patients underwent microvascular reconstruction±ablation (24% vs 12%,). Operative times increased, especially among patients undergoing microvascular reconstruction±ablation (687 ± 112 vs 596 ± 91 minutes, P = .04). Complication rates and length of stay were similar. Conclusions During COVID-19, perioperative outcomes were similar, operative time increased, and there were no recorded transmissions to staff or patients. Continued surgical management of head and neck cancer patients can be provided safely. more...
- Published
- 2020
- Full Text
- View/download PDF
39. Long-Term Stability of Vascularized Adipofascial Flaps in Facial Reconstruction
- Author
-
Adrian E House, P. Daniel Knott, Chase M. Heaton, Andrea M. Park, Rahul Seth, Jaqueline C Junn, and Madeleine P. Strohl
- Subjects
Adult ,Male ,medicine.medical_specialty ,Subcutaneous Fat ,Volume change ,Free Tissue Flaps ,medicine ,Humans ,Fascia ,skin and connective tissue diseases ,Aged ,Retrospective Studies ,Patient factors ,Aged, 80 and over ,business.industry ,Middle Aged ,Plastic Surgery Procedures ,Anterolateral thigh ,Term (time) ,Surgery ,Treatment Outcome ,Thigh ,Facial reconstruction ,Head and Neck Neoplasms ,Face ,Linear Models ,Female ,sense organs ,business ,Follow-Up Studies - Abstract
Objectives: To determine the quantitative volume change over time of vascularized adipofascial anterolateral thigh (AFALT) free flaps in facial reconstruction, and to evaluate patient factors that ... more...
- Published
- 2020
- Full Text
- View/download PDF
40. Objective Photoanalysis of Feminizing Frontal Cranioplasty Outcomes
- Author
-
Abel P. David, Adrian E. House, Sonia Targ, W. Taylor DeBusk, Andrea Park, P. Daniel Knott, and Rahul Seth
- Subjects
Otorhinolaryngology ,Surgery ,Oral Surgery - Abstract
Study Design Retrospective analysis at a tertiary care center. Objective This study describes a method of analyzing postoperative results using lateral view clinical photographs to create normalized projection ratios of the glabella and radix. Methods We reviewed preoperative and postoperative photographs of 15 patients. All photographs were in the lateral view Frankfort horizontal plane. We calculated the distances between the (a) tragus and cornea, (b) cornea and radix, (c) cornea and glabella, and the (θ) nasofrontal angle. Results Fifteen sets of patient photographs were analyzed and found that there was a favorable 14% reduction at the radix and an even greater reduction (78.9%) at the glabella. The nasofrontal angle was improved to a more feminine range from 131.84° preoperatively to 145.86° postoperatively. Conclusions Normalized projection ratios of the glabella and radix, along with the nasofrontal angle, can be used to objectively measure outcomes of frontal feminizing cranioplasty. more...
- Published
- 2023
- Full Text
- View/download PDF
41. Convalescence from prototype SARS-CoV-2 protects Syrian hamsters from disease caused by the Omicron variant
- Author
-
Kathryn A. Ryan, Robert J. Watson, Kevin R. Bewley, Christopher Burton, Oliver Carnell, Breeze E. Cavell, Amy Challis, Naomi S. Coombes, Kirsty Emery, Rachel Fell, Susan A. Fotheringham, Karen E. Gooch, Kathryn Gowan, Alastair Handley, Debbie J. Harris, Richard Humphreys, Rachel Johnson, Daniel Knott, Sian Lister, Daniel Morley, Didier Ngabo, Karen L. Osman, Jemma Paterson, Elizabeth J. Penn, Steven T. Pullan, Kevin S. Richards, Imam Shaik, Sian Summers, Stephen R. Thomas, Thomas Weldon, Nathan R. Wiblin, Richard Vipond, Bassam Hallis, Simon G. P. Funnell, and Yper Hall more...
