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1. Trends in Cardiovascular Disease–Related Mortality in Texas

Author: Muhammad Shariq Usman, MD, Adeena Jamil, MBBS, Zainali Chunawala, MD, Mahboob Alam, MD, Vijay Nambi, MD, PhD, Layla A. Abushamat, MD, MPH, Arunima Misra, MD, Salim S. Virani, MD, PhD, Christie M. Ballantyne, MD, George E. Taffet, MD, Khurram Nasir, MD, Sachin Goel, MD, Sadeer Al-Kindi, MD, Javed Butler, MD, and Abdul Mannan Khan Minhas, MD
Subjects: cardiovascular diseases, mortality, epidemiology, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background: Cardiovascular disease (CVD) is associated with high mortality in the United States, but the burden of CVD mortality is unevenly distributed between demographic and geographic subgroups, with poor characterization of state-specific trends. In this study, the disparities in CVD-related mortality trends in Texas and the United States from 1999 to 2019 were assessed. Methods: Trends in CVD-related mortality were evaluated through analysis of the Multiple Causes of Death Files from the National Center for Health Statistics. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population with associated annual percentage changes were determined. Joinpoint regression was used to assess trends in the CVD-related mortality rates. Results: Between 1999 and 2019, 29,455,193 CVD-related deaths were reported in the United States, of which 1,937,166 occurred in Texas. After an initial decline in the overall AAMR in Texas (annual percentage change, −2.5 [95% CI, −2.8 to −2.1]), a steady level was maintained from 2009 to 2019 (annual percentage change, 0.2 [95% CI, −0.5 to 0.2]). In the United States, after initial decline, AAMR plateaued from 2011 to 2019. Overall, CVD-related AAMR was slightly higher in Texas than in the overall United States (AAMR, 674.1 [95% CI, 673.2-675.1] vs 654 [95% CI, 653.8-654.3]). Men, non-Hispanic Black people, and people 85 years of age and older had the highest AAMRs in Texas and nationwide. Nonmetropolitan areas, both nationally and in Texas, consistently had higher mortality rates. The AAMRs also varied significantly by county within Texas. Conclusion: Despite an initial period of decline, CVD-related mortality rates have plateaued in Texas and the United States. Higher AAMRs were observed in Texas than in the overall United States. Prevalent disparities also exist based on demographic and geographic subgroups.
Published: 2024
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2. Clinical Outcomes in Hypertensive Emergency: A Systematic Review and Meta‐Analysis

Author: Tariq Jamal Siddiqi, Muhammad Shariq Usman, Ahmed Mustafa Rashid, Syed Sarmad Javaid, Aymen Ahmed, Donald Clark, John M. Flack, Daichi Shimbo, Eunhee Choi, Daniel W. Jones, and Michael E. Hall
Subjects: emergency departments, hypertension‐mediated organ damage, hypertensive emergency, ischemic stroke, malignant hypertension, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background To study the prevalence and types of hypertension‐mediated organ damage and the prognosis of patients presenting to the emergency department (ED) with hypertensive emergencies. Methods and Results PubMed was queried from inception through November 30, 2021. Studies were included if they reported the prevalence or prognosis of hypertensive emergencies in patients presenting to the ED. Studies reporting data on hypertensive emergencies in other departments were excluded. The extracted data were arcsine transformed and pooled using a random‐effects model. Fifteen studies (n=4370 patients) were included. Pooled analysis demonstrates that the prevalence of hypertensive emergencies was 0.5% (95% CI, 0.40%–0.70%) in all patients presenting to ED and 35.9% (95% CI, 26.7%–45.5%) among patients presenting in ED with hypertensive crisis. Ischemic stroke (28.1% [95% CI, 18.7%–38.6%]) was the most prevalent hypertension‐mediated organ damage, followed by pulmonary edema/acute heart failure (24.1% [95% CI, 19.0%–29.7%]), hemorrhagic stroke (14.6% [95% CI, 9.9%–20.0%]), acute coronary syndrome (10.8% [95% CI, 7.3%–14.8%]), renal failure (8.0% [95% CI, 2.9%–15.5%]), subarachnoid hemorrhage (6.9% [95% CI, 3.9%–10.7%]), encephalopathy (6.1% [95% CI, 1.9%–12.4%]), and the least prevalent was aortic dissection (1.8% [95% CI, 1.1%–2.8%]). Prevalence of in‐hospital mortality among patients with hypertensive emergency was 9.9% (95% CI, 1.4%–24.6%). Conclusions Our findings demonstrate a pattern of hypertension‐mediated organ damage primarily affecting the brain and heart, substantial cardiovascular renal morbidity and mortality, as well as subsequent hospitalization in patients with hypertensive emergencies presenting to the ED.
Published: 2023
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3. AMSTAR 2 appraisal of systematic reviews and meta-analyses in the field of heart failure from high-impact journals

Author: Lin Li, Iriagbonse Asemota, Bolun Liu, Javier Gomez-Valencia, Lifeng Lin, Abdul Wahab Arif, Tariq Jamal Siddiqi, and Muhammad Shariq Usman
Subjects: AMSTAR 2, Heart failure, Meta-analysis, Systematic review, Medicine
Abstract: Abstract Background The Measurement Tool to Assess systematic Reviews (AMSTAR) 2 is a critical appraisal tool for systematic reviews (SRs) and meta-analyses (MAs) of interventions. We aimed to perform the first AMSTAR 2-based quality assessment of heart failure-related studies. Methods Eleven high-impact journals were searched from 2009 to 2019. The included studies were assessed on the basis of 16 domains. Seven domains were deemed critical for high-quality studies. On the basis of the performance in these 16 domains with different weights, overall ratings were generated, and the quality was determined to be “high,” “moderate,” “low,” or “critically low.” Results Eighty-one heart failure-related SRs with MAs were included. Overall, 79 studies were of “critically low quality” and two were of “low quality.” These findings were attributed to insufficiency in the following critical domains: a priori protocols (compliance rate, 5%), complete list of exclusions with justification (5%), risk of bias assessment (69%), meta-analysis methodology (78%), and investigation of publication bias (60%). Conclusions The low ratings for these potential high-quality heart failure-related SRs and MAs challenge the discrimination capacity of AMSTAR 2. In addition to identifying certain areas of insufficiency, these findings indicate the need to justify or modify AMSTAR 2’s rating rules.
Published: 2022
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4. Robustness of outcomes in trials evaluating sodium–glucose co‐transporter 2 inhibitors for heart failure

Author: Muhammad Shariq Usman, Muhammad Shahzeb Khan, Gregg C. Fonarow, Stephen J. Greene, Tim Friede, Muthiah Vaduganathan, Gerasimos Filippatos, Andrew J. Stewart Coats, Stefan D. Anker, and Javed Butler
Subjects: Fragility index, Robustness, Sodium–glucose co‐transporter 2 inhibitors, Cardiac failure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims Recent trials have evaluated sodium–glucose co‐transporter 2 inhibitors in patients with heart failure (HF). We sought to assess the robustness of findings from these trials using the fragility index (FI). Methods and results Fragility index is defined as the minimum number of patients that must be moved from the ‘non‐event’ to the ‘event’ group to turn a statistically significant result to non‐significant. In addition to FI, fragility quotient [(FQ); FI divided by the sample size] was calculated to assess the proportion of events that must be moved to change the significance. For statistically non‐significant outcomes, reverse fragility index (RFI) and reverse fragility quotient (RFQ) were calculated. Robustness of findings after pooling data from all three trials was also assessed. A robust reduction in first HF hospitalization or cardiovascular mortality was seen with dapagliflozin (FI = 62 and FQ = 0.013), empagliflozin (FI = 50 and FQ = 0.013), and sotagliflozin (FI = 60 and FQ = 0.049). Dapagliflozin nominally improved all‐cause and cardiovascular mortality, with modest FI (n = 8 and 5) and FQ (0.002 and 0.001). Empagliflozin and sotagliflozin did not demonstrate statistically significant reductions in all‐cause mortality, with modest RFI (empagliflozin: RFI = 26 and RFQ = 0.007; sotagliflozin: RFI = 6 and RFQ = 0.005). A similar trend was seen with cardiovascular mortality (empagliflozin: RFI = 24 and RFQ = 0.006; sotagliflozin: RFI = 7 and RFQ = 0.006). Upon meta‐analysis, the result for first HF hospitalization or cardiovascular mortality was robust (FI = 95 and FQ = 0.010). The reductions in all‐cause (FI = 12 and FQ = 0.001) and cardiovascular mortality (FI = 9 and FQ = 0.001), while statistically significant, were fragile. Conclusion Improvement in the composite outcome of first HF hospitalization or cardiovascular death was highly concordant and robust across sodium–glucose co‐transporter 2 inhibitor trials. In contrast, secondary endpoints of all‐cause and cardiovascular mortality were statistically fragile, underscoring the need to power trials for mortality to fully understand the benefit of therapies on fatal events.
Published: 2022
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5. Mental health disorders and readmissions following acute myocardial infarction in the United States

Author: Jayakumar Sreenivasan, Risheek Kaul, Muhammad Shahzeb Khan, Aaqib Malik, Muhammad Shariq Usman, and Erin D. Michos
Subjects: Medicine, Science
Abstract: Abstract Hospital readmissions following an acute myocardial infarction (MI) are associated with increased mortality and morbidity. The aim of this study was to investigate if there is a significant association between specific mental health disorders (MHD) and risk of hospital readmission after an index hospitalization for acute MI. We analyzed the U.S. National Readmission Database for adult acute MI hospitalizations from 2016 to 2017. Co-morbid diagnoses of MHD were obtained using appropriate ICD-10-CM diagnostic codes. The primary outcome of interest was 30-day all-cause unplanned readmission. Cox-regression analysis was used to identify the association of various MHD and risk of 30-day readmission adjusted for demographics, medical and cardiac comorbidities, and coronary revascularization. We identified a total of 1,045,752 hospitalizations for acute MI; patients had mean age of 67 ± 13 years with 37.6% female. The prevalence of any MHD was 15.0 ± 0.9%. After adjusting for potential confounders, comorbid diagnosis of major depression [HR 1.11 (95% CI 1.07–1.15)], bipolar disorders [1.32 (1.19–1.45)], anxiety disorders [1.09 (1.05–1.13)] and schizophrenia/other psychotic disorders [1.56 (1.43–1.69)] were independently associated with higher risk of 30-day readmission compared to those with no comorbid MHD. We conclude that MHD are significantly associated with a higher independent risk of 30-day all-cause hospital readmissions among acute MI hospitalizations.
Published: 2022
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6. Ferric carboxymaltose for the treatment of iron‐deficient heart failure patients: a systematic review and meta‐analysis

