Publications by authors named "Kho M"

Article Synopsis
  • Survivors of critical illness often experience physical dysfunction post-ICU discharge, and the CYCLE trial aims to evaluate the effectiveness of in-bed cycle ergometry for improving short-term physical function in these patients.!* -
  • The CYCLE trial, involving 360 patients across multiple centers, employs a prespecified statistical analysis plan to assess outcomes like the PFIT-s score three days after ICU discharge, while considering variables such as age, frailty, and sex.!* -
  • Funded in 2017, the CYCLE study completed enrollment in May 2023, with data analyses finished and first results expected to be published in 2024.!*
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Background: Cycle ergometry is a rehabilitation strategy used in the intensive care unit (ICU) which may help mitigate post-ICU impairments. We aimed to systematically review and summarize evidence examining the efficacy and safety of cycle ergometry in the ICU.

Methods: We included randomized controlled trials (RCTs) of critically ill adults with any diagnosis admitted to the ICU for >24 hours, comparing cycling interventions to control (no cycling).

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Article Synopsis
  • Symptoms of Post-COVID-19 Condition are often vague, making it hard to identify them compared to other medical issues.
  • In the study, over one-third of emergency department patients with confirmed COVID-19 infections showed symptoms fitting the World Health Organization's criteria for Post-COVID-19 Condition three months later.
  • Notably, one in five patients who tested negative reported similar symptoms, indicating the current clinical criteria's lack of specificity and the need for continued testing during acute infections.
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Purpose: Physical rehabilitation (PR) in the intensive care unit (ICU) may improve outcomes for survivors but clinical trial results have been discordant. We hypothesized that discordant results may reflect treatment heterogeneity received by "usual care" comparator groups in PR studies. Usual-care PR is typically underspecified, which is a barrier to comparing results across treatment studies.

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Background: In HLA-incompatible kidney transplantation, the efficacy of desensitization in terms of anti-HLA antibody kinetics is not well characterized. We present an overview of the course of anti-HLA antibodies throughout plasma exchange (PE) desensitization in a series of crossmatch-positive patients.

Methods: All consecutive candidates in the Dutch HLA-incompatible kidney transplantation program between November 2012 and January 2022 were included.

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Delayed graft function (DGF) after kidney transplantation heralds a worse prognosis. In patients with hyperoxaluria, the incidence of DGF is high. Oxalic acid is a waste product that accumulates when kidney function decreases.

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Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes.

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Purpose: To identify research priorities related to COVID rehabilitation from the perspectives of persons with lived experiences, clinicians, researchers, community organization and policy representatives.

Materials & Methods: We conducted five international consultations to identify key issues and research priorities in COVID rehabilitation using (i) web-based questionnaires, (ii) synchronous discussions, and (iii) content analysis of COVID rehabilitation research conference presentations. We collated responses and notes and then analyzed data using content analytical techniques.

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Article Synopsis
  • The study examines whether incorporating balance training into pulmonary rehabilitation (PR) can reduce fall incidents in individuals with COPD, marking a significant international effort in this area.
  • The research involved an international team from ten outpatient PR programs and tracked 1275 patients, with key findings highlighting logistical challenges faced during the trial due to the COVID-19 pandemic.
  • Lessons learned emphasized the importance of understanding funding policies, preparing for staffing setbacks, and having contingency plans for site dropouts in multi-centre rehabilitation trials.
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Rapid urbanization will cause various land use changes and the vast occupation of green spaces, a critical factor in the deterioration of biodiversity in urbanized areas. Some species of wildlife are endangered due to habitat shrunk and fragmentation. However, Malaysia's current biodiversity protection range is still limited.

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Article Synopsis
  • The COVID-19 pandemic significantly disrupted clinical trials globally, leading to issues such as premature closures and compromised trial integrity, necessitating changes in research protocols.
  • The study aimed to assess challenges faced during interrupted critical care trials, identifying barriers and developing strategies for future trials based on input from principal investigators and project coordinators.
  • Results indicated that major challenges included the prioritization of COVID-19 studies and restrictions on hospital visitation, while participants offered various solutions and suggestions to enhance trial conduct moving forward.
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Background: Insight into cellular immune responses to COVID-19 vaccinations is crucial for optimizing booster programs in kidney transplant recipients (KTRs).