- Abstract
The mutation profile of the SARS-CoV-2 Omicron variant poses a concern for naturally acquired and vaccine-induced immunity. We investigated the ability of prior infection with an early SARS-CoV-2, 99.99% identical to Wuhan-Hu-1, to protect against disease caused by the Omicron variant. We established that infection with Omicron in naïve Syrian hamsters resulted in a less severe disease than a comparable dose of prototype SARS-CoV-2 (Australia/VIC01/2020), with fewer clinical signs and less weight loss. We present data to show that these clinical observations were almost absent in convalescent hamsters challenged with the same dose of Omicron 50 days after an initial infection with Australia/VIC01/2020. The data provide evidence for immunity raised against prototype SARS-CoV-2 being protective against Omicron in the Syrian hamster model. Further investigation is required to conclusively determine whether Omicron is less pathogenic in Syrian hamsters and whether this is predictive of pathogenicity in humans. more...
- Published
- 2021
- Full Text
- View/download PDF
42. Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications
- Author
-
Abel P. David, Aaron L. Zebolsky, Andrea M. Park, Chase M. Heaton, P. Daniel Knott, and Rahul Seth
- Subjects
General Medicine - Abstract
Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction. The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting.Prospective, single-blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1-3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection.Twenty-nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation.Level of Evidence 2. more...
- Published
- 2021
43. Sex Differences in Adult Facial Three-Dimensional Morphology: Application to Gender-Affirming Facial Surgery
- Author
-
Jordan J. Bannister, Hailey Juszczak, Jose David Aponte, David C. Katz, P. Daniel Knott, Seth M. Weinberg, Benedikt Hallgrímsson, Nils D. Forkert, and Rahul Seth
- Subjects
Adult ,Male ,Biological Products ,Sex Characteristics ,Face ,Sex Reassignment Surgery ,Gender Identity ,Humans ,Female ,Surgery - Published
- 2022
- Full Text
- View/download PDF
44. Clinical Feasibility and Efficacy of the Externally Scarless Transoral Chondrolaryngoplasty
- Author
-
Abel P. David, P. Daniel Knott, Clark A. Rosen, VyVy N. Young, Andrea M. Park, and Rahul Seth
- Subjects
Dissection ,Feasibility Studies ,Humans ,Surgery - Published
- 2022
- Full Text
- View/download PDF
45. Gender-Affirming Facial Surgery: Experiences and Outcomes at an Academic Center
- Author
-
Jacqueline A. Wulu, P. Daniel Knott, Tania Benjamin, Rahul Seth, Madeleine A. Salesky, Aaron L. Zebolsky, and Andrea M. Park
- Subjects
Adult ,Male ,medicine.medical_specialty ,Surgical approach ,business.industry ,Middle Aged ,humanities ,Surgery ,Young Adult ,Treatment Outcome ,Face ,Transgender ,Sex Reassignment Surgery ,Medicine ,Humans ,Center (algebra and category theory) ,Female ,business ,Gender Dysphoria ,Aged ,Follow-Up Studies ,Retrospective Studies - Abstract
Background: Gender-affirming facial surgery (GFS) is becoming more widely available for transgender individuals, but data on surgical approaches and outcomes remain limited. Methods: Retrospective ... more...
- Published
- 2021
46. Smile Outcomes of an Externally Scarless, Intraoral Orthodromic Temporalis Tendon Transfer
- Author
-
Philip Daniel Knott, Andrea M. Park, Aaron L. Zebolsky, Rahul Seth, and Neil N. Patel
- Subjects
Temporalis tendon ,Orthodontics ,business.industry ,education ,Facial Paralysis ,Tendon Transfer ,Temporal Muscle ,Plastic Surgery Procedures ,Nasolabial fold ,Smiling ,medicine.anatomical_structure ,Facial reanimation ,medicine ,Humans ,Surgery ,business ,Orthodromic - Abstract
Background: Temporalis tendon transfer (TTT) often relies on external incisions in the nasolabial fold, temporal region, or both. Herein, we studied smile outcomes of a TTT technique via a single i... more...