Author: Muhammad Shahzeb Khan, Muhammad Shariq Usman, Stephan vonHaehling, Wolfram Doehner, and Andrew J. Stewart Coats
Subjects: Heart failure, Iron deficiency, Iron therapy, Meta‐analysis, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims Intravenous ferric carboxymaltose (FCM) has been shown to improve functional capacity and quality of life in iron deficient heart failure patients. However, FCM's effect on hospitalizations and mortality remains unclear as previous randomized controlled trials (RCTs) and their meta‐analyses have been underpowered to detect significant differences. We sought to conduct an updated meta‐analysis using recently published RCT data. Methods and results Online databases were searched from inception until November 2020 for RCTs evaluating the effects of FCM on clinical outcomes in iron‐deficient heart failure patients. Outcomes of interest included heart failure hospitalizations, all‐cause mortality, and cardiovascular mortality. Meta‐analysis was performed using a fixed‐effect model and estimates were reported as odds ratios (ORs), hazard ratios, or rate ratios (RRs) along with corresponding 95% confidence intervals (CIs). A total of 1947 patients (n = 1062 in the FCM group; n = 885 in the placebo group) were included. FCM, compared with placebo, significantly reduced the risk of the composite endpoint of time to first heart failure hospitalization or cardiovascular death (hazard ratio = 0.76; 95% CI = 0.63–0.90; I2 = 55%). FCM also significantly reduced the risk of recurrent heart failure hospitalizations (RR = 0.68; 95% CI = 0.54–0.85; I2 = 71%) and recurrent cardiovascular hospitalizations (RR = 0.71; 95% CI = 0.59–0.86; I2 = 56%). However, FCM had no significant effect on the risk of all‐cause (OR = 0.97; 95% CI = 0.73–1.28; I2 = 0%) or cardiovascular mortality (OR = 0.93; 95% CI = 0.69–1.27; I2 = 0%). Conclusions Ferric carboxymaltose reduces heart failure hospitalizations and cardiovascular hospitalizations with no beneficial effect on all‐cause and cardiovascular mortality in iron‐deficient heart failure patients. These findings reinforce the role of FCM as a therapeutic option in heart failure patients.
Published: 2020
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7. Efficacy and safety of SGLT2 inhibitors in heart failure: systematic review and meta‐analysis

Author: Javed Butler, Muhammad Shariq Usman, Muhammad Shahzeb Khan, Stephen J. Greene, Tim Friede, Muthiah Vaduganathan, Gerasimos Filippatos, Andrew J. Stewart Coats, and Stefan D. Anker
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Aims We sought to conduct a meta‐analysis regarding the safety and efficacy of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors in patients with heart failure (HF). Methods and results MEDLINE, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were searched from their inception to November 2020 for placebo‐controlled randomized controlled trials of SGLT2 inhibitors. Randomized controlled trials were selected if they reported at least one of the prespecified outcomes in patients with HF. Hazard ratios (HRs) or risk ratios and their corresponding 95% confidence intervals were pooled using a random‐effects model. A total of seven trials including 16 820 HF patients (N = 8884 in the SGLT2 inhibitor arms; N = 7936 in the placebo arms) were included. In the overall HF cohort, SGLT2 inhibitors compared with placebo significantly reduced the risk of the composite endpoint of first HF hospitalization or cardiovascular death [HR: 0.77 (0.72–0.83); P
Published: 2020
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8. Assessment of fear, anxiety, obsession and functional impairment due to COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal [version 2; peer review: 2 approved]

Author: Samata Nepal, Alok Atreya, Arbin Dev Sapkota, Md Nazmul Islam, Chandra Kumari Garbuja, Ritesh G Menezes, Muskaan Doulat Ram, Sana Qazi, Sristi Ghimire, Anu Marhatta, Muhammad Shariq Usman, and Qazi Shurjeel
Subjects: COVID-19, SARS-CoV-2, anxiety, depression, health care workers, Nepal, eng, Medicine, Science
Abstract: Background: The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. Methods: This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey. In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. Results: In total, 403 health-care workers and trainees participated in our study. The mean age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value
Published: 2022
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9. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000–17

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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10. The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis

Author: Aniruddha Deshpande, Molly K Miller-Petrie, Paulina A Lindstedt, Mathew M Baumann, Kimberly B Johnson, Brigette F Blacker, Hedayat Abbastabar, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R.M. Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Abdu A Adamu, Oladimeji M Adebayo, Isaac Akinkunmi Adedeji, Rufus Adesoji Adedoyin, Victor Adekanmbi, Olatunji O Adetokunboh, Tara Ballav Adhikari, Mohsen Afarideh, Marcela Agudelo-Botero, Mehdi Ahmadi, Keivan Ahmadi, Muktar Beshir Ahmed, Anwar E Ahmed, Temesgen Yihunie Akalu, Ali S Akanda, Fares Alahdab, Ziyad Al-Aly, Samiah Alam, Noore Alam, Genet Melak Alamene, Turki M Alanzi, James Albright, Ammar Albujeer, Jacqueline Elizabeth Alcalde-Rabanal, Animut Alebel, Zewdie Aderaw Alemu, Muhammad Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J. Alvis-Zakzuk, Saeed Amini, Arianna Maever L. Amit, Gianna Gayle Herrera Amul, Catalina Liliana Andrei, Mina Anjomshoa, Ansariadi Ansariadi, Carl Abelardo T. Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Olatunde Aremu, Bahram Armoon, Amit Arora, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Daniel Asmelash, Hagos Tasew Atalay, Seyyede Masoume Athari, Seyyed Shamsadin Athari, Sachin R Atre, Marcel Ausloos, Shally Awasthi, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Yared Asmare Aynalem, Samad Azari, Andrew S Azman, Ebrahim Babaee, Alaa Badawi, Mojtaba Bagherzadeh, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Maciej Banach, Joseph Adel Mattar Banoub, Aleksandra Barac, Miguel A Barboza, Till Winfried Bärnighausen, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Neeraj Bedi, Mahya Beheshti, Meysam Behzadifar, Masoud Behzadifar, Diana Fernanda Bejarano Ramirez, Michelle L Bell, Derrick A. Bennett, Habib Benzian, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Krittika Bhattacharyya, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Muhammad Shahdaat Bin Sayeed, Raaj Kishore Biswas, Somayeh Bohlouli, Soufiane Boufous, Oliver J Brady, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Alexandria Brown, Sharath Burugina Nagaraja, Zahid A Butt, Luis Alberto Cámera, Ismael R Campos-Nonato, Julio Cesar Campuzano Rincon, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Carlos A Castañeda-Orjuela, Franz Castro, Ester Cerin, Binaya Chalise, Vijay Kumar Chattu, Ken Lee Chin, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Elizabeth A Cromwell, Abel Fekadu Fekadu Dadi, Tukur Dahiru, Saad M A Dahlawi, Rakhi Dandona, Lalit Dandona, Anh Kim Dang, Farah Daoud, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Claudio Alberto Dávila-Cervantes, Nicole Davis Weaver, Fernando Pio De la Hoz, Jan-Walter De Neve, Dereje Bayissa Demissie, Gebre Teklemariam Demoz, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Isaac Oluwafemi Dipeolu, Hoa Thi Do, Christiane Dolecek, Kerrie E Doyle, Eleonora Dubljanin, Andre Rodrigues Duraes, Hisham Atan Edinur, Andem Effiong, Aziz Eftekhari, Nevine El Nahas, Maysaa El Sayed Zaki, Maha El Tantawi, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Ziad El-Khatib, Hajer Elkout, Aisha Elsharkawy, Shymaa Enany, Daniel Adane Endalew, Babak Eshrati, Sharareh Eskandarieh, Arash Etemadi, Oluchi Ezekannagha, Emerito Jose A. Faraon, Mohammad Fareed, Andre Faro, Farshad Farzadfar, Alebachew Fasil Fasil, Mehdi Fazlzadeh, Valery L. Feigin, Wubalem Fekadu, Netsanet Fentahun, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Carsten Flohr, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Richard Charles Franklin, Joseph Jon Frostad, Takeshi Fukumoto, Mohamed M Gad, Gregory M Garcia, Augustine Mwangi Gatotoh, Reta Tsegaye Gayesa, Ketema Bizuwork Gebremedhin, Yilma Chisha Dea Geramo, Hailay Abrha Gesesew, Kebede Embaye Gezae, Ahmad Ghashghaee, Farzaneh Ghazi Sherbaf, Tiffany K Gill, Paramjit Singh Gill, Themba G Ginindza, Alem Girmay, Zemichael Gizaw, Amador Goodridge, Sameer Vali Gopalani, Bárbara Niegia Garcia Goulart, Alessandra C Goulart, Ayman Grada, Manfred S Green, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Rajeev Gupta, Rahul Gupta, Giang Hai Ha, Juanita A. Haagsma, Nima Hafezi-Nejad, Dessalegn H Haile, Michael Tamene Haile, Brian J. Hall, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Ninuk Hariyani, Ahmed I. Hasaballah, Md. Mehedi Hasan, Amir Hasanzadeh, Hamid Yimam Hassen, Desta Haftu Hayelom, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Andualem Henok, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru, Thomas R Hird, Chi Linh Hoang, Gillian I Hollerich, Praveen Hoogar, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Guoqing Hu, Ayesha Humayun, Syed Ather Hussain, Mamusha Aman A Hussen, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Milena D. Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Rebecca Q Ivers, Chinwe Juliana Iwu, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ensiyeh Jenabi, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Jost B. Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Tanuj Kanchan, André Karch, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A. Kayode, Mihiretu M Kebede, Peter Njenga Keiyoro, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Junaid Khan, Md Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Amir M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Adnan Kisa, Sonali Kochhar, Tufa Kolola, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Kewal Krishan, Barthelemy Kuate Defo, Nuworza Kugbey, Pushpendra Kumar, G Anil Kumar, Manasi Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Aparna Lal, Dharmesh Kumar Lal, Hilton Lam, Faris Hasan Lami, Van Charles Lansingh, Savita Lasrado, Georgy Lebedev, Paul H Lee, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Aubrey J Levine, Sonia Lewycka, Shanshan Li, Shai Linn, Shiwei Liu, Jaifred Christian F Lopez, Platon D Lopukhov, Muhammed Magdy Abd El Razek, D.R. Mahadeshwara Prasad, Phetole Walter Mahasha, Narayan B. Mahotra, Azeem Majeed, Reza Malekzadeh, Deborah Carvalho Malta, Abdullah A Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Gabriel Martinez, Santi Martini, Francisco Rogerlândio Martins-Melo, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Entezar Mehrabi Nasab, Kala M Mehta, Teferi Mekonnen, Tefera Chane Mekonnen, Gebrekiros Gebremichael Meles, Hagazi Gebre Meles, Peter T N Memiah, Ziad A Memish, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Tomislav Mestrovic, Workua Mekonnen Metekiya, Bartosz Miazgowski, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Yousef Mohammad, Dara K. Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Shafiu Mohammed, Jemal Abdu Mohammed, Hassen Mohammed, Farnam Mohebi, Ali H Mokdad, Yoshan Moodley, Masoud Moradi, Ghobad Moradi, Mohammad Moradi-Joo, Paula Moraga, Linda Morales, Abbas Mosapour, Jonathan F. Mosser, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor, Sandra B Munro, Moses K. Muriithi, Christopher J L Murray, Kamarul Imran Musa, Ghulam Mustafa, Saravanan Muthupandian, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Mohsen Naghavi, Gurudatta Naik, Vinay Nangia, Bruno Ramos Nascimento, Javad Nazari, Duduzile Edith Ndwandwe, Ionut Negoi, Henok Biresaw Netsere, Josephine W. Ngunjiri, Cuong Tat Nguyen, Huong Lan Thi Nguyen, QuynhAnh P Nguyen, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Ole F Norheim, Jean Jacques Noubiap, Bogdan Oancea, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Jacob Olusegun Olusanya, Bolajoko Olubukunola Olusanya, Obinna E Onwujekwe, Doris V. Ortega-Altamirano, Osayomwanbo Osarenotor, Frank B Osei, Mayowa O Owolabi, Mahesh P A, Jagadish Rao. Padubidri, Smita Pakhale, Adrian Pana, Eun-Kee Park, Sangram Kishor Patel, Ashish Pathak, Ajay Patle, Kebreab Paulos, Veincent Christian Filipino Pepito, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Konrad Pesudovs, Hai Quang Pham, David M Pigott, Thomas Pilgrim, Meghdad Pirsaheb, Mario Poljak, Ian Pollock, Maarten J Postma, Farshad Pourmalek, Akram Pourshams, Sergio I Prada, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Mohammad Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Siavash Rahimi, Vafa Rahimi-Movaghar, Muhammad Aziz Rahman, Mohammad Hifz Ur Rahman, Fatemeh Rajati, Chhabi Lal Ranabhat, Puja C Rao, Davide Rasella, Goura Kishor Rath, Salman Rawaf, Lal Rawal, Wasiq Faraz Rawasia, Giuseppe Remuzzi, Vishnu Renjith, Andre M.N. Renzaho, Serge Resnikoff, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Luca Ronfani, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Siamak Sabour, Ehsan Sadeghi, Sahar Saeedi Moghaddam, Yahya Safari, Rajesh Sagar, Mohammad Ali Sahraian, S. Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Ahsan Saleem, Hosni Salem, Marwa Rashad Salem, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Itamar S Santos, Milena M. Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Nizal Sarrafzadegan, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Maheswar Satpathy, Monika Sawhney, Mehdi Sayyah, Alyssa N Sbarra, Lauren E Schaeffer, David C Schwebel, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Azadeh Shafieesabet, Amira A Shaheen, Izza Shahid, Masood Ali Shaikh, Ali S Shalash, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Rajesh Sharma, Aziz Sheikh, B Suresh Kumar Shetty, Wondimeneh Shibabaw Shiferaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Reza Shirkoohi, K M Shivakumar, Si Si, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Virendra Singh, Narinder Pal Singh, Balbir Bagicha Singh Singh, Jasvinder A. Singh, Ambrish Singh, Dhirendra Narain Sinha, Malede Mequanent Sisay, Eirini Skiadaresi, David L Smith, Adauto Martins Soares Filho, Mohammad Reza Sobhiyeh, Anton Sokhan, Joan B Soriano, Muluken Bekele Sorrie, Ireneous N Soyiri, Emma Elizabeth Spurlock, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Hafiz Ansar Rasul Suleria, Bryan L. Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Ingan Ukur Tarigan, Bineyam Taye, Yonatal Mesfin Tefera, Arash Tehrani-Banihashemi, Shishay Wahdey Tekelemedhin, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay, Fisaha Haile Tesfay, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Akhil Soman ThekkePurakkal, Nihal Thomas, Robert L Thompson, Alan J Thomson, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Olalekan A Uthman, Benjamin S. Chudi Uzochukwu, Pascual R Valdez, Santosh Varughese, Yousef Veisani, Francesco S Violante, Sebastian Vollmer, Feleke Gebremeskel W/hawariat, Yasir Waheed, Mitchell Taylor Wallin, Yuan-Pang Wang, Yafeng Wang, Kinley Wangdi, Daniel J Weiss, Girmay Teklay Weldesamuel, Adhena Ayaliew Werkneh, Ronny Westerman, Taweewat Wiangkham, Kirsten E Wiens, Tissa Wijeratne, Charles Shey Wiysonge, Haileab Fekadu Wolde, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Getasew Taddesse Worku, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Mehdi Yaseri, Hiroshi Yatsuya, Alex Yeshaneh, Mekdes Tigistu Yilma, Paul Yip, Engida Yisma, Naohiro Yonemoto, Mustafa Z Younis, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Telma Zahirian Moghadam, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Heather J Zar, Taddese Alemu Zerfu, Yunquan Zhang, Arash Ziapour, Sanjay Zodpey, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection. Methods: A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected. Findings: We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination. Interpretation: Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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11. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author: Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.
Published: 2020
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12. Performance of the TIMI risk score in predicting mortality after primary percutaneous coronary intervention in elderly women: Results from a developing country.

