Publications
573 results found
Ashrafian H, 2015, Deciphering the death of Jean-Francois Champollion (1790-1832), the man who decoded ancient Egyptian hieroglyphs, NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY, Vol: 45, Pages: 178-179, ISSN: 0987-7053
Hankir MK, Ashrafian H, Hesse S, et al., 2015, Distinctive striatal dopamine signaling after dieting and gastric bypass, TRENDS IN ENDOCRINOLOGY AND METABOLISM, Vol: 26, Pages: 223-230, ISSN: 1043-2760
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- Citations: 12
Stavridis GT, Vasili M, Ashrafian H, et al., 2015, Trans-aortic endoscopic ventricular thrombectomy in a patient with HIT and concomitant Aortic and ventricular thromboses., Gen Thorac Cardiovasc Surg, Vol: 64, Pages: 621-624
Dual aortic and ventricular thrombi are rare following myocardial infraction. We report the case of a 56-year-old man who initially denied primary percutaneous coronary intervention as a result of psychological phobia. Initial pharmacological management by thrombolysis and heparin was followed by multiple arterial thromboses including those of the left ventricle and right iliac artery with a subsequent diagnosis of heparin-induced thrombocytopaenia. Ensuing surgical management revealed the unanticipated finding of an additional aortic sinus thrombosis that was excised. The left ventricular thrombus was removed endoscopically to prevent ventricular incisions. This case emphasizes the technical advantages of video-endoscopic management of intracardiac thrombi and highlights the unexpected nature of multiple thromboses associated with heparin-induced thrombocytopaenia.
Ashrafian H, 2015, Artificial Intelligence and Robot Responsibilities: Innovating Beyond Rights, SCIENCE AND ENGINEERING ETHICS, Vol: 21, Pages: 317-326, ISSN: 1353-3452
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- Citations: 30
Ali A, Schechter M, Harling L, et al., 2015, Right Ventricular Assist Device Support for Right Ventricular Dysfunction following Heart Transplantation: Risk Factors and Clinical Outcome, 35th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation, Publisher: ELSEVIER SCIENCE INC, Pages: S60-S61, ISSN: 1053-2498
Ashrafian H, 2015, Intelligent robots must uphold human rights, NATURE, Vol: 519, Pages: 391-391, ISSN: 0028-0836
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- Citations: 9
Wu Q, Li JV, Seyfried F, et al., 2015, Metabolic phenotype-microRNA data fusion analysis of the systemic consequences of Roux-en-Y gastric bypass surgery., International Journal of Obesity, Vol: 2015, Pages: 1126-1134, ISSN: 1476-5497
Background/Objectives: Bariatric surgery offers sustained dramatic weight loss and often remission of type 2 diabetes, yet the mechanisms of establishment of these health benefits are not clear.Subjects/MethodsWe mapped the co-ordinated systemic responses of gut hormones, the circulating miRNAome and the metabolome in a rat model of Roux-en-Y gastric bypass (RYGB) surgery. Results: The response of circulating miRNAs to RYGB was striking and selective. Analysis of 14 significantly altered circulating miRNAs within a pathway context was suggestive of modulation of signalling pathways including G protein signalling, neurodegeneration, inflammation, and growth and apoptosis responses. Concomitant alterations in the metabolome indicated increased glucose transport, accelerated glycolysis and inhibited gluconeogenesis in the liver. Of particular significance, we show significantly decreased circulating miRNA-122 levels and a more modest decline in hepatic levels, following surgery. In mechanistic studies, manipulation of miRNA-122 levels in a cell model induced changes in the activity of key enzymes involved in hepatic energy metabolism, glucose transport, glycolysis, TCA cycle, pentose phosphate shunt, fatty acid oxidation and gluconeogenesis, consistent with the findings of the in vivo surgery-mediated responses, indicating the powerful homeostatic activity of the miRNAs. Conclusions: The close association between energy metabolism, neuronal signalling and gut microbial metabolites derived from the circulating miRNA, plasma, urine and liver metabolite and gut hormone correlations further supports an enhanced gut-brain signaling, which we suggest is hormonally mediated by both traditional gut hormones and miRNAs. This transomic approach to map the crosstalk between the circulating miRNAome and metabolome offers opportunities to understand complex systems biology within a disease and interventional treatment setting.International Journal of Obesity accepted article previe
Ashrafian H, Darzi A, Athanasiou T, 2015, A novel modification of the Turing test for artificial intelligence and robotics in healthcare, International Journal of Medical Robotics and Computer Assisted Surgery, Vol: 11, Pages: 38-43, ISSN: 1478-5951
BackgroundThe increasing demands of delivering higher quality global healthcare has resulted in a corresponding expansion in the development of computer‐based and robotic healthcare tools that rely on artificially intelligent technologies. The Turing test was designed to assess artificial intelligence (AI) in computer technology. It remains an important qualitative tool for testing the next generation of medical diagnostics and medical robotics.MethodsDevelopment of quantifiable diagnostic accuracy meta‐analytical evaluative techniques for the Turing test paradigm.ResultsModification of the Turing test to offer quantifiable diagnostic precision and statistical effect–size robustness in the assessment of AI for computer‐based and robotic healthcare technologies.ConclusionsModification of the Turing test to offer robust diagnostic scores for AI can contribute to enhancing and refining the next generation of digital diagnostic technologies and healthcare robotics.