- Published
- 2021
47. An update in facial gender confirming surgery
- Author
-
Andrea M. Park, Rahul Seth, P. Daniel Knott, Hailey M Juszczak, and Zachary C. Fridirici
- Subjects
Male ,medicine.medical_specialty ,Coping (psychology) ,MEDLINE ,Transgender Persons ,Dysphoria ,Facial feminization surgery ,03 medical and health sciences ,0302 clinical medicine ,Transgender ,Sex Reassignment Surgery ,medicine ,Humans ,030223 otorhinolaryngology ,Social stress ,Gender identity ,business.industry ,Gender Identity ,Surgical training ,Surgery ,Otorhinolaryngology ,Face ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,business - Abstract
Purpose of review To summarize current surgical and nonsurgical approaches to facial gender confirming surgery (FGCS) and highlight standards of care and areas of future research. Recent findings Gender nonconforming individuals may encounter considerable internal coping and external social stressors that may contribute to gender-associated dysphoria. FGCS provides patients the ability to align facial appearance with gender identity, using recently described advances in surgical and nonsurgical techniques. The majority of FGCS is performed on transwomen (individuals identifying as female), yielding the more common term of facial feminization surgery (FFS). Although no set protocols or standards are in place, certain procedures are commonly performed to alter sex-determining characteristics of the face, and further research may help define guidelines. As many training programs have minimal exposure to FGCS, promotion of transgender health awareness is paramount for diverse and inclusive surgical training. Summary Although demand for FGCS is increasing, there remains a need for improving surgical approaches, developing evidence-based care guidelines, and implementing education and awareness in training programs. more...
- Published
- 2019
- Full Text
- View/download PDF
48. Surveillance Imaging Following Head and Neck Cancer Treatment and Microvascular Reconstruction
- Author
-
Chase M. Heaton, Adrian E House, Ilya Likhterov, Aaron L. Zebolsky, Joanna Jacobs, Rahul Seth, Christine M. Glastonbury, Philip Daniel Knott, and Spencer C. Behr
- Subjects
Male ,medicine.medical_specialty ,Reconstructive surgery ,Microsurgery ,Free flap ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,Aged ,Retrospective Studies ,PET-CT ,medicine.diagnostic_test ,business.industry ,Head and neck cancer ,Area under the curve ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Otorhinolaryngology ,Positron emission tomography ,Head and Neck Neoplasms ,Female ,Radiology ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,business - Abstract
OBJECTIVES/HYPOTHESIS To assess the accuracy and utility of positron emission tomography/computed tomography (PET/CT) compared with magnetic resonance imaging (MRI) for detecting head and neck cancer (HNC) recurrence after microvascular reconstructive surgery. STUDY DESIGN Retrospective cohort study. METHODS Analysis of HNC patients who underwent microvascular reconstruction at a single, tertiary academic center following ablative surgery from 1998 to 2015. Forty-six patients aged 61.4 ± 15.8 years with both PET/CT and MRI examinations were identified. Two radiologists were blinded and interpreted each imaging study. Recurrence certainty scores were determined via continuous (0-100) and Likert ("Likely" to "Unlikely") scales, with larger values indicating a higher likelihood of recurrence. Pathologic confirmation of recurrence was confirmed in 23 patients (50%). RESULTS Among those with primary site recurrences, mean recurrence certainty was significantly higher with PET/CT versus MRI on the continuous scale (63.9 vs. 44.4, P = .006). A receiver operating characteristic analysis for predicting primary site recurrence demonstrated a significantly larger area under the curve of 0.79 for PET/CT compared to 0.64 for MRI (P = .044). Categorization of "Likely" primary site recurrence on PET/CT, versus MRI, had higher sensitivity (0.63 vs. 0.40), but lower specificity (0.90 vs. 1.0). MRI demonstrated higher sensitivity (1.0 vs. 0.78) at detecting regional site recurrences. CONCLUSION PET/CT demonstrates greater sensitivity than MRI as a surveillance tool for primary site recurrence following microvascular reconstruction where clinical evaluation is hindered by anatomical distortion. Therefore, PET/CT should be pursued as first-line imaging, with MRI utilized for confirmation of positive imaging findings at the primary site. LEVEL OF EVIDENCE 2 Laryngoscope, 131:2713-2718, 2021. more...
- Published
- 2021
49. Commentary on 'Hypoglossal and Masseteric Nerve Transfer for Facial Reanimation: A Systematic Review and Meta-Analysis' by Urban et al: 5-7-12: What's the Correct Combination?