Author: Shumaila Furnaz, Musa Karim, Tariq Ashraf, Sajjad Ali, Izza Shahid, Sara Ali, Uzzam Ahmed Khawaja, Muhammad Tanzeel Ul Haque, Muhammad Shariq Usman, and Tariq Jamal Siddiqi
Subjects: Medicine, Science
Abstract: BackgroundDespite women undergoing primary percutaneous coronary intervention (PPCI) having a higher rate of adverse outcomes than men, data evaluating prognostic risk scores, especially in elderly women, remains scarce. This study was conducted to validate the predictive value of Thrombolysis in Myocardial Infarction (TIMI) risk score in elderly female patients.Materials and methodsThis was a retrospective analysis of elderly (>65 years) female patients who underwent PPCI for ST-elevated myocardial infarction (STEMI) from October 2016 to September 2018. Patients' demographic details and elements of TIMI risk score including age, co-morbidities, Killip classification; weight, anterior MI and total ischemic time were extracted from hospital records. The primary outcome was in-hospital mortality and post-discharge mortality reported on telephonic follow-up.ResultsA total of 404 elderly women with a median age of 70 years were included. The mean TIMI score was 5.25±1.45 with 40.3% (163) patients of TIMI score > 5. In-hospital mortality rate was 6.4% (26) and was found to be associated with TIMI score (pConclusionIncreased adverse outcomes were observed with higher TIMI risk score for in hospital and post-discharge follow-up. Therefore, the prognostic TIMI risk score is a robust tool in predicting both in-hospital as well as post-discharge mortality in elderly females.
Published: 2019
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13. Percutaneous Mitral Valve Repair versus Optimal Medical Therapy in Patients with Functional Mitral Regurgitation: A Systematic Review and Meta-Analysis

Author: Muhammad Uzair Lodhi, Muhammad Shariq Usman, Tariq Jamal Siddiqi, Muhammad Shahzeb Khan, Muhammad Arbaz Arshad Khan, Safi U. Khan, Intekhab Askari Syed, Mustafa Rahim, Srihari S. Naidu, Rami Doukky, and Mohamad Alkhouli
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Objectives. To compare percutaneous mitral valve repair (PMVR) with optimal medical therapy (OMT) in patients with heart failure (HF) and severe functional mitral regurgitation (FMR). Background. Many patients with HF and FMR are not suitable for surgical valve replacement and remain symptomatic despite maximal OMT. PMVR has recently emerged as an alternative solution. Methods. We performed a systematic review and a meta-analysis to address this question. Cochrane CENTRAL, MEDLINE, and Scopus were searched for randomized (RCT) and nonrandomized studies comparing PMVR with OMT in patients with HF and FMR. Primary endpoint was all-cause midterm mortality (at 1 and 2 years). Secondary endpoints were 30-day mortality and cardiovascular mortality and HF hospitalizations, at maximum follow-up. Studies including mixed cohort of degenerative and functional MR were allowed initially but were excluded in a secondary sensitivity analysis for each of the study’s end points. This meta-analysis was performed following the publication of two RCTs (MITRA-FR and COAPT). Results. Eight studies (six observational, two RCTs) comprising 3,009 patients were included in the meta-analysis. In comparison with OMT, PMVR significantly reduced 1-year mortality (RR: 0.70 [0.56, 0.87]; p=0.002; I2=47.6%), 2-year mortality (RR: 0.63 [0.55, 0.73]; p
Published: 2019
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14. Assessment of fear, anxiety, obsession and functional impairment due to COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal [version 2; peer review: 2 approved]

Author: Alok Atreya, Samata Nepal, Ritesh G Menezes, Qazi Shurjeel, Sana Qazi, Muskaan Doulat Ram, Muhammad Shariq Usman, Sristi Ghimire, Anu Marhatta, Md Nazmul Islam, Arbin Dev Sapkota, and Chandra Kumari Garbuja
Subjects: Research Article, Articles, COVID-19, SARS-CoV-2, anxiety, depression, health care workers, Nepal
Abstract: Background: The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. Methods: This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey. In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. Results: In total, 403 health-care workers and trainees participated in our study. The mean age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value Conclusion: This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line health-care workers.
Published: 2022
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15. Assessment of fear, anxiety, obsession and functional impairment of COVID-19 amongst health-care workers and trainees: A cross-sectional study in Nepal [version 1; peer review: 1 approved, 1 approved with reservations]

Author: Alok Atreya, Samata Nepal, Ritesh G Menezes, Qazi Shurjeel, Sana Qazi, Muskaan Doulat Ram, Muhammad Shariq Usman, Sristi Ghimire, Anu Marhatta, Md Nazmul Islam, Arbin Dev Sapkota, and Chandra Kumari Garbuja
Subjects: Research Article, Articles, COVID-19, SARS-CoV-2, anxiety, depression, health care workers, Nepal
Abstract: Background: The emergence of the COVID-19 epidemic threw the world into turmoil. The medical community bore the brunt of the pandemic's toll. Long work hours, and a lack of personal protective equipment (PPE) and social support all had an influence on mental health. Methods: This cross-sectional study was conducted among Lumbini Medical College Teaching Hospital students and employees in Palpa, Nepal. Data entailing their demographic details, pre-existing comorbidities, or death in the family due to COVID-19 was collected using a self-administered survey. In addition, the level of fear, anxiety, obsession, and functional impairment due to COVID-19 was recorded using previously validated respective scales. Results: In total, 403 health-care workers and trainees participated in our study. The average age of the study participants was 23±4 years, and more than half of them (n=262, 65%) were females. A significant association was found between fear score with age (p-value=0.04), gender (p-value Conclusion: This study revealed various socio-demographic characteristics as risk factors for psychological stress in the people related to the health-care profession of Nepal during the COVID-19 pandemic. A viable answer to this quandary might be adequate psychosocial intervention by health-care authorities, increased social support, and the introduction of better mental health management measures for the front-line medical workers.
Published: 2022
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16. Is it safe and effective to administer COVID-19 vaccines during pregnancy? A systematic review and meta-analysis

Author: Ishaque Hameed, Mohammad Omer Khan, Khushboo Nusrat, Samar Mahmood, Muhammad Nashit, Shanza Malik, Omer Mustafa Siddiqui, Syed Abdus Samad, Shayan Marsia, Muhammad Shariq Usman, and Tariq Jamal Siddiqi
Subjects: Infectious Diseases, Epidemiology, Health Policy, Public Health, Environmental and Occupational Health
Abstract: To evaluate the safety and efficacy of COVID-19 vaccines in pregnant women performing an updated meta-analysis.We searched PubMed, Cochrane Central, and SCOPUS from inception to March 2022. Outcomes of interest were incidence of adverse maternal, fetal and neonatal consequences pertaining to safety of the vaccines. Secondarily, we analyzed the number of SARS-CoV-2 infections, hospitalization for COVID-19, and admission to the I.C.U. for COVID-19 assessing the effectiveness of vaccines. Results were pooled using a random effects model.Ten observational studies (n=326,499) analyzing pregnant women were included. Our results suggest that COVID-19 vaccination prevents infection (OR: 0.56, 95% CI: 0.47, 0.67; P = 0.00001) and related hospitalizations (OR: 0.50, 95% CI: 0.31, 0.82; P = 0.006) effectively. It was also observed that vaccination does not change adverse outcomes in pregnancy, namely preeclampsia or eclampsia, stroke (four weeks of delivery), meconium-stained amniotic fluid, spontaneous vaginal delivery, operative vaginal delivery, cesarean delivery, postpartum hemorrhage, and blood transfusions. Furthermore, the vaccine was observed to be protective against neonatal COVID-19 I.C.U. admissions (OR: 0.85; 95% CI: 0.81, 0.90; P = 0.00001).Our pooled analysis suggests that the COVID-19 vaccination in pregnant women prevents infection effectively and has no adverse outcomes. Future large-scale trials in a randomized fashion are needed to confirm our results.
Published: 2023
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17. Leveraging electronic health records to streamline the conduct of cardiovascular clinical trials