Methods: In an immunologic substudy of a multicenter randomized controlled trial (NCT05030974) investigating different repeated vaccination strategies in KTR who showed poor serological responses after 2 or 3 doses of an messenger RNA (mRNA)-based vaccine, we compared SARS-CoV-2-specific interleukin-21 memory T-cell and B-cell responses by enzyme-linked immunosorbent spot (ELISpot) assays and serum IgG antibody levels. Patients were randomized to receive: a single dose of mRNA-1273 (100 μg, n = 25), a double dose of mRNA-1273 (2 × 100 μg, n = 25), or a single dose of adenovirus type 26 encoding the SARS-CoV-2 spike glycoprotein (Ad26.

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Background: The response of Canada's research community to the COVID-19 pandemic provides a unique opportunity to examine the country's clinical health research ecosystem. We sought to describe patterns of enrolment across Canadian Institutes of Health Research (CIHR)-funded studies on COVID-19.

Methods: We identified COVID-19 studies funded by the CIHR and that enrolled participants from Canadian acute care hospitals between January 2020 and April 2023.

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Article Synopsis
  • Critical illness requiring invasive mechanical ventilation can lead to significant physical disability, and early in-bed cycle ergometry may help reduce this impairment when added to standard physiotherapy in ICU patients.
  • A study with 360 adult patients randomly assigned to either early in-bed cycling plus usual physiotherapy or just usual physiotherapy found no significant difference in physical function scores three days after ICU discharge.
  • The addition of cycling did not result in any serious adverse events, indicating it is safe, but did not enhance recovery outcomes compared to standard therapy alone.
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Purpose: Frailty is common in critically ill patients but the timing and optimal method of frailty ascertainment, trajectory and relationship with care processes remain uncertain. We sought to elucidate the trajectory and care processes of frailty in critically ill patients as measured by the Clinical Frailty Scale (CFS) and Frailty Index (FI).

Methods: This is a multi-centre prospective cohort study enrolling patients ≥ 50 years old receiving life support > 24 h.

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Article Synopsis
  • The study aimed to analyze how sex and gender are considered in acute care trials and whether there have been changes in reporting practices since the 2016 guidelines on sex and gender equity in research.
  • The systematic review included 88 trials published in major medical journals, finding that the representation of female participants was low at 34.2%, and only 28.4% reported race or ethnicity, predominantly featuring white and male participants.
  • Results revealed limited use of sex and gender-based analysis (SGBA), with cardiovascular trials performing better than ICU trials, indicating a significant need for improvement in inclusivity and reporting practices in clinical research.*
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: The number of kidney transplant recipients over 70 years of age is increasing but detailed data on patient and graft survival in the modern era of immune suppression are few. : A single-center cohort of patients of 70 years and older (n = 349) at time of kidney transplantation from 2010-2020 were followed until January 2023. : The median age was 73 years with a median follow-up of 4.

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This study explores how providing assisted dying services affects the psychological distress of practitioners. It investigates the influence of professional norms that endorse such services within their field. Study 1 included veterinarians ( = 137, 75.

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Background: Intensive care unit (ICU) survivors face functional limitations due to ICU-acquired weakness. Arm cycle ergometry (ACE) introduced in the ICU may improve physical function. To our knowledge, there is limited evidence on the effectiveness of ACE and physical function outcomes in critically ill patients.

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Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to genes involved in neurological, thyroidal, bone metabolism, and hematopoietic pathways.

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Purpose: Explore the use, characteristics, feasibility, and functional outcomes of rehabilitation interventions used for individuals with head and neck cancer (HNC) during treatment.

Methods: Searches were conducted in four databases from Jan 2011 to Dec 31, 2022. Included studies had to include adults with HNC undergoing treatment, a rehabilitation intervention, an assessment of functional outcome(s) addressed by the International Classification of Functioning Framework (ICF) and be published in English language.

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