- Author
-
P. Daniel Knott and Rahul Seth
- Subjects
2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Mandibular Nerve ,Facial Paralysis ,MEDLINE ,Masseteric nerve ,Facial Nerve ,Physical medicine and rehabilitation ,Facial reanimation ,Meta-analysis ,Medicine ,Humans ,Surgery ,business - Published
- 2021
50. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK
- Author
-
Merryn Voysey, Sue Ann Costa Clemens, Shabir A Madhi, Lily Y Weckx, Pedro M Folegatti, Parvinder K Aley, Brian Angus, Vicky L Baillie, Shaun L Barnabas, Qasim E Bhorat, Sagida Bibi, Carmen Briner, Paola Cicconi, Andrea M Collins, Rachel Colin-Jones, Clare L Cutland, Thomas C Darton, Keertan Dheda, Christopher J A Duncan, Katherine R W Emary, Katie J Ewer, Lee Fairlie, Saul N Faust, Shuo Feng, Daniela M Ferreira, Adam Finn, Anna L Goodman, Catherine M Green, Christopher A Green, Paul T Heath, Catherine Hill, Helen Hill, Ian Hirsch, Susanne H C Hodgson, Alane Izu, Susan Jackson, Daniel Jenkin, Carina C D Joe, Simon Kerridge, Anthonet Koen, Gaurav Kwatra, Rajeka Lazarus, Alison M Lawrie, Alice Lelliott, Vincenzo Libri, Patrick J Lillie, Raburn Mallory, Ana V A Mendes, Eveline P Milan, Angela M Minassian, Alastair McGregor, Hazel Morrison, Yama F Mujadidi, Anusha Nana, Peter J O’Reilly, Sherman D Padayachee, Ana Pittella, Emma Plested, Katrina M Pollock, Maheshi N Ramasamy, Sarah Rhead, Alexandre V Schwarzbold, Nisha Singh, Andrew Smith, Rinn Song, Matthew D Snape, Eduardo Sprinz, Rebecca K Sutherland, Richard Tarrant, Emma C Thomson, M Estée Török, Mark Toshner, David P J Turner, Johan Vekemans, Tonya L Villafana, Marion E E Watson, Christopher J Williams, Alexander D Douglas, Adrian V S Hill, Teresa Lambe, Sarah C Gilbert, Andrew J Pollard, Marites Aban, Fatola Abayomi, Kushala Abeyskera, Jeremy Aboagye, Matthew Adam, Kirsty Adams, James Adamson, Yemi A. Adelaja, Gbadebo Adewetan, Syed Adlou, Khatija Ahmed, Yasmeen Akhalwaya, Saajida Akhalwaya, Andrew Alcock, Aabidah Ali, Elizabeth R. Allen, Lauren Allen, Thamires C. D. S. C Almeida, Mariana P.S. Alves, Fabio Amorim, Foteini Andritsou, Rachel Anslow, Matthew Appleby, Edward H. Arbe-Barnes, Mark P. Ariaans, Beatriz Arns, Laiana Arruda, Paula Azi, Lorena Azi, Gavin Babbage, Catherine Bailey, Kenneth F. Baker, Megan Baker, Natalie Baker, Philip Baker, Lisa Baldwin, Ioana Baleanu, Danieli Bandeira, Anna Bara, Marcella A.S. Barbosa, Debbie Barker, Gavin D. Barlow, Eleanor Barnes, Andrew S. Barr, Jordan R. Barrett, Jessica Barrett, Louise Bates, Alexander Batten, Kirsten Beadon, Emily Beales, Rebecca Beckley, Sandra Belij-Rammerstorfer, Jonathan Bell, Duncan Bellamy, Nancy Bellei, Sue Belton, Adam Berg, Laura Bermejo, Eleanor Berrie, Lisa Berry, Daniella Berzenyi, Amy Beveridge, Kevin R. Bewley, Helen Bexhell, Sutika Bhikha, Asad E. Bhorat, Zaheda E. Bhorat, Else Bijker, Geeta Birch, Sarah Birch, Adam Bird, Olivia Bird, Karen Bisnauthsing, Mustapha