Author: Muhammad Shahzeb Khan, Muhammad Shariq Usman, Khawaja M Talha, Harriette G C Van Spall, Stephen J Greene, Muthiah Vaduganathan, Sadiya S Khan, Nicholas L Mills, Ziad A Ali, Robert J Mentz, Gregg C Fonarow, Sunil V Rao, John A Spertus, Matthew T Roe, Stefan D Anker, Stefan K James, Javed Butler, and Darren K McGuire
Subjects: Cardiology and Cardiovascular Medicine
Abstract: Conventional randomized controlled trials (RCTs) can be expensive, time intensive, and complex to conduct. Trial recruitment, participation, and data collection can burden participants and research personnel. In the past two decades, there have been rapid technological advances and an exponential growth in digitized healthcare data. Embedding RCTs, including cardiovascular outcome trials, into electronic health record systems or registries may streamline screening, consent, randomization, follow-up visits, and outcome adjudication. Moreover, wearable sensors (i.e. health and fitness trackers) provide an opportunity to collect data on cardiovascular health and risk factors in unprecedented detail and scale, while growing internet connectivity supports the collection of patient-reported outcomes. There is a pressing need to develop robust mechanisms that facilitate data capture from diverse databases and guidance to standardize data definitions. Importantly, the data collection infrastructure should be reusable to support multiple cardiovascular RCTs over time. Systems, processes, and policies will need to have sufficient flexibility to allow interoperability between different sources of data acquisition. Clinical research guidelines, ethics oversight, and regulatory requirements also need to evolve. This review highlights recent progress towards the use of routinely generated data to conduct RCTs and discusses potential solutions for ongoing barriers. There is a particular focus on methods to utilize routinely generated data for trials while complying with regional data protection laws. The discussion is supported with examples of cardiovascular outcome trials that have successfully leveraged the electronic health record, web-enabled devices or administrative databases to conduct randomized trials.
Published: 2023
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18. Performance of current risk stratification models for predicting mortality in patients with heart failure: a systematic review and meta-analysis

Author: Tariq Jamal Siddiqi, Aymen Ahmed, Stephen J Greene, Izza Shahid, Muhammad Shariq Usman, Adebamike Oshunbade, Mohamad Alkhouli, Michael E Hall, Mohammad Hassan Murad, Rohan Khera, Vardhmaan Jain, Harriette G C Van Spall, and Muhammad Shahzeb Khan
Subjects: Heart Failure, Risk Factors, Epidemiology, Humans, Hospital Mortality, Prognosis, Cardiology and Cardiovascular Medicine, Risk Assessment
Abstract: Aims There are several risk scores designed to predict mortality in patients with heart failure (HF). This study aimed to assess performance of risk scores validated for mortality prediction in patients with acute HF (AHF) and chronic HF. Methods and results MEDLINE and Scopus were searched from January 2015 to January 2021 for studies which internally or externally validated risk models for predicting all-cause mortality in patients with AHF and chronic HF. Discrimination data were analysed using C-statistics, and pooled using generic inverse-variance random-effects model. Nineteen studies (n = 494 156 patients; AHF: 24 762; chronic HF mid-term mortality: 62 000; chronic HF long-term mortality: 452 097) and 11 risk scores were included. Overall, discrimination of risk scores was good across the three subgroups: AHF mortality [C-statistic: 0.76 (0.68–0.83)], chronic HF mid-term mortality [1 year; C-statistic: 0.74 (0.68–0.79)], and chronic HF long-term mortality [≥2 years; C-statistic: 0.71 (0.69–0.73)]. MEESSI-AHF [C-statistic: 0.81 (0.80–0.83)] and MARKER-HF [C-statistic: 0.85 (0.80–0.89)] had an excellent discrimination for AHF and chronic HF mid-term mortality, respectively, whereas MECKI had good discrimination [C-statistic: 0.78 (0.73–0.83)] for chronic HF long-term mortality relative to other models. Overall, risk scores predicting short-term mortality in patients with AHF did not have evidence of poor calibration (Hosmer–Lemeshow P > 0.05). However, risk models predicting mid-term and long-term mortality in patients with chronic HF varied in calibration performance. Conclusions The majority of recently validated risk scores showed good discrimination for mortality in patients with HF. MEESSI-AHF demonstrated excellent discrimination in patients with AHF, and MARKER-HF and MECKI displayed an excellent discrimination in patients with chronic HF. However, modest reporting of calibration and lack of head-to-head comparisons in same populations warrant future studies.
Published: 2022
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19. Safety and Efficacy of Empagliflozin and Diuretic Use in Patients with Heart Failure and Preserved Ejection Fraction

Author: Javed Butler, Muhammad Shariq Usman, Gerasimos Filippatos, João Pedro Ferreira, Michael Böhm, Martina Brueckmann, James L. Januzzi, Sanjay Kaul, Ileana L. Piña, Piotr Ponikowski, Michele Senni, Mikhail Sumin, Subodh Verma, Liliana Zaremba-Pechmann, Stuart J. Pocock, Milton Packer, and Stefan Anker
Subjects: Cardiology and Cardiovascular Medicine
Abstract: ImportanceThe diuretic effect of sodium-glucose cotransporter 2 inhibitors may result in interaction with background diuretic therapy in patients with heart failure and preserved ejection fraction (HFpEF).ObjectiveTo assess the safety and efficacy of empagliflozin in combination with background diuretic therapy and the association of empagliflozin with the need for conventional diuretics.Design, Setting, and ParticipantsThis was a post hoc analysis of the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Preserved Ejection Fraction (EMPEROR-Preserved). EMPEROR-Preserved was a phase 3, randomized, placebo-controlled, double-blind clinical trial conducted from March 2017 to April 2021. Patients with class II to IV heart failure and left ventricular ejection fraction greater than 40% were included. Of 5988 patients enrolled, 5815 (97.1%) had baseline data on diuretic use and were included in this analysis, which was conducted from November 2021 to August 2022.InterventionsParticipants in EMPEROR-Preserved were randomized to empagliflozin or placebo. In this analysis, participants were divided into 4 subgroups: no diuretics and furosemide-equivalent diuretic dose of less than 40 mg, 40 mg, and greater than 40 mg at baseline.Main Outcomes and MeasuresThe main outcomes of interest were first hospitalization for heart failure (HHF) or cardiovascular death (CV death) and its components. Association of empagliflozin vs placebo with outcomes by baseline diuretic status (no diuretic vs any dose) and dose (no diuretic, 40mg) was assessed. Association of empagliflozin use with changes in diuretic therapy was also studied.ResultsAmong 5815 patients (mean [SD] age, 71.9 [9.4] years; 2594 [44.6%] female) with known baseline diuretic use, 1179 (20.3%) were not taking diuretics, 1725 (29.7%) were taking less than 40 mg, 1772 (30.5%) were taking 40 mg, and 1139 (19.6%) were taking greater than 40 mg. In the placebo arm, patients with higher diuretic doses had worse outcomes. Empagliflozin decreased the risk of HHF or CV death, regardless of background diuretic status (hazard ratio [HR], 0.81; 95% CI, 0.70-0.93] for the diuretic group vs HR, 0.72; 95% CI, 0.48-1.06 for the nondiuretic group; P for interaction = .58). Similarly, diuretic status was not associated with changes in improvements in first HHF, total HHF, rate of decline in estimated glomerular filtration rate, and Kansas City Cardiomyopathy Questionnaire 23 clinical summary score with empagliflozin. Findings were consistent when patients were categorized by diuretic dose. Empagliflozin was associated with a decreased likelihood of diuretic dose escalation (HR, 0.74; 95% CI, 0.65-0.84) and an increased likelihood of de-escalation (HR, 1.15; 95% CI, 1.02-1.30). Empagliflozin was associated with an increased risk of volume depletion in patients taking diuretics (HR, 1.34; 95% CI, 1.13-1.59).ConclusionIn this study, treatment with empagliflozin was similar regardless of diuretic use or dose. Empagliflozin use was associated with decreased conventional diuretic dosing.Trial RegistrationClinicalTrials.gov Identifier: NCT03057951
Published: 2023
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20. Patient Phenotype Profiling in Heart Failure with Preserved Ejection Fraction to Guide Therapeutic Decision Making A Scientific Statement of the Heart Failure Association (HFA) and the European Heart Rhythm Association (EHRA) of the ESC, and the European Society of Hypertension (ESH)

Author: Stefan D. Anker, Muhammad Shariq Usman, Markus S. Anker, Javed Butler, Michael Böhm, William T Abraham, Marianna Adamo, Vijay K Chopra, Mariantonietta Cicoira, Francesco Cosentino, Gerasimos Filippatos, Lars H Lund, Brenda Moura, Wilfried Mullens, Burkert Pieske, Piotr Ponikowski, Jose R. Gonzalez‐Juanatey, Gianluigi Savarese, Petar Seferovic, John R. Teerlink, Carsten Tschöpe, Maurizio Volterrani, Stephan von Haehling, Jian Zhang, Yuhui Zhang, Johann Bauersachs, Ulf Landmesser, Shelley Zieroth, Konstantinos Tsioufis, Antoni Bayes‐Genis, Ovidiu Chioncel, Felicita Andreotti, Enrico Agabiti‐Rosei, Jose L. Merino, Marco Metra, Andrew JS Coats, and Giuseppe MC Rosano
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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21. Effect of Canagliflozin on Heart Failure Hospitalization in Diabetes According to Baseline Heart Failure Risk

Author: Muhammad Shahzeb Khan, Matthew W. Segar, Muhammad Shariq Usman, Kershaw V. Patel, Harriette G.C. Van Spall, Adam D. DeVore, Muthiah Vaduganathan, Carolyn S.P. Lam, Faiez Zannad, Subodh Verma, Javed Butler, W.H. Wilson Tang, and Ambarish Pandey
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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22. Effect of vitamin D on postoperative atrial fibrillation in patients who underwent coronary artery bypass grafting: A systematic review and Meta-analysis

Author: Ishaque Hameed, Shanza Malik, Khushboo Nusrat, Omer Mustafa Siddiqui, Mohammad Omer Khan, Samar Mahmood, Areeba Memon, Muhammad Shariq Usman, and Tariq Jamal Siddiqi
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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23. SGLT2 Inhibitors: From Antihyperglycemic Agents to All-Around Heart Failure Therapy

Author: Stefan D. Anker, Muhammad Shariq Usman, and Javed Butler
Subjects: Physiology (medical), Cardiology and Cardiovascular Medicine
Published: 2022
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24. Evaluating the effect of multivalvular disease on mortality after transcatheter aortic valve replacement for aortic stenosis: a meta-analysis and systematic review

Author: Tariq Jamal Siddiqi, Muhammad Shariq Usman, Jawad Ahmed, Izza Shahid, Warda Ahmed, and Mohamad Alkhouli
Subjects: Molecular Medicine, Cardiology and Cardiovascular Medicine
Abstract: Aims: To determine the prognosis of multivalvular disease in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. Methods: Patients undergoing TAVR for aortic stenosis with covariate-adjusted risk of mortality associated with concomitant valve disease (mitral regurgitation [MR], mitral stenosis [MS] or tricuspid regurgitation [TR]) were included. Results: Moderate-to-severe MR was associated with increased mortality at 30 days (hazard ratio [HR]: 1.60; 95% CI: 1.11–2.30; p = 0.01) and 1 year (HR: 1.87; 95% CI: 1.22–2.87; p = 0.004). The presence of all-grade MS did not impact 30-day or 1-year mortality (HR, 30 days: 1.60; 95% CI: 0.71–3.63; p = 0.26; and HR, 1 year: 1.90; 95% CI: 0.98–3.69; p = 0.06); however, an increased risk of 1-year mortality (HR: 1.67; 95% CI: 1.03–2.70; p = 0.04) was observed with severe MS compared with no MS. Moderate-to-severe TR had a higher risk of all-cause mortality at 1 year (HR: 1.49; 95% CI: 1.24–1.78; p
Published: 2022
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25. The need for increased pragmatism in cardiovascular clinical trials