Moscarelli M, Harling L, Ashrafian H, et al., 2015, Challenges facing totally endoscopic robotic coronary artery bypass grafting, INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Vol: 11, Pages: 18-29, ISSN: 1478-5951
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- Citations: 6
Ashrafian H, 2015, AIonAI: A Humanitarian Law of Artificial Intelligence and Robotics, SCIENCE AND ENGINEERING ETHICS, Vol: 21, Pages: 29-40, ISSN: 1353-3452
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- Citations: 28
Segura-Sampedro JJ, Navarro-Sánchez A, Ashrafian H, et al., 2015, Laparoscopic approach to the intrahepatic gallbladder. A case report., Rev Esp Enferm Dig, Vol: 107, Pages: 122-123, ISSN: 1130-0108
Ashrafian H, Navarro-Sanchez A, Athanasiou T, et al., 2015, Thoracoscopic Esophageal Repair of a Spontaneous Barrett's Ulcer Perforation, ANNALS OF THORACIC SURGERY, Vol: 99, Pages: 331-333, ISSN: 0003-4975
Protopapas AD, Ashrafian H, Athanasiou T, et al., 2014, DURA CENSOR SED CENSOR: A REVIEWER’S AUDIT OF 10 YEARS IN THE JOURNALS OF THE EUROPEAN ASSOCIATION FOR CARDIO-THORACIC SURGERY
INTRODUCTION: The globalisation of the media and especially the World Wide Web facilitate all intercontinental communication. Almost all biomedical periodicals have applied an online review process since the beginning of the 21st Century. The online manuscript submission has considerably streamlined biomedical publishing. The geographical limitations of submitting a paper have thus been minimised!The European Association for Cardio-thoracic Surgery is affiliated to two paper journals that jointly receive manuscripts by an online submission tool. The reviewing process is led by an Associate Editor referring the manuscript to one or more reviewers. The reviewers submit recommendations to the Associate Editor who is responsible for the final decision: The reviewer’s recommendations and the editorial decisions may be simplified as either of 3 options: accept, send for reviision or reject. The reviewers are not currently blinded to the identity of the authors or the country of origin of the manuscript.Our primary aim was to search for any association between the attributes of the submitted manuscripts, directly deducible from the submission tool (including the recommendations of a long-standing European reviewer) and the decisions of various associate editors for the European Association for Cardio-thoracic Surgery.METHODS: The Associate Editors’ decisions (accept/revise/reject) in a cohort of manuscripts submitted to the Journals of the European Association for Cardio-thoracic Surgery from 2004 till 2014 and Reviewed by one Reviewer (ADP) were analysed by uni and multi variate regression to detect association to a variety of attributes: identity of Associate Editor, European or non-European origin, type of manuscript, previous presentation of manuscript in a European congress, thematic category of manuscript, target journal, recommendation of the Reviewer.RESULTS: 89 manuscripts were assessed (1/2015), 32 from Europe and 57 from the other continents. Ther
Wali MA, Ashrafian H, Schofield KL, et al., 2014, Is Social Deprivation Associated with Weight Loss Outcomes Following Bariatric Surgery? A 10-Year Single Institutional Experience (vol 24, pg 2126, 2014), OBESITY SURGERY, Vol: 24, Pages: 2133-2133, ISSN: 0960-8923
Wali MA, Ashrafian H, Schofield KL, et al., 2014, Is Social Deprivation Associated with Weight Loss Outcomes Following Bariatric Surgery? A 10-Year Single Institutional Experience, OBESITY SURGERY, Vol: 24, Pages: 2126-2132, ISSN: 0960-8923
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- Citations: 17
Toma T, Athanasiou T, Harling L, et al., 2014, Online social networking services in the management of patients with diabetes mellitus: systematic review and meta-analysis of randomised controlled trials, Diabetes Research and Clinical Practice, Vol: 106, Pages: 200-211, ISSN: 0168-8227
AimsSocial networking services (SNS) can facilitate real-time communication and feedback of blood glucose and other physiological data between patients and healthcare professionals. This systematic review and meta-analysis aims to summarise the current evidence surrounding the role of online social networking services in diabetes care.MethodsWe performed a systematic literature review of the Medline, EMBASE and PsychINFO databases of all studies reporting HbA1c (glycated haemoglobin) as a measure of glycaemic control for social networking services in diabetes care. HbA1c, clinical outcomes and the type of technology used were extracted. Study quality and publication bias were assessed.ResultsSNS interventions beneficially reduced HbA1c when compared to controls, which was confirmed by sensitivity analysis. SNS interventions also significantly improved systolic and diastolic blood pressure, triglycerides and total cholesterol. Subgroup analysis according to diabetes type demonstrated that Type 2 diabetes patients had a significantly greater reduction in HbA1c than those with Type 1 diabetes.ConclusionsOnline SNS provide a novel, feasible approach to improving glycaemic control, particularly in patients with Type 2 diabetes. Further mechanistic and cost-effectiveness studies are required to improve our understanding of SNS and its efficacy in diabetes care.