Bittaye, Katherine Blackstone, Luke Blackwell, Heather Bletchly, Caitlin L. Blundell, Susannah R. Blundell, Pritesh Bodalia, Bruno C. Boettger, Emma Bolam, Elena Boland, Daan Bormans, Nicola Borthwick, Francesca Bowring, Amy Boyd, Penny Bradley, Tanja Brenner, Phillip Brown, Claire Brown, Charlie Brown-O'Sullivan, Scott Bruce, Emily Brunt, Ruaridh Buchan, William Budd, Yusuf A. Bulbulia, Melanie Bull, Jamie Burbage, Hassan Burhan, Aileen Burn, Karen R. Buttigieg, Nicholas Byard, Ingrid Cabera Puig, Gloria Calderon, Anna Calvert, Susana Camara, Michelangelo Cao, Federica Cappuccini, João R. Cardoso, Melanie Carr, Miles W. Carroll, Andrew Carson-Stevens, Yasmin de M. Carvalho, José A.M. Carvalho, Helen R. Casey, Paul Cashen, Thais Castro, Lucia Carratala Castro, Katrina Cathie, Ana Cavey, José Cerbino-Neto, Jim Chadwick, David Chapman, Sue Charlton, Irina Chelysheva, Oliver Chester, Sunder Chita, Jee-Sun Cho, Liliana Cifuentes, Elizabeth Clark, Matthew Clark, Andrea Clarke, Elizabeth A. Clutterbuck, Sarah L.K. Collins, Christopher P. Conlon, Sean Connarty, Naomi Coombes, Cushla Cooper, Rachel Cooper, Lynne Cornelissen, Tumena Corrah, Catherine Cosgrove, Tony Cox, Wendy E.M. Crocker, Sarah Crosbie, Lorraine Cullen, Dan Cullen, Debora R.M.F. Cunha, Christina Cunningham, Fiona C. Cuthbertson, Suzete N. Farias Da Guarda, Larissa P. da Silva, Brad E. Damratoski, Zsofia Danos, Maria T.D.C. Dantas, Paula Darroch, Mehreen S. Datoo, Chandrabali Datta, Malika Davids, Sarah L. Davies, Hannah Davies, Elizabeth Davis, Judith Davis, John Davis, Maristela M.D. De Nobrega, Lis Moreno De Oliveira Kalid, David Dearlove, Tesfaye Demissie, Amisha Desai, Stefania Di Marco, Claudio Di Maso, Maria I.S. Dinelli, Tanya Dinesh, Claire Docksey, Christina Dold, Tao Dong, Francesca R. Donnellan, Tannyth Dos Santos, Thainá G. dos Santos, Erika Pachecho Dos Santos, Naomi Douglas, Charlotte Downing, Jonathan Drake, Rachael Drake-Brockman, Kimberley Driver, Ruth Drury, Susanna J. Dunachie, Benjamin S. Durham, Lidiana Dutra, Nicholas J.W. Easom, Samual van Eck, Mandy Edwards, Nick J. Edwards, Omar M. El Muhanna, Sean C. Elias, Mike Elmore, Marcus English, Alisgair Esmail, Yakub Moosa Essack, Eoghan Farmer, Mutjaba Farooq, Madi Farrar, Leonard Farrugia, Beverley Faulkner, Sofiya Fedosyuk, Sally Felle, Carla Ferreira Da Silva, Samantha Field, Richard Fisher, Amy Flaxman, James Fletcher, Hazel Fofie, Henry Fok, Karen J. Ford, Jamie Fowler, Pedro H.A. Fraiman, Emma Francis, Marilia M. Franco, John Frater, Marilúcia S.M. Freire, Samantha H. Fry, Sabrina Fudge, Julie Furze, Michelle Fuskova, Pablo Galian-Rubio, Eva Galiza, Harriet Garlant, Madita Gavrila, Ailsa Geddes, Karyna A. Gibbons, Ciaran Gilbride, Hardeep Gill, Sharon Glynn, Kerry Godwin, Karishma Gokani, Ursula Carvalho Goldoni, Maria Goncalves, Isabela G.S. Gonzalez, Jayne Goodwin, Amina Goondiwala, Katherine Gordon-Quayle, Giacomo Gorini, Janet Grab, Lara