Author: Muhammad Shariq Usman, Harriette G. C. Van Spall, Stephen J. Greene, Ambarish Pandey, Darren K. McGuire, Ziad A. Ali, Robert J. Mentz, Gregg C. Fonarow, John A. Spertus, Stefan D. Anker, Javed Butler, Stefan K. James, and Muhammad Shahzeb Khan
Subjects: Comparative Effectiveness Research, Heart Disease, Cardiovascular System & Hematology, Clinical Research, Cardiovascular Diseases, Prevention, Clinical Trials and Supportive Activities, Humans, Cardiorespiratory Medicine and Haematology, Cardiovascular, Cardiology and Cardiovascular Medicine
Abstract: The majority of cardiovascular randomized controlled trials (RCTs) test interventions in selected patient populations under explicitly protocol-defined settings. Although these 'explanatory' trial designs optimize conditions to test the efficacy and safety of an intervention, they limit the generalizability of trial findings in broader clinical settings. The concept of 'pragmatism' in RCTs addresses this concern by providing counterbalance to the more idealized situation underpinning explanatory RCTs and optimizing effectiveness over efficacy. The central tenets of pragmatism in RCTs are to test interventions in routine clinical settings, with patients who are representative of broad clinical practice, and to reduce the burden on investigators and participants by minimizing the number of trial visits and the intensity of trial-based testing. Pragmatic evaluation of interventions is particularly important in cardiovascular diseases, where the risk of death among patients has remained fairly stable over the past few decades despite the development of new therapeutic interventions. Pragmatic RCTs can help to reveal the 'real-world' effectiveness of therapeutic interventions and elucidate barriers to their implementation. In this Review, we discuss the attributes of pragmatism in RCT design, conduct and interpretation as well as the general need for increased pragmatism in cardiovascular RCTs. We also summarize current challenges and potential solutions to the implementation of pragmatism in RCTs and highlight selected ongoing and completed cardiovascular RCTs with pragmatic trial designs.
Published: 2022
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26. Frailty, Guideline-Directed Medical Therapy, and Outcomes in HFrEF

Author: Muhammad Shahzeb Khan, Matthew W. Segar, Muhammad Shariq Usman, Sumitabh Singh, Stephen J. Greene, Gregg C. Fonarow, Stefan D. Anker, G. Michael Felker, James L. Januzzi, Javed Butler, and Ambarish Pandey
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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27. Polypharmacy and Optimization of Guideline-Directed Medical Therapy in Heart Failure

Author: Muhammad Shahzeb Khan, Sumitabh Singh, Matthew W. Segar, Muhammad Shariq Usman, Neil Keshvani, Andrew P. Ambrosy, Mona Fiuzat, Harriette G.C. Van Spall, Gregg C. Fonarow, Faiez Zannad, G. Michael Felker, James L. Januzzi, Christopher O’Connor, Javed Butler, and Ambarish Pandey
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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28. ‘Normal weight’ is really not normal in chronic disease

Author: Stefan D Anker, Muhammad Shariq Usman, and Javed Butler
Subjects: Heart Failure, Body Weight, Chronic Disease, Humans, Cardiology and Cardiovascular Medicine, Body Mass Index
Published: 2022
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29. Pragmatism in clinical trials: essential, not optional

Author: Muhammad Shariq Usman, Javed Butler, and Muhammad Shahzeb Khan
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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30. Meta-Analysis of Racial Disparity in Outcomes of Acute Myocardial Infarction

Author: Izza Shahid, Muhammad Shariq Usman, Ramil Dadabhoy, Qazi Shurjeel, Pankaj Kumar, and Tariq Jamal Siddiqi
Subjects: Racial Groups, Myocardial Infarction, Humans, Cardiology and Cardiovascular Medicine, White People
Published: 2022
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31. High-Intensity Interval Training Versus Moderate Continuous Training in Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-analysis

Author: Tariq Jamal Siddiqi, Ahmed Mustafa Rashid, Syed Sarmad Javaid, Ahmed Kamal Siddiqi, Muhammad Shariq Usman, Oliver Hervir, Daisuke Kamimura, Carl J. Lavie, Robert J. Mentz, Javed Butler, and Michael E. Hall
Subjects: General Medicine, Cardiology and Cardiovascular Medicine
Published: 2023
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32. Target trial emulations: bridging the gap between clinical trial and real‐world data

Author: Bertram Pitt, Javed Butler, and Muhammad Shariq Usman
Subjects: Heart Failure, Clinical trial, medicine.medical_specialty, Bridging (networking), business.industry, MEDLINE, Humans, Medicine, Medical physics, Cardiology and Cardiovascular Medicine, business, Real world data
Published: 2021
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33. Soluble guanylate cyclase stimulators in patients with heart failure with reduced ejection fraction across the risk spectrum

Author: Javed Butler, Muhammad Shariq Usman, Kevin J. Anstrom, Robert O. Blaustein, Marc P. Bonaca, Justin A. Ezekowitz, Cecilia Freitas, Carolyn S.P. Lam, Eldrin F. Lewis, JoAnn Lindenfeld, Ciaran J. McMullan, Robert J. Mentz, Christopher O'Connor, Giuseppe M.C. Rosano, Clara Inés Saldarriaga, Michele Senni, James Udelson, Adriaan A. Voors, and Faiez Zannad
Subjects: Vericiguat, HFrEF, Soluble guanylate cyclase stimulators, Cardiology and Cardiovascular Medicine
Abstract: Patients with heart failure with reduced ejection fraction (HFrEF) have a high residual risk of adverse outcomes, even when treated with optimal guideline-directed medical therapy and in a clinically stable state. Soluble guanylate cyclase (sGC) stimulators have the potential to lower this risk by modifying the nitric oxide–sGC–cyclic guanosine monophosphate cascade – a pathophysiological pathway that has been targeted with limited success in HFrEF previously. Vericiguat, an sGC stimulator, was shown to improve outcomes in patients with HFrEF in the VICTORIA (Vericiguat Global Study in Subjects with Heart Failure with Reduced Ejection Fraction) trial. However, this trial included patients with recently worsening disease. In this brief review, we discuss the rationale of evaluating sGC stimulators in lower-risk HFrEF patients. First, all key HFrEF medications have been evaluated in both higher- and lower-risk populations, and the treatment effect is not always consistent across the risk spectrum. Second, pre-clinical studies and post-hoc studies of the VICTORIA trial have suggested that sGC stimulators may have cardioprotective effects – these effects may be more apparent when the medication is initiated earlier in the disease process. Third, the effect of vericiguat on cardiovascular mortality remains uncertain and a trial with a longer follow-up in a lower-risk population may allow better assessment of its effect on cardiovascular mortality. Therefore, there is a pertinent need to investigate the effects of vericiguat in optimally treated, low-risk HFrEF patients (i.e. those without recently worsening heart failure).
Published: 2022

34. The Interplay Between Diabetes, Cardiovascular Disease, and Kidney Disease

Author: Muhammad Shahzeb Khan, Javed Butler, and Muhammad Shariq Usman
Subjects: medicine.medical_specialty, business.industry, Internal medicine, Diabetes mellitus, medicine, MEDLINE, Disease, medicine.disease, business, Kidney disease
Abstract: The Global Burden of Disease Study estimates that there are currently 476 million patients with diabetes worldwide, the large majority of whom suffer from type 2 diabetes. The metabolic system is closely interrelated with the cardiac and renal systems, and these three systems share a symbiotic relationship that helps maintain homeostasis. The heart is one of the most metabolically demanding organs and is sensitive to changes in energy and volume status. Thus, it relies on the liver, pancreas, and fat for optimal energy metabolism and on the kidneys for volume maintenance. Similarly, the kidneys rely on the heart for adequate perfusion and on the metabolic system for the appropriate hormonal milieu, both of which are necessary to maintain their function.
Published: 2021
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35. Incidence and prognosis of COVID-19 amongst heart transplant recipients: a systematic review and meta-analysis

Author: Marat Fudim, Minaam Abid, Talha Maniya, Muhammad Shariq Usman, and Furqan Ahmed
Subjects: 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, Epidemiology, business.industry, Incidence, Incidence (epidemiology), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, COVID-19, Prognosis, Internal medicine, Meta-analysis, Research Letter, medicine, Heart Transplantation, Humans, AcademicSubjects/MED00200, Cardiology and Cardiovascular Medicine, business
Published: 2021
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36. Utilization of Implantable Cardioverter Defibrillators Among Patients with a Left Ventricular Assist Device: Insights From a National Database

Author: Muhammad Shariq Usman, Abdul Mannan Khan Minhas, Stephen J Greene, Harriette GC Van Spall, Robert J Mentz, Gregg C Fonarow, Sana M. Al-Khatib, Javed Butler, and Muhammad Shahzeb Khan
Subjects: Heart Failure, Hospitalization, Humans, General Medicine, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, Defibrillators, Implantable, Retrospective Studies
Abstract: The trends of implantable cardioverter defibrillator (ICD) use in patients with a durable left ventricular assist device (LVAD) remain uncertain. We used the National Inpatient Sample to identify hospitalizations between 2009 and 2018 in which patients received a new LVAD or had a pre-existing one. Procedure codes were then used to identify hospitalizations in which a new ICD was implanted. In 34,113 hospitalizations for new and/or replacement LVADs, an ICD was implanted in 1297 (3.8%). The rate of ICD implantation along with an LVAD declined from 2009 to 2018 (annual percent change: -23.2%; P-trend0.001). Independent factors associated with concurrent ICD implantation in patients receiving LVAD were younger age, White (compared with Black) race, and in-hospital cardiac arrest. Concurrent ICD implantation was associated with a longer hospital stay (adjusted mean difference: 4.48 days) and higher inflation-adjusted costs (adjusted mean difference: $31,679), but lower in-hospital mortality rates (adjusted odds ratio: 0.29; P0.001), compared with LVAD placement alone. Amongst 95,583 hospitalizations of patients with a pre-existing LVAD, an ICD was placed in 616 (0.64%). There was no change in the rate of ICD implantation from 2009 to 2018 in patients with a pre-existing LVAD (annual percent change: -10.34%; P = 0.18).
Published: 2022

37. EFFECT OF SGLT2 INHIBITORS ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH HEART FAILURE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Muhammad Shariq Usman, Arsalan Hamid, Tariq Jamal Siddiqi, Qazi Shurjeel, Sana Qazi, and Javed Butler
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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38. ANGIOTENSIN RECEPTOR NEPRILYSIN INHIBITION IN ACUTE MYOCARDIAL INFARCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Tariq Jamal Siddiqi, Muhammad Shariq Usman, Ahmed Mustafa Rashid, Dayab Asad, Syed Sarmad Javaid, Mahmoud Al Rifai, Javed Butler, and Michael E. Hall
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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39. Efficacy of empagliflozin in heart failure with preserved versus mid-range ejection fraction