Soylu E, Harling L, Ashrafian H, et al., 2014, Does coronary endarterectomy technique affect surgical outcome when combined with coronary artery bypass grafting?, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 848-855, ISSN: 1569-9293
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- Citations: 12
Antonakis PT, Ashrafian H, Isla AM, 2014, Laparoscopic gastric surgery for cancer: Where do we stand?, WORLD JOURNAL OF GASTROENTEROLOGY, Vol: 20, Pages: 14280-14291, ISSN: 1007-9327
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- Citations: 24
Kidher E, Harling L, Sugden C, et al., 2014, Aortic stiffness is an indicator of cognitive dysfunction before and after aortic valve replacement for aortic stenosis, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 595-604, ISSN: 1569-9293
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- Citations: 16
Harling L, Ashrafian H, Athanasiou T, 2014, A piece of the aorta as patch material for angioplasty of the left main coronary artery Reply, EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, Vol: 46, Pages: 758-758, ISSN: 1010-7940
Harling L, Ashrafian H, Casula RP, et al., 2014, Late surgical repair of a traumatic ventricular septal defect, Journal of Cardiothoracic Surgery, Vol: 9, ISSN: 1749-8090
Ventricular Septal Defect (VSD) complicates approximately 1-5% of patients presenting with penetrating chest trauma, however not all VSDs are evident at the time of initial presentation to the emergency department. Acute closure of traumatic VSDs is indicated in patients with a large defect and haemodynamic compromise, however closure may be delayed in smaller defects in order to minimise operative time, reduce operative mortality and allow for recovery from the initial trauma. We describe the case of a previously healthy 23 year-old Caucasian man who presented in extremis following stab wounds to the precordium. After emergency cardiopulmonary bypass and closure of lacerations to both the left and right ventricles, postoperative trans-thoracic echocardiography (TTE) noted a restrictive intramuscular VSD with a high velocity left to right shunt, initially managed conservatively. Elective surgical closure was performed 10 months after the initial injury through a right ventriculotomy using 4–0 Proline sutures reinforced with Teflon pledgets. Despite excellent clinical recovery, 3-month follow-up TTE noted a residual VSD in the mid apical septum. However, given the presence of minimal left to right shunt and the small size of the defect, the patient was managed conservatively with annual review and repeat transthoracic echo. This case highlights the potential pitfalls in both the diagnosis and management of traumatic VSDs particularly where the patient presents in extremis with other life-threatening injuries. Furthermore, it exemplifies the importance of a multidisciplinary approach when planning any elective intervention. Regardless of the management strategy, repeated re-assessment and re-evaluation is vital following penetrating cardiac trauma, and vigilant long-term follow-up is of paramount importance in these cases.
Protopapas AD, Ashrafian H, Athanasiou T, 2014, DURA CENSOR SED CENSOR: A REVIEWER’S AUDIT OF 10 YEARS IN THE JOURNALS OF THE EUROPEAN ASSOCIATION FOR CARDIO-THORACIC SURGERY, online, 4th World Cardiovascular Online Conference, Publisher: Target Meeting
INTRODUCTION: Media globalisation and the World Wide Web facilitate intercontinental communication. The European Association for Cardio-thoracic Surgery publishes papers in two journals and receives submissions from around the world.METHODS: the Associate Editors’ decisions (accept/revise/reject) in a cohort of manuscripts submitted to the Journals of the European Association for Cardio-thoracic Surgery from 2004 till 2014 and Reviewed by one Reviewer (ADP) were analysed RESULTS: 83 manuscripts were reviewed, 29 from Europe and 54 from the other continents. There was strong association of the Editorial decision to the Reviewer’s recommendation (p<0.0002). In 78% of manuscripts, the Editor agreed with the Reviewer’s recommendation. In 63 manuscripts the Editor agreed with this Reviewer, in 19 disagreed: the Editor being more lenient in 15 of these decisionsCONCLUSION: There has been no bias from origin of the manuscript from within or without Europe or other variable apart from this Reviewer’s recommendation to the Editors’ decision.
