Digital Commons Network^™

Health-Related Quality Of Life (Hrqol) In A Population At Risk Of Type 2 Diabetes: A Cross-Sectional Study In Two Latin American Cities, Luis A. Anillo Arrieta, Tania Acosta Vergara, Rafael Tuesca, Sandra Rodríguez Acosta, Karen C. Flórez Lozano, Pablo Aschner, Rafael Gabriel, Sandra De La Rosa, Julieth P. Nieto Castillo, Noël C. Barengo

HWCOM Faculty Publications

PURPOSE: The purpose of this study was to describe the health-related quality of life (HRQoL) characteristics in a population at risk of developing type 2 diabetes in Barranquilla and Bogotá, Colombia. METHODS: A cross-sectional study with 1135 participants older than 30 years-of-age recruited in Bogotá D.C., and Barranquilla by cluster sampling in 2018 to 2019. The Finnish Diabetes Risk Score (FINDRISC) was used to detect participants at risk of developing type 2 diabetes (T2D). HRQoL was assessed using the EQ-5D-3L questionnaire. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and their corresponding 95% confidence intervals …

Decreased Levels Of Soluble Cd44 In A High-Risk Population Following A Smoking Cessation Program, Drew H. Smith, Shahm Raslan, Isildinha M. Reis, Abdurrahman Al-Awady, Isabella Buitron, Melanie Perez, Huaping Liu, Jerri Halgowich, Claudia Gordon, Monica Webb Hooper, Noël C. Barengo, Elizabeth J. Franzmann

HWCOM Faculty Publications

Tobacco is a risk factor of head and neck cancer (HNC) and smoking cessation alone may reduce HNC risk by 70%. Soluble CD44 (solCD44), a cell surface receptor linked to cell proliferation and migration, and total protein (TP) levels can detect early HNC. This study aims to determine whether salivary solCD44 and TP levels in oral rinses change following a smoking cessation program. 150 smokers provided oral rinse samples at baseline and at a 12-month follow-up after participation in a smoking cessation program. Assays to measure levels of solCD44, TP, and cotinine, a metabolite used as a biomarker of tobacco …

Carbohydrate-To-Fiber Ratio, A Marker Of Dietary Intake, As An Indicator Of Depressive Symptoms, Sarah S. Makhani, Camron Davies, Kevin A. George, Grettel Castro, Pura Rodriguez De La Vega, Noel C. Barengo

HWCOM Faculty Publications

Objective: The aim of this study is to evaluate the association between a marker of dietary intake, the carbohydrate-to-fiber (CF) ratio, and moderate-to-severe depressive symptoms. Design: Cross-sectional study. Setting: National Health and Nutrition Examination Survey (NHANES) database from 2013-2016. Participants: Individuals 18 years and older were included. Participants with total energy intake outside of three standard deviations of the mean, pregnant or breastfeeding women, and those with missing data were excluded. Measurements: The main independent variable, CF ratio, was generated using corresponding variables in NHANES and divided into quartiles. The main outcome was depressive symptoms using the Patient Health Questionnaire-9. …

The Associations Between Access To Recreational Facilities And Adherence To The American Heart Association's Physical Activity Guidelines In Us Adults, Larissa Andrade, Ryan Geffin, Mark Maguire, Pura Rodriguez, Grettel Castro, Ahmad Alkhatib, Noel C. Barengo

HWCOM Faculty Publications

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines. This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 …

Dysglycemia Risk Score In Saudi Arabia: A Tool To Identify People At High Future Risk Of Developing Type 2 Diabetes, Suhad Bahijri, Rajaa Al-Raddadi, Ghada Ajabnoor, Hanan Jambi, Jawaher Al Ahmadi, Anwar Borai, Noel C. Barengo, Jaakko Tuomilehto

HWCOM Faculty Publications

AIMS/INTRODUCTION: To develop a non-invasive risk score to identify Saudis having prediabetes or undiagnosed type 2 diabetes. METHODS: Adult Saudis without diabetes were recruited randomly using a stratified two-stage cluster sampling method. Demographic, dietary, lifestyle variables, personal and family medical history were collected using a questionnaire. Blood pressure and anthropometric measurements were taken. Body mass index was calculated. The 1-h oral glucose tolerance test was carried out. Glycated hemoglobin, fasting and 1-h plasma glucose were measured, and obtained values were used to define prediabetes and type 2 diabetes (dysglycemia). Logistic regression models were used for assessing the association between various …

Causal Inference In Microbiomes Using Intervention Calculus, Musfiqur Rahman Sazal, Vitalii Stebliankin, Kalai Mathee, Giri Narasimhan