Author: Stefan D. Anker, Javed Butler, Muhammad Shariq Usman, Gerasimos Filippatos, João Pedro Ferreira, Edimar Bocchi, Michael Böhm, Hans Pieter Brunner-La Rocca, Dong-Ju Choi, Vijay Chopra, Eduardo Chuquiure, Nadia Giannetti, Juan Esteban Gomez-Mesa, Stefan Janssens, James L. Januzzi, José R. González-Juanatey, Bela Merkely, Stephen J. Nicholls, Sergio V. Perrone, Ileana L. Piña, Piotr Ponikowski, Michele Senni, David Sim, Jindrich Spinar, Iain Squire, Stefano Taddei, Hiroyuki Tsutsui, Subodh Verma, Dragos Vinereanu, Jian Zhang, Tomoko Iwata, Janet M. Schnee, Martina Brueckmann, Stuart J. Pocock, Faiez Zannad, MUMC+: MA Cardiologie (3), RS: Carim - H02 Cardiomyopathy, and Cardiologie
Subjects: General Medicine, General Biochemistry, Genetics and Molecular Biology
Abstract: The EMPEROR-Preserved trial showed that the sodium–glucose co-transporter 2 inhibitor empagliflozin significantly reduces the risk of cardiovascular death or hospitalization for heart failure (HHF) in heart failure patients with left ventricular ejection fraction (LVEF) > 40%. Here, we report the results of a pre-specified analysis that separately evaluates these patients stratified by LVEF: preserved (≥ 50%) (n = 4,005; 66.9%) or mid-range (41–49%). In patients with LVEF ≥ 50%, empagliflozin reduced the risk of cardiovascular death or HHF (the primary endpoint) by 17% versus placebo (hazard ratio (HR) 0.83; 95% confidence interval (CI): 0.71–0.98, P = 0.024). For the key secondary endpoint, the HR for total HHF was 0.83 (95%CI: 0.66–1.04, P = 0.11). For patients with an LVEF of 41–49%, the HR for empagliflozin versus placebo was 0.71 (95%CI: 0.57–0.88, P = 0.002) for the primary outcome (Pinteraction = 0.27), and 0.57 (95%CI: 0.42–0.79, P Pinteraction = 0.06). These results, together with those from the EMPEROR-Reduced trial in patients with LVEF
Published: 2022

40. Robustness of outcomes in trials evaluating sodium-glucose co-transporter 2 inhibitors for heart failure

Author: Muhammad Shariq Usman, Muhammad Shahzeb Khan, Gregg C. Fonarow, Stephen J. Greene, Tim Friede, Muthiah Vaduganathan, Gerasimos Filippatos, Andrew J. Stewart Coats, Stefan D. Anker, and Javed Butler
Subjects: Heart Failure, RM, Glucose, Symporters, Sodium, Humans, Cardiology and Cardiovascular Medicine, QP, Sodium-Glucose Transporter 2 Inhibitors, RC
Abstract: Aims: Recent trials have evaluated sodium–glucose co‐transporter 2 inhibitors in patients with heart failure (HF). We sought to assess the robustness of findings from these trials using the fragility index (FI). \ud \ud Methods and results: Fragility index is defined as the minimum number of patients that must be moved from the ‘non‐event’ to the ‘event’ group to turn a statistically significant result to non‐significant. In addition to FI, fragility quotient [(FQ); FI divided by the sample size] was calculated to assess the proportion of events that must be moved to change the significance. For statistically non‐significant outcomes, reverse fragility index (RFI) and reverse fragility quotient (RFQ) were calculated. Robustness of findings after pooling data from all three trials was also assessed. A robust reduction in first HF hospitalization or cardiovascular mortality was seen with dapagliflozin (FI = 62 and FQ = 0.013), empagliflozin (FI = 50 and FQ = 0.013), and sotagliflozin (FI = 60 and FQ = 0.049). Dapagliflozin nominally improved all‐cause and cardiovascular mortality, with modest FI (n = 8 and 5) and FQ (0.002 and 0.001). Empagliflozin and sotagliflozin did not demonstrate statistically significant reductions in all‐cause mortality, with modest RFI (empagliflozin: RFI = 26 and RFQ = 0.007; sotagliflozin: RFI = 6 and RFQ = 0.005). A similar trend was seen with cardiovascular mortality (empagliflozin: RFI = 24 and RFQ = 0.006; sotagliflozin: RFI = 7 and RFQ = 0.006). Upon meta‐analysis, the result for first HF hospitalization or cardiovascular mortality was robust (FI = 95 and FQ = 0.010). The reductions in all‐cause (FI = 12 and FQ = 0.001) and cardiovascular mortality (FI = 9 and FQ = 0.001), while statistically significant, were fragile. \ud \ud Conclusion: Improvement in the composite outcome of first HF hospitalization or cardiovascular death was highly concordant and robust across sodium–glucose co‐transporter 2 inhibitor trials. In contrast, secondary endpoints of all‐cause and cardiovascular mortality were statistically fragile, underscoring the need to power trials for mortality to fully understand the benefit of therapies on fatal events.
Published: 2021

41. Citrus Biotechnology: Current Innovations and Future Prospects

Author: Ghulam Mustafa, Muhammad Shariq Usman, Muhammad Sarwar Khan, and Faiz Ahmad Joyia
Subjects: Natural resource economics, food and beverages, Current (fluid), Biology
Abstract: Citrus is a valuable fruit crop worldwide. It not only provides essential minerals and vitamins but is also of great commercial importance. Conventional research has contributed a lot to the improvement of this fruit plant. Numerous improved varieties have been developed through conventional breeding, mutational breeding, polyploidization and tissue culture yet pathogens continue to emerge at a consistent pace over a wide range of citrus species. Citriculture is vulnerable to various biotic and abiotic stresses which are quite difficult to be controlled through conventional research. Biotechnological intervention including transgenesis, genome editing, and OMICS offers several innovative options to resolve existing issues in this fruit crop. Genetic transformation has been established in many citrus species and transgenic plants have been developed having the ability to tolerate bacterial, viral, and fungal pathogens. Genome editing has also been worked out to develop disease-resistant plants. Likewise, advancement in OMICS has helped to improve citrus fruit through the knowledge of genomics, transcriptomics, proteomics, metabolomics, interactomics, and phenomics. This chapter highlights not only the milestones achieved through conventional research but also briefs about the achievements attained through advanced molecular biology research.
Published: 2021

42. Frailty, Guideline-Directed Medical Therapy, and Outcomes in HFrEF: From the GUIDE-IT Trial

Author: Muhammad Shahzeb, Khan, Matthew W, Segar, Muhammad Shariq, Usman, Sumitabh, Singh, Stephen J, Greene, Gregg C, Fonarow, Stefan D, Anker, G Michael, Felker, James L, Januzzi, Javed, Butler, and Ambarish, Pandey
Subjects: Heart Failure, Frailty, Humans, Angiotensin-Converting Enzyme Inhibitors, Stroke Volume, Mineralocorticoid Receptor Antagonists
Abstract: In this study, we sought to evaluate the association of frailty with the use of optimal guideline-directed medical therapy (GDMT) and outcomes in heart failure with reduced ejection fraction (HFrEF).The burden of frailty in HFrEF is high, and the patterns of GDMT use according to frailty status have not been studied previously.A post hoc analysis of patients with HFrEF enrolled in the GUIDE-IT (Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial was conducted. Frailty was assessed with the use of a frailty index (FI) using a 38-variable deficit model, and participants were categorized into 3 groups: class 1: nonfrail, FI 0.21); class 2: intermediate frailty, FI 0.21-0.31), and class 3: high frailty, FI0.31). Multivariate-adjusted Cox models were used to study the association of frailty status with clinical outcomes. Use of optimal GDMT over time (beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and mineralocorticoid receptor antagonists) across frailty strata was assessed with the use of adjusted linear and logistic mixed-effect models.The study included 879 participants, of which 56.3% had high frailty burden (class 3 FI). A higher frailty burden was associated with a significantly higher risk of HF hospitalization or death in adjusted Cox models: high frailty vs nonfrail HR: 1.76, 95% CI: 1.20-2.58. On follow-up, participants with high frailty burden also had a significantly lower likelihood of achieving optimal GDMT: high frailty vs non-frail GDMT triple therapy use at study end: 17.7% vs 28.4%; P interaction, frailty class × time 0.001.Patients with HFrEF with a high burden of frailty have a significantly higher risk for adverse clinical outcomes and are less likely to be initiated and up-titrated on an optimal GDMT regimen.
Published: 2021

43. Efficacy and Safety of Oral P2Y12 Inhibitors in Older Patients with Acute Coronary Syndrome: A Frequentist Network Meta-Analysis

Author: Pradhum Ram, Fahd Makhdom, Vanita Motiani, Muhammad Abdullah Nizam, Muhammad Shariq Usman, Unaiza Naeem, Tehlil Rizwan, Izza Shahid, Ritesh G. Menezes, and Tariq Jamal Siddiqi
Subjects: Acute coronary syndrome, medicine.medical_specialty, Ticagrelor, Prasugrel, Network Meta-Analysis, law.invention, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Humans, Pharmacology (medical), Acute Coronary Syndrome, Aged, business.industry, medicine.disease, Clopidogrel, Confidence interval, Treatment Outcome, Relative risk, Purinergic P2Y Receptor Antagonists, Geriatrics and Gerontology, business, Mace, Platelet Aggregation Inhibitors, medicine.drug
Abstract: BACKGROUND AND OBJECTIVE Previous studies and meta-analyses have assessed optimal P2Y12 inhibitors following acute coronary syndrome in overall trial cohorts. However, there are insufficient data for the elderly cohort who are prone to high bleeding and ischemic events. We aimed to assess the optimal P2Y12 inhibitor therapy for older patients. METHODS PubMed, CENTRAL, and ClinicalTrials.gov databases were searched from inception through July 2020 to identify randomized controlled trials and propensity-matched observational studies including older patients (aged ≥ 65 years) that reported study-defined major adverse cardiovascular events (MACE) or major bleeding events. Outcomes at the mid-term follow-up were pooled to conduct a frequentist network meta-analysis. RESULTS Fourteen studies involving 12,953 older patients were included in our analysis. No significant difference was observed with MACE when all three P2Y12 inhibitors were compared with each other. Compared with clopidogrel, ticagrelor significantly increased the risk of major bleeding (risk ratio 1.35, 95% confidence interval 1.10-1.67) while prasugrel did not (risk ratio 1.02, 95% confidence interval 0.67-1.57). A sensitivity analysis of only randomized controlled trials yielded similar results for both MACE and major bleeding. The P score displayed prasugrel (0.5871) as the best treatment for MACE, while clopidogrel (0.7701) was the best P2Y12 inhibitor to decrease the risk of major bleeding. Ticagrelor (0.0634) was ranked the lowest because of an increased bleeding risk. CONCLUSIONS No significant difference is observed between the three P2Y12 inhibitors in study-defined MACE. Ranking by p-score suggests prasugrel as the best P2Y12 inhibitor to reduce the risk of MACE while clopidogrel is a better alternative than ticagrelor in older patients with acute coronary syndrome to decrease the risk of major bleeding. Because of a lack of individual-patient data analysis and heterogeneity amongst studies, future studies representing older patients with acute coronary syndrome are required to strengthen evidence regarding optimal antithrombotic therapy in this cohort.
Published: 2021

44. Sodium glucose co-transporter inhibitors and heart failure outcomes across different patient populations

Author: Stefan D. Anker, Gerasimos Filippatos, Milton Packer, Javed Butler, João Pedro Ferreira, Muhammad Shariq Usman, and Faiez Zannad
Subjects: Heart Failure, Symporters, business.industry, Sodium, chemistry.chemical_element, Transporter, Pharmacology, medicine.disease, Glucose, chemistry, Diabetes Mellitus, Type 2, Heart failure, medicine, Humans, Cardiology and Cardiovascular Medicine, business, Sodium-Glucose Transporter 2 Inhibitors
Published: 2021