Ashrafian H, Toma T, Harling L, et al., 2014, Social networking strategies that aim to reduce obesity have achieved significant although modest results, Health Affairs, Vol: 33, Pages: 1641-1647, ISSN: 0278-2715
The global epidemic of obesity continues to escalate. Obesity accounts for an increasing proportion of the international socioeconomic burden of noncommunicable disease. Online social networking services provide an effective medium through which information may be exchanged between obese and overweight patients and their health care providers, potentially contributing to superior weight-loss outcomes. We performed a systematic review and meta-analysis to assess the role of these services in modifying body mass index (BMI). Our analysis of twelve studies found that interventions using social networking services produced a modest but significant 0.64 percent reduction in BMI from baseline for the 941 people who participated in the studies’ interventions. We recommend that social networking services that target obesity should be the subject of further clinical trials. Additionally, we recommend that policy makers adopt reforms that promote the use of anti-obesity social networking services, facilitate multistakeholder partnerships in such services, and create a supportive environment to confront obesity and its associated noncommunicable diseases.
Soylu E, Harling L, Ashrafian H, et al., 2014, Adjunct coronary endarterectomy increases myocardial infarction and early mortality after coronary artery bypass grafting: a meta-analysis, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 462-473, ISSN: 1569-9293
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- Citations: 37
Jarral OA, Saso S, Harling L, et al., 2014, Organ Dysfunction in Patients with Left Ventricular Impairment: What is the Effect of Cardiopulmonary Bypass?, HEART LUNG AND CIRCULATION, Vol: 23, Pages: 852-862, ISSN: 1443-9506
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- Citations: 3
Attaran S, Harling L, Ashrafian H, et al., 2014, Off-pump versus on-pump revascularization in females: a meta-analysis of observational studies, PERFUSION-UK, Vol: 29, Pages: 385-396, ISSN: 0267-6591
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- Citations: 9
Nagayama A, Hayashida T, Jinno H, et al., 2014, Comparative Effectiveness of Neoadjuvant Therapy for HER2-Positive Breast Cancer: A Network Meta-Analysis, JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, Vol: 106, ISSN: 0027-8874
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- Citations: 43
Hasegawa H, Okabayashi K, Watanabe M, et al., 2014, What is the effect of laparoscopic colectomy on pattern of colon cancer recurrence? A propensity score and competing risk analysis compared with open colectomy, Annals of Surgical Oncology, Vol: 21, Pages: 2627-2635, ISSN: 1068-9265
BackgroundVariability in colon cancer recurrence after laparoscopic colectomy (LAC) remains poorly understood. The aim of our study was to quantify the influence of LAC on colon cancer recurrence patterns.MethodsWe included 986 patients undergoing curative colectomy at our institution between 1992 and 2008. Kaplan–Meier, multivariable Cox regression, propensity score adjustment, and competing risks modeling were used to evaluate the influence of laparoscopic surgery on the site of colon cancer recurrence, including the following: liver metastasis, lung metastasis, local recurrence, peritoneal dissemination, other, and multiple sites. We estimated the risk factors for each recurrence site.ResultsLaparoscopic surgery was used in 419 (42.5 %) of 986 patients, with an overall median follow-up time of 5.0 years (interquartile range 3.5). The overall 5-year disease-free survival rate was 86.1 % (open surgery 81.8 % vs. laparoscopic surgery 92.0 %; p < 0.001). However, after covariates and propensity score adjustment, laparoscopic surgery was not a significant risk factor for each type of recurrence: liver hazard ratio (HR) 0.93 (95 % CI 0.45–1.89), p = 0.84; lung HR 0.67 (95 % CI 0.26–1.70), p = 0.39; local HR 0.56 (95 % CI 0.12–2.63), p = 0.46; peritoneal HR 2.49 (95 % CI 0.75–8.27), p = 0.14; others HR 0.47 (95 % CI 0.04–5.13), p = 0.53; multiple HR 0.88 (95 % CI 0.25–3.14), p = 0.84. The risk factors for each type of recurrence were variable and characterized by specific clinicopathological features.ConclusionOur study reveals that LAC and open colectomy demonstrate comparable overall colon cancer recurrence rates and recurrence sites. Specific clinicopathological characteristics may have a stronger influence on colon cancer recurrence site compared with the surgical technique.
Kokotsakis J, Rouska EG, Harling L, et al., 2014, Right Ventricular Outflow Tract Obstruction Caused by Double-Chambered Right Ventricle Presenting in Adulthood, TEXAS HEART INSTITUTE JOURNAL, Vol: 41, Pages: 425-428, ISSN: 0730-2347
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- Citations: 4
Kidher E, Harling L, Nihoyannopoulos P, et al., 2014, High aortic pulse wave velocity is associated with poor quality of life in surgical aortic valve stenosis patients, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 189-197, ISSN: 1569-9293
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- Citations: 15
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