Gracie, Melanie Greenland, Nicola Greenwood, Johann Greffrath, Marisa M. Groenewald, Leonardo Grossi, Gaurav Gupta, Mark Hackett, Bassam Hallis, Mainga Hamaluba, Elizabeth Hamilton, Joseph Hamlyn, Daniel Hammersley, Aidan T. Hanrath, Brama Hanumunthadu, Stephanie A. Harris, Clair Harris, Tara Harris, Thomas D. Harrison, Daisy Harrison, Thomas C. Hart, Birgit Hartnell, Shadin Hassan, John Haughney, Sophia Hawkins, Jodie Hay, Ian Head, John Henry, Macarena Hermosin Herrera, David B. Hettle, Jennifer Hill, Gina Hodges, Elizea Horne, Mimi M. Hou, Catherine Houlihan, Elizabeth Howe, Nicola Howell, Jonathan Humphreys, Holly E. Humphries, Katrina Hurley, Claire Huson, Angela Hyder-Wright, Catherine Hyams, Sabina Ikram, Alka Ishwarbhai, Monica Ivan, Poppy Iveson, Vidyashankara Iyer, Frederic Jackson, Jeanne De Jager, Shameem Jaumdally, Helen Jeffers, Natasha Jesudason, Bryony Jones, Kathryn Jones, Elizabeth Jones, Christopher Jones, Marianna Rocha Jorge, Aylin Jose, Amar Joshi, Eduardo A.M.S. Júnior, Joanne Kadziola, Reshma Kailath, Faeeza Kana, Konstantinos Karampatsas, Mwila Kasanyinga, Jade Keen, Elizabeth J. Kelly, Dearbhla M. Kelly, Debbie Kelly, Sarah Kelly, David Kerr, Renato de Ávila Kfouri, Liaquat Khan, Baktash Khozoee, Sarah Kidd, Annabel Killen, Jasmin Kinch, Patrick Kinch, Lloyd D.W. King, Thomas B. King, Lucy Kingham, Paul Klenerman, Francesca Knapper, Julian C. Knight, Daniel Knott, Stanislava Koleva, Matilda Lang, Gail Lang, Colin W. Larkworthy, Jessica P.J. Larwood, Rebecca Law, Erica M. Lazarus, Amanda Leach, Emily A. Lees, Nana-Marie Lemm, Alvaro Lessa, Stephanie Leung, Yuanyuan Li, Amelia M. Lias, Kostas Liatsikos, Aline Linder, Samuel Lipworth, Shuchang Liu, Xinxue Liu, Adam Lloyd, Stephanie Lloyd, Lisa Loew, Raquel Lopez Ramon, Leandro Lora, Vicki Lowthorpe, Kleber Luz, Jonathan C. MacDonald, Gordon MacGregor, Meera Madhavan, David O. Mainwaring, Edson Makambwa, Rebecca Makinson, Mookho Malahleha, Ross Malamatsho, Garry Mallett, Kushal Mansatta, Takalani Maoko, Katlego Mapetla, Natalie G. Marchevsky, Spyridoula Marinou, Emma Marlow, Gabriela N. Marques, Paula Marriott, Richard P. Marshall, Julia L. Marshall, Flávia J. Martins, Masebole Masenya, Mduduzi Masilela, Shauna K. Masters, Moncy Mathew, Hosea Matlebjane, Kedidimetse Matshidiso, Olga Mazur, Andrea Mazzella, Hugh McCaughan, Joanne McEwan, Joanna McGlashan, Lorna McInroy, Zoe McIntyre, Daniela McLenaghan, Nicky McRobert, Steve McSwiggan, Clare Megson, Savviz Mehdipour, Wilma Meijs, Renata N.