45. Readmissions in Patients With Heart Failure and Mental Health Disorders (from a National Database)

Author: Marat Fudim, Tariq Jamal Siddiqi, Muhammad Shahzeb Khan, Muhammad Usman Almani, John O. Kolawole, Vanessa Blumer, Muhammad Shariq Usman, Jayakumar Sreenivasan, Gabriel A. Hernandez, and Muhammad Sameer Arshad
Subjects: Heart Failure, Male, medicine.medical_specialty, Databases, Factual, business.industry, Mental Disorders, medicine.disease, Patient Readmission, Mental health, United States, Internal medicine, Heart failure, Emergency medicine, medicine, Cardiology, Humans, Female, National database, In patient, Cardiology and Cardiovascular Medicine, business, Aged
Published: 2021
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46. Chest computed tomography findings in hospitalized COVID-19 patients: a systematic review and meta-analysis

Author: Syed Zaki, Muhammad, Areeba, Ahmed, Izza, Shahid, Abdullah, Khalid, Ritesh G, Menezes, Muhammad Usman, Sheikh, Tariq Jamal, Siddiqi, Muhammad Shariq, Usman, and Faisal, Khosa
Subjects: Male, Clinical Laboratory Techniques, SARS-CoV-2, Pneumonia, Viral, COVID-19, Medical Records, Hospitalization, Betacoronavirus, COVID-19 Testing, Confidence Intervals, Humans, Regression Analysis, Female, Radiography, Thoracic, Coronavirus Infections, Tomography, X-Ray Computed, Lung, Pandemics, Retrospective Studies
Abstract: Most studies evaluating chest computed tomography (CT) features in coronavirus disease 2019 (COVID-19) have been small-sized and have presented varied findings. We aim to systematically review these studies and to conduct a meta-analysis of their results to provide a well-powered assessment of chest CT findings in patients with COVID-19. PubMed and EMBASE databases were systematically searched to identify published studies that evaluated chest CT findings in COVID-19 patients. Data regarding study characteristics and CT findings, including distribution of lesions, the lobe of lung involved, lesion densities, and radiological patterns, were extracted. Arcsine transformed proportions from individual studies were pooled using a random-effects model to derive pooled proportions (PPs) and 95% confidence intervals (CIs). A total of fifty-four studies (n=2693 confirmed COVID-19 patients) were included in the final review. Prevalence of different CT findings varied across studies; however, the most common findings were bilateral pulmonary involvement (PP: 74.1% [68.4%, 79.5%]; I2 = 85.76%), ground glass opacification (PP: 64.6% [57.6%, 71.4%]; I2 = 91.52%), involvement of the left lower lobe (PP: 71.2% [58.9%, 82.1%]; I2 = 90.91%), and subpleural distribution of lesions (PP: 57.2% [39.0%, 74.3%]; I2 = 93.08%). Multivariate meta-regression revealed a positive association between prevalence of air bronchograms and average age of the population (p=0.013). Bilateral ground glass opacification, a subpleural distribution of lesions, and involvement of the left lower lobe were the most notable chest CT findings in COVID-19 patients.
Published: 2020

47. The Burden of Dementia due to down Syndrome, Parkinson's Disease, Stroke, and Traumatic Brain Injury: A Systematic Analysis for the Global Burden of Disease Study 2019

Author: Nichols, E, Abd-Allah, F, Abdoli, A, Abu-Gharbieh, E, D Adelson, J, Olusola Akinyemi, R, Mashhour Alanezi, F, Alipour, V, Arabloo, J, Ayano, G, Amin Baig, A, Banach, M, A Barboza, M, Lyn Barker-Collo, S, T Baune, B, Srikanth Bhagavathula, A, Bhattacharyya, K, Bijani, A, Biondi, A, Biswas, A, Rao Bolla, S, Boloor, A, Brayne, C, Brenner, H, Burkart, K, A Burns, R, Burugina Nagaraja, S, Alberto Cámera, L, Carvalho, F, S Castro-de-Araujo, L, Cerin, E, Cernigliaro, A, Cherbuin, N, Jasmine Choi, J, Chu, D, S Couto, R, Dagnew, B, Kim Dang, A, Diaz, D, Sadat Dibaji Forooshani, Z, Djalalinia, S, Narh Doku, P, I El-Jaafary, S, Eskandari, K, Eskandarieh, S, Farzadfar, F, L Feigin, V, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Gaidhane, S, Ghashghaee, A, Gialluisi, A, V Gnedovskaya, E, Golechha, M, Rifat Haider, M, Hamidi, S, J Hankey, G, Hassan, A, I Hay, S, I Hegazy, M, Heidari, G, Heidari-Soureshjani, R, Househ, M, Hwang, B, Iacoviello, L, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Sina Naghibi Irvani, S, Mofizul Islam, M, Iso, H, Iwagami, M, Prakash Jha, R, B Jonas, J, Jerzy Jozwiak, J, Kalani, R, Karch, A, Semachew Kasa, A, Nazli Khatib, M, Jin Kim, Y, Kisa, A, Kisa, S, Koyanagi, A, A Kukull, W, Kumar, M, Landires, I, E LeGrand, K, Leonardi, M, Li, B, Liu, X, Logroscino, G, Lorkowski, S, Amin, H, Madhava Kunjathur, S, Manjunatha, N, Geta Meharie, B, Mohan Mehndiratta, M, Mekonnen Metekiya, W, Mohamed Ibrahim, N, Mohammad, Y, Mohammed, S, Mohapatra, A, H Mokdad, A, Mondello, S, Moradi, G, Belete Mossie, T, Nagel, G, David Naimzada, M, Muhammad Naveed, D, C Nayak, V, Tat Nguyen, C, Lan Thi Nguyen, H, Hoang Nguyen, S, Nunez-Samudio, V, T Olagunju, A, M Ostojic, S, M Ostroff, S, Otstavnov, N, S Otstavnov, S, O Owolabi, M, Panda-Jonas, S, K Patel, U, Pathak, M, Pazoki Toroudi, H, B Peterson, C, Quang Pham, H, Pinheiro, M, A Piradov, M, Hyder Pottoo, F, Pourshams, A, I Prada, S, Ria Angga Pribadi, D, Radfar, A, Raggi, A, Rahim, F, Ram, P, Rana, J, Rashedi, V, Laith Rawaf, D, Rawaf, S, Reinig, N, Rezaei, N, Rezapour, A, R Robinson, S, Romoli, M, Roshandel, G, S Sachdev, P, Sahebkar, A, Ali Sahraian, M, Sattin, D, Sawhney, M, Saylan, M, Schiavolin, S, Sha, F, Shahid, I, Ali Shaikh, M, H Shaw, D, Shigematsu, M, Il Shin, J, Shiri, R, Jamal Siddiqi, T, Pedro Silva, J, A Singh, J, Singhal, D, Soheili, A, I Szoeke, C, Tabarés-Seisdedos, R, Wogayehu Taddele, B, Thakur, B, Roberto Tovani-Palone, M, Xuan Tran, B, S Travillian, R, Wudie Tsegaye, G, Shariq Usman, M, Vacante, M, R Valdez, P, Zuleika Velazquez, D, Venketasubramanian, N, Vlassov, V, Thu Vu, G, Wang, Y, Hailay Weldemariam, A, Westerman, R, Wu, C, Yadollahpour, A, Yamagishi, K, Yano, Y, Gizachew Yeshitila, Y, Yonemoto, N, Yu, C, Zhang, Z, L Murray, C, Theo Vos, A, Emma Nichols, Foad Abd-Allah, Amir Abdoli, Eman Abu-Gharbieh, Jaimie D Adelson, Rufus Olusola Akinyemi, Fahad Mashhour Alanezi, Vahid Alipour, Jalal Arabloo, Getinet Ayano, Atif Amin Baig, Maciej Banach, Miguel A Barboza, Suzanne Lyn Barker-Collo, Bernhard T Baune, Akshaya Srikanth Bhagavathula, Krittika Bhattacharyya, Ali Bijani, Antonio Biondi, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Sharath Burugina Nagaraja, Luis Alberto Cámera, Felix Carvalho, Luis F S Castro-de-Araujo, Ester Cerin, Achille Cernigliaro, Nicolas Cherbuin, Jee-Young Jasmine Choi, Dinh-Toi Chu, Rosa A S Couto, Baye Dagnew, Anh Kim Dang, Daniel Diaz, Zahra Sadat Dibaji Forooshani, Shirin Djalalinia, Paul Narh Doku, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Farshad Farzadfar, Valery L Feigin, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Florian Fischer, Shilpa Gaidhane, Ahmad Ghashghaee, Alessandro Gialluisi, Elena V Gnedovskaya, Mahaveer Golechha, Mohammad Rifat Haider, Samer Hamidi, Graeme J Hankey, Amr Hassan, Simon I Hay, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Mowafa Househ, Bing-Fang Hwang, Licia Iacoviello, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, M Mofizul Islam, Hiroyasu Iso, Masao Iwagami, Ravi Prakash Jha, Jost B Jonas, Jacek Jerzy Jozwiak, Rizwan Kalani, André Karch, Ayele Semachew Kasa, Mahalaqua Nazli Khatib, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Ai Koyanagi, Walter A Kukull, Manasi Kumar, Iván Landires, Kate E LeGrand, Matilde Leonardi, Bingyu Li, Xuefeng Liu, Giancarlo Logroscino, Stefan Lorkowski, Hawraz Ibrahim M. Amin, Shilpashree Madhava Kunjathur, Narayana Manjunatha, Birhanu Geta Meharie, Man Mohan Mehndiratta, Workua Mekonnen Metekiya, Norlinah Mohamed Ibrahim, Yousef Mohammad, Salahuddin Mohammed, Archisman Mohapatra, Ali H Mokdad, Stefania Mondello, Ghobad Moradi, Tilahun Belete Mossie, Gabriele Nagel, Mukhammad David Naimzada, Dr Muhammad Naveed, Vinod C Nayak, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Son Hoang Nguyen, Virginia Nunez-Samudio, Andrew T Olagunju, Sergej M Ostojic, Samuel M Ostroff, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Urvish K Patel, Mona Pathak, Hamidreza Pazoki Toroudi, Carrie B Peterson, Hai Quang Pham, Marina Pinheiro, Michael A Piradov, Faheem Hyder Pottoo, Akram Pourshams, Sergio I Prada, Dimas Ria Angga Pribadi, Amir Radfar, Alberto Raggi, Fakher Rahim, Pradhum Ram, Juwel Rana, Vahid Rashedi, David Laith Rawaf, Salman Rawaf, Nickolas Reinig, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Perminder S Sachdev, Amirhossein Sahebkar, Mohammad Ali Sahraian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Feng Sha, Izza Shahid, Masood Ali Shaikh, David H Shaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Tariq Jamal Siddiqi, João Pedro Silva, Jasvinder A Singh, Deepika Singhal, Amin Soheili, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Biruk Wogayehu Taddele, Bhaskar Thakur, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Ravensara S Travillian, Gebiyaw Wudie Tsegaye, Muhammad Shariq Usman, Marco Vacante, Pascual R Valdez, Diana Zuleika Velazquez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Yuan-Pang Wang, Abrha Hailay Weldemariam, Ronny Westerman, Chenkai Wu, Ali Yadollahpour, Kazumasa Yamagishi, Yuichiro Yano, Yordanos Gizachew Yeshitila, Naohiro Yonemoto, Chuanhua Yu, Zhi-Jiang Zhang, Christopher J L Murray, and Theo Vos, Nichols, E, Abd-Allah, F, Abdoli, A, Abu-Gharbieh, E, D Adelson, J, Olusola Akinyemi, R, Mashhour Alanezi, F, Alipour, V, Arabloo, J, Ayano, G, Amin Baig, A, Banach, M, A Barboza, M, Lyn Barker-Collo, S, T Baune, B, Srikanth Bhagavathula, A, Bhattacharyya, K, Bijani, A, Biondi, A, Biswas, A, Rao Bolla, S, Boloor, A, Brayne, C, Brenner, H, Burkart, K, A Burns, R, Burugina Nagaraja, S, Alberto Cámera, L, Carvalho, F, S Castro-de-Araujo, L, Cerin, E, Cernigliaro, A, Cherbuin, N, Jasmine Choi, J, Chu, D, S Couto, R, Dagnew, B, Kim Dang, A, Diaz, D, Sadat Dibaji Forooshani, Z, Djalalinia, S, Narh Doku, P, I El-Jaafary, S, Eskandari, K, Eskandarieh, S, Farzadfar, F, L Feigin, V, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Filip, I, Fischer, F, Gaidhane, S, Ghashghaee, A, Gialluisi, A, V Gnedovskaya, E, Golechha, M, Rifat Haider, M, Hamidi, S, J Hankey, G, Hassan, A, I Hay, S, I Hegazy, M, Heidari, G, Heidari-Soureshjani, R, Househ, M, Hwang, B, Iacoviello, L, Stephen Ilesanmi, O, M Ilic, I, D Ilic, M, Sina Naghibi Irvani, S, Mofizul Islam, M, Iso, H, Iwagami, M, Prakash Jha, R, B Jonas, J, Jerzy Jozwiak, J, Kalani, R, Karch, A, Semachew Kasa, A, Nazli Khatib, M, Jin Kim, Y, Kisa, A, Kisa, S, Koyanagi, A, A Kukull, W, Kumar, M, Landires, I, E LeGrand, K, Leonardi, M, Li, B, Liu, X, Logroscino, G, Lorkowski, S, Amin, H, Madhava Kunjathur, S, Manjunatha, N, Geta Meharie, B, Mohan Mehndiratta, M, Mekonnen Metekiya, W, Mohamed Ibrahim, N, Mohammad, Y, Mohammed, S, Mohapatra, A, H Mokdad, A, Mondello, S, Moradi, G, Belete Mossie, T, Nagel, G, David Naimzada, M, Muhammad Naveed, D, C Nayak, V, Tat Nguyen, C, Lan Thi Nguyen, H, Hoang Nguyen, S, Nunez-Samudio, V, T Olagunju, A, M Ostojic, S, M Ostroff, S, Otstavnov, N, S Otstavnov, S, O Owolabi, M, Panda-Jonas, S, K Patel, U, Pathak, M, Pazoki Toroudi, H, B Peterson, C, Quang Pham, H, Pinheiro, M, A Piradov, M, Hyder Pottoo, F, Pourshams, A, I Prada, S, Ria Angga Pribadi, D, Radfar, A, Raggi, A, Rahim, F, Ram, P, Rana, J, Rashedi, V, Laith Rawaf, D, Rawaf, S, Reinig, N, Rezaei, N, Rezapour, A, R Robinson, S, Romoli, M, Roshandel, G, S Sachdev, P, Sahebkar, A, Ali Sahraian, M, Sattin, D, Sawhney, M, Saylan, M, Schiavolin, S, Sha, F, Shahid, I, Ali Shaikh, M, H Shaw, D, Shigematsu, M, Il Shin, J, Shiri, R, Jamal Siddiqi, T, Pedro Silva, J, A Singh, J, Singhal, D, Soheili, A, I Szoeke, C, Tabarés-Seisdedos, R, Wogayehu Taddele, B, Thakur, B, Roberto Tovani-Palone, M, Xuan Tran, B, S Travillian, R, Wudie Tsegaye, G, Shariq Usman, M, Vacante, M, R Valdez, P, Zuleika Velazquez, D, Venketasubramanian, N, Vlassov, V, Thu Vu, G, Wang, Y, Hailay Weldemariam, A, Westerman, R, Wu, C, Yadollahpour, A, Yamagishi, K, Yano, Y, Gizachew Yeshitila, Y, Yonemoto, N, Yu, C, Zhang, Z, L Murray, C, Theo Vos, A, Emma Nichols, Foad Abd-Allah, Amir Abdoli, Eman Abu-Gharbieh, Jaimie D Adelson, Rufus Olusola Akinyemi, Fahad Mashhour Alanezi, Vahid Alipour, Jalal Arabloo, Getinet Ayano, Atif Amin Baig, Maciej Banach, Miguel A Barboza, Suzanne Lyn Barker-Collo, Bernhard T Baune, Akshaya Srikanth Bhagavathula, Krittika Bhattacharyya, Ali Bijani, Antonio Biondi, Atanu Biswas, Srinivasa Rao Bolla, Archith Boloor, Carol Brayne, Hermann Brenner, Katrin Burkart, Richard A Burns, Sharath Burugina Nagaraja, Luis Alberto Cámera, Felix Carvalho, Luis F S Castro-de-Araujo, Ester Cerin, Achille Cernigliaro, Nicolas Cherbuin, Jee-Young Jasmine Choi, Dinh-Toi Chu, Rosa A S Couto, Baye Dagnew, Anh Kim Dang, Daniel Diaz, Zahra Sadat Dibaji Forooshani, Shirin Djalalinia, Paul Narh Doku, Shaimaa I El-Jaafary, Khalil Eskandari, Sharareh Eskandarieh, Farshad Farzadfar, Valery L Feigin, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Irina Filip, Florian Fischer, Shilpa Gaidhane, Ahmad Ghashghaee, Alessandro Gialluisi, Elena V Gnedovskaya, Mahaveer Golechha, Mohammad Rifat Haider, Samer Hamidi, Graeme J Hankey, Amr Hassan, Simon I Hay, Mohamed I Hegazy, Golnaz Heidari, Reza Heidari-Soureshjani, Mowafa Househ, Bing-Fang Hwang, Licia Iacoviello, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Seyed Sina Naghibi Irvani, M Mofizul Islam, Hiroyasu Iso, Masao Iwagami, Ravi Prakash Jha, Jost B Jonas, Jacek Jerzy Jozwiak, Rizwan Kalani, André Karch, Ayele Semachew Kasa, Mahalaqua Nazli Khatib, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Ai Koyanagi, Walter A Kukull, Manasi Kumar, Iván Landires, Kate E LeGrand, Matilde Leonardi, Bingyu Li, Xuefeng Liu, Giancarlo Logroscino, Stefan Lorkowski, Hawraz Ibrahim M. Amin, Shilpashree Madhava Kunjathur, Narayana Manjunatha, Birhanu Geta Meharie, Man Mohan Mehndiratta, Workua Mekonnen Metekiya, Norlinah Mohamed Ibrahim, Yousef Mohammad, Salahuddin Mohammed, Archisman Mohapatra, Ali H Mokdad, Stefania Mondello, Ghobad Moradi, Tilahun Belete Mossie, Gabriele Nagel, Mukhammad David Naimzada, Dr Muhammad Naveed, Vinod C Nayak, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Son Hoang Nguyen, Virginia Nunez-Samudio, Andrew T Olagunju, Sergej M Ostojic, Samuel M Ostroff, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Songhomitra Panda-Jonas, Urvish K Patel, Mona Pathak, Hamidreza Pazoki Toroudi, Carrie B Peterson, Hai Quang Pham, Marina Pinheiro, Michael A Piradov, Faheem Hyder Pottoo, Akram Pourshams, Sergio I Prada, Dimas Ria Angga Pribadi, Amir Radfar, Alberto Raggi, Fakher Rahim, Pradhum Ram, Juwel Rana, Vahid Rashedi, David Laith Rawaf, Salman Rawaf, Nickolas Reinig, Nima Rezaei, Aziz Rezapour, Stephen R Robinson, Michele Romoli, Gholamreza Roshandel, Perminder S Sachdev, Amirhossein Sahebkar, Mohammad Ali Sahraian, Davide Sattin, Monika Sawhney, Mete Saylan, Silvia Schiavolin, Feng Sha, Izza Shahid, Masood Ali Shaikh, David H Shaw, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Tariq Jamal Siddiqi, João Pedro Silva, Jasvinder A Singh, Deepika Singhal, Amin Soheili, Cassandra E I Szoeke, Rafael Tabarés-Seisdedos, Biruk Wogayehu Taddele, Bhaskar Thakur, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Ravensara S Travillian, Gebiyaw Wudie Tsegaye, Muhammad Shariq Usman, Marco Vacante, Pascual R Valdez, Diana Zuleika Velazquez, Narayanaswamy Venketasubramanian, Vasily Vlassov, Giang Thu Vu, Yuan-Pang Wang, Abrha Hailay Weldemariam, Ronny Westerman, Chenkai Wu, Ali Yadollahpour, Kazumasa Yamagishi, Yuichiro Yano, Yordanos Gizachew Yeshitila, Naohiro Yonemoto, Chuanhua Yu, Zhi-Jiang Zhang, Christopher J L Murray, and and Theo Vos
Abstract: Background: In light of the increasing trend in the global number of individuals affected by dementia and the lack of any available disease-modifying therapies, it is necessary to fully understand and quantify the global burden of dementia. This work aimed to estimate the proportion of dementia due to Down syndrome, Parkinson's disease, clinical stroke, and traumatic brain injury (TBI), globally and by world region, in order to better understand the contribution of clinical diseases to dementia prevalence. Methods: Through literature review, we obtained data on the relative risk of dementia with each condition and estimated relative risks by age using a Bayesian meta-regression tool. We then calculated population attributable fractions (PAFs), or the proportion of dementia attributable to each condition, using the estimates of relative risk and prevalence estimates for each condition from the Global Burden of Disease Study 2019. Finally, we multiplied these estimates by dementia prevalence to calculate the number of dementia cases attributable to each condition. Findings: For each clinical condition, the relative risk of dementia decreased with age. Relative risks were highest for Down syndrome, followed by Parkinson's disease, stroke, and TBI. However, due to the high prevalence of stroke, the PAF for dementia due to stroke was highest. Together, Down syndrome, Parkinson's disease, stroke, and TBI explained 10.0% (95% UI: 6.0-16.5) of the global prevalence of dementia. Interpretation: Ten percent of dementia prevalence globally could be explained by Down syndrome, Parkinson's disease, stroke, and TBI. The quantification of the proportion of dementia attributable to these 4 conditions constitutes a small contribution to our overall understanding of what causes dementia. However, epidemiological research into modifiable risk factors as well as basic science research focused on elucidating intervention approaches to prevent or delay the neuropathological changes that
Published: 2021

48. Gender Disparities In Heart Failure Related Mortality Rates Among Older Adults; Data From CDC Wonder 1999-2019

Author: Abdul Mannan Khan Minhas, Ahmed Hassaan Qavi, Muhammad Shahzeb Khan, Muhammad Shariq Usman, Marat Fudim, and Khurram Nasir
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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49. EFFECT OF SGLT2 INHIBITORS ON LEFT VENTRICULAR REMODELING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Muhammad Shariq Usman, Tariq Jamal Siddiqi, Andrew Coats, Giuseppe Rosano, Gerasimos Filippatos, Stefan D. Anker, and Javed Butler
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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50. THE EFFECT OF SGLT2 INHIBITORS ON HEART FAILURE OUTCOMES ACROSS DIFFERENT DISEASE STATES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Author: Muhammad Shariq Usman, Tariq Jamal Siddiqi, Andrew Coats, Giuseppe Rosano, Gerasimos Filippatos, Stefan D. Anker, and Javed Butler
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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