Á. Mendonça, Alexander J. Mentzer, Neginsadat Mirtorabi, Celia Mitton, Sibusiso Mnyakeni, Fiona Moghaddas, Kgaogelo Molapo, Mapule Moloi, Maria Moore, M. Isabel Moraes-Pinto, Marni Moran, Ella Morey, Róisín Morgans, Susan Morris, Sheila Morris, Helen C. Morris, Franca Morselli, Gertraud Morshead, Richard Morter, Lynelle Mottal, Andrew Moultrie, Nathifa Moya, Mushiya Mpelembue, Sibekezelo Msomi, Yvonne Mugodi, Ekta Mukhopadhyay, Jilly Muller, Alasdair Munro, Claire Munro, Sarah Murphy, Philomena Mweu, Celia Hatsuko Myasaki, Gurudutt Naik, Kush Naker, Eleni Nastouli, Abida Nazir, Bongani Ndlovu, Fabio Neffa, Cecilia Njenga, Helena Noal, Andrés Noé, Gabrielle Novaes, Fay L. Nugent, Géssika Nunes, Katie O'Brien, Daniel O'Connor, Miranda Odam, Suzette Oelofse, Blanche Oguti, Victoria Olchawski, Neil J. Oldfield, Marianne G. Oliveira, Catarina Oliveira, Angela Oosthuizen, Paula O'Reilly, Piper Osborne, David R.J. Owen, Lydia Owen, Daniel Owens, Nelly Owino, Mihaela Pacurar, Brenda V.B. Paiva, Edna M.F. Palhares, Susan Palmer, Sivapriyai Parkinson, Helena M.R.T. Parracho, Karen Parsons, Dipak Patel, Bhumika Patel, Faeezah Patel, Kelly Patel, Maia Patrick-Smith, Ruth O. Payne, Yanchun Peng, Elizabeth J. Penn, Anna Pennington, Marco Polo Peralta Alvarez, James Perring, Nicola Perry, Rubeshan Perumal, Sahir Petkar, Tricia Philip, Daniel J. Phillips, Jennifer Phillips, Mary Kgomotso Phohu, Lorinda Pickup, Sonja Pieterse, Jo Piper, Dimitra Pipini, Mary Plank, Joan Du Plessis, Samuel Pollard, Jennifer Pooley, Anil Pooran, Ian Poulton, Claire Powers, Fernando B. Presa, David A. Price, Vivien Price, Marcelo Primeira, Pamela C. Proud, Samuel Provstgaard-Morys, Sophie Pueschel, David Pulido, Sheena Quaid, Ria Rabara, Alexandra Radford, Kajal Radia, Durga Rajapaska, Thurkka Rajeswaran, Alberto San Francisco Ramos, Fernando Ramos Lopez, Tommy Rampling, Jade Rand, Helen Ratcliffe, Tom Rawlinson, David Rea, Byron Rees, Jesús Reiné, Mila Resuello-Dauti, Emilia Reyes Pabon, Carla M. Ribiero, Marivic Ricamara, Alex Richter, Neil Ritchie, Adam J. Ritchie, Alexander J. Robbins, Hannah Roberts, Ryan E. Robinson, Hannah Robinson, Talita T. Rocchetti, Beatriz Pinho Rocha, Sophie Roche, Christine Rollier, Louisa Rose, Amy L. Ross Russell, Lindie Rossouw, Simon Royal, Indra Rudiansyah, Sarah Ruiz, Stephen Saich, Claudia Sala, Jessica Sale, Ahmed M. Salman, Natalia Salvador, Stephannie Salvador, Milla Sampaio, Annette D. Samson, Amada Sanchez-Gonzalez, Helen Sanders, Katherine Sanders, Erika Santos, Mayara F.S. Santos Guerra, Iman Satti, Jack E. Saunders, Caroline Saunders, Aakifah Sayed, Ina Schim van der Loeff, Annina B. Schmid, Ella Schofield, Gavin Screaton, Samiullah Seddiqi, Rameswara R. Segireddy, Roberta Senger, Sonia Serrano, Rajiv Shah, Imam Shaik, Hannah E. Sharpe, Katherine Sharrocks, Robert Shaw, Adam Shea, Amy Shepherd, James G. Shepherd, Farah Shiham, Emad Sidhom, Sarah E. Silk, Antonio Carlos da Silva Moraes, Gilberto Silva-Junior, Laura Silva-Reyes, Anderson D. Silveira, Mariana B.V. Silveira, Jaisi Sinha, Donal T. Skelly, Daniel C. Smith, Nick Smith, Holly E. Smith, David J. Smith, Catherine C. Smith, Airanuédida Soares, Tiago Soares, Carla Solórzano, Guilherme L. Sorio, Kim Sorley, Tiffany Sosa-Rodriguez, Cinthia M.C.D.L. Souza, Bruno S.D.F. Souza, Alessandra R. Souza, Alexandra J. Spencer, Fernanda Spina, Louise Spoors, Lizzie Stafford, Imogen Stamford, Igor Starinskij, Ricardo Stein, Jill Steven, Lisa Stockdale, Lisa V. Stockwell, Louise H. Strickland, Arabella C. Stuart, Ann Sturdy, Natalina Sutton, Anna Szigeti, Abdessamad Tahiri-Alaoui, Rachel Tanner, Carol Taoushanis, Alexander W. Tarr, Keja Taylor, Ursula Taylor, Iona Jennifer Taylor, Justin Taylor, Rebecca te Water Naude, Yrene Themistocleous, Andreas Themistocleous, Merin Thomas, Kelly Thomas, Tonia M. Thomas, Asha Thombrayil, Fawziyah Thompson, Amber Thompson, Kevin Thompson, Ameeka Thompson, Julia Thomson, Viv Thornton-Jones, Patrick J. Tighe, Lygia Accioly Tinoco, Gerlynn Tiongson, Bonolo Tladinyane, Michele Tomasicchio, Adriana Tomic, Susan Tonks, James Towner, Nguyen Tran, Julia Tree, Gerry Trillana, Charlotte Trinham, Rose Trivett, Adam Truby, Betty Lebogang Tsheko, Aadil Turabi, Richard Turner, Cheryl Turner, Marta Ulaszewska, Benjamin R. Underwood, Rachel Varughese, Dennis Verbart, Marije Verheul, Iason Vichos, Taiane Vieira, Claire S. Waddington, Laura Walker, Erica Wallis, Matthew Wand, Deborah Warbick, Theresa Wardell, George Warimwe, Sarah C. Warren, Bridget Watkins, Ekaterina Watson, Stewart Webb, Alice Webb-Bridges, Angela Webster, Jessica Welch, Jeanette Wells, Alison West, Caroline White, Rachel White, Paul Williams, Rachel L. Williams, Rebecca Winslow, Mark Woodyer, Andrew T. Worth, Danny Wright, Marzena Wroblewska, Andy Yao, Rafael Zimmer, Dalila Zizi, Peter Zuidewind, Group, Oxford COVID Vaccine Trial, Toshner, Mark [0000-0002-3969-6143], and Apollo - University of Cambridge Repository more...
- Subjects
Male ,COVID-19/prevention & control ,030204 cardiovascular system & hematology ,law.invention ,South Africa ,0302 clinical medicine ,Randomized controlled trial ,law ,Oxford COVID Vaccine Trial Group ,wc_505 ,Single-Blind Method ,030212 general & internal medicine ,Young adult ,11 Medical and Health Sciences ,wa_105 ,Covid19 ,General Medicine ,Articles ,Middle Aged ,Treatment Outcome ,Cohort ,Perspective ,Female ,Brazil ,Adult ,medicine.medical_specialty ,COVID-19 Vaccines ,Adolescent ,qw_806 ,qw_805 ,03 medical and health sciences ,Young Adult ,Double-Blind Method ,Conjugate vaccine ,Internal medicine ,General & Internal Medicine ,ChAdOx1 nCoV-19 ,medicine ,Humans ,Adverse effect ,Aged ,business.industry ,SARS-CoV-2 ,COVID-19 ,Viral Vaccines ,Vaccine efficacy ,Interim analysis ,United Kingdom ,Clinical trial ,bf023de6 ,business ,COVID-19 Vaccines/adverse effects - Abstract
BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. \ud \ud \ud METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. \ud \ud \ud FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. \ud \ud \ud INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. \ud \ud \ud FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca. more...
- Published
- 2020
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.