HWCOM Faculty Publications

Inferring causal effects is critically important in biomedical research as it allows us to move from the typical paradigm of associational studies to causal inference, and can impact treatments and therapeutics. Association patterns can be coincidental and may lead to wrong inferences in complex systems. Microbiomes are highly complex, diverse, and dynamic environments. Microbes are key players in health and diseases. Hence knowledge of genuine causal relationships among the entities in a microbiome, and the impact of internal and external factors on microbial abundance and interactions are essential for understanding disease mechanisms and making treatment recommendations. In this paper, we …

Inferring Directional Relationships In Microbial Communities Using Signed Bayesian Networks, Musfiquer Sazal, Kalai Mathee, Daniel Ruiz-Perez, Trevor Cickovski, Giri Narasimhan

HWCOM Faculty Publications

Background: Microbe-microbe and host-microbe interactions in a microbiome play a vital role in both health and disease. However, the structure of the microbial community and the colonization patterns are highly complex to infer even under controlled wet laboratory conditions. In this study, we investigate what information, if any, can be provided by a Bayesian Network (BN) about a microbial community. Unlike the previously proposed Co-occurrence Networks (CoNs), BNs are based on conditional dependencies and can help in revealing complex associations. Results: In this paper, we propose a way of combining a BN and a CoN to construct a signed Bayesian …

Cellular Stress Responses And Dysfunctional Mitochondrial–Cellular Senescence, And Therapeutics In Chronic Respiratory Diseases, Marko Manaveski, Thivanka Muthumalage, Dinesh Devadoss, Isaac K. Sundar, Qixin Wang, Kameshwar P. Singh, Hoshang Unwalla, Hitendra S. Chand, Irfan Rahman

HWCOM Faculty Publications

The abnormal inflammatory responses due to the lung tissue damage and ineffective repair/resolution in response to the inhaled toxicants result in the pathological changes associated with chronic respiratory diseases. Investigation of such pathophysiological mechanisms provides the opportunity to develop the molecular phenotype-specific diagnostic assays and could help in designing the personalized medicine-based therapeutic approaches against these prevalent diseases. As the central hubs of cell metabolism and energetics, mitochondria integrate cellular responses and interorganellar signaling pathways to maintain cellular and extracellular redox status and the cellular senescence that dictate the lung tissue responses. Specifically, as observed in chronic obstructive pulmonary disease …

Pulmonary Toxicity And The Pathophysiology Of Electronic Cigarette, Or Vaping Product, Use Associated Lung Injury, Hitendra S. Chand

HWCOM Faculty Publications

New emerging tobacco products, especially electronic cigarettes (E-Cig) or electronic nicotine delivery systems (ENDS), have gained a huge popularity, particularly in younger populations. The lack of sufficient evidence-based health effect studies has promoted widespread use/abuse with the assumption that E-Cig or ENDS and/or vaping products are safer and less toxic than conventional tobacco smoking. However, the recent escalation in acute lung injuries and their associated fatalities among ENDS or vaping product users has now brought attention to this silent epidemic via investigation into the constituents of ENDS/vaping products and their toxic effects on pulmonary health. Accordingly, CDC has declared an …

Factors Associated With Low Physical Activity In Two Latin American Populations At Risk Of Developing Type 2 Diabetes: An Exploratory Analysis, Tania Acosta, Rafael Tuesca, Karen Florez, Noël C. Barengo, Luis Anillo, Victor Flórez-García, Jorge Acosta, Liliana Carvajal, Sandra De La Rosa, María Julieta Pachón, Pablo Aschner

HWCOM Faculty Publications

Low level of physical activity is a risk factor for chronic non-communicable diseases. Specifically, people at risk of Type 2 Diabetes (T2D) have shown to benefit from being physically active. The objective of this study was to explore what factors were associated with low physical activity in people at high risk of T2D living in Bogota and Barranquilla, Colombia. Cross-sectional study using baseline data from a quasi-experimental clinical trial (PREDICOL Project). The study included 1,135 participants of Bogota and Barranquilla that presented a high risk of developing T2D according to the Finnish Diabetes Risk Score (>12 points) and who …

Dynamic Bayesian Networks For Integrating Multi-Omics Time-Series Microbiome Data, Daniel Ruiz-Perez, Jose Lugo-Martinez, Natalia Bourguignon, Betiana Lerner, Ziv Bar-Joseph, Giri Narasimhan

HWCOM Faculty Publications

. A key challenge in the analysis of longitudinal microbiomes data is to go beyond computing their compositional profiles and infer the complex web of interactions between the various microbial taxa, their genes, and the metabolites they consume and produce. To address this challenge, we developed a computational pipeline that first aligns multi-omics data and then uses dynamic Bayesian networks (DBNs) to integrate them into a unified model. We discuss how our approach handles the different sampling and progression rates between individuals, how we reduce the large number of different entities and parameters in the DBNs, and the construction and …

Acetylcholinesterase Inhibitor Pyridostigmine Bromide Attenuates Gut Pathology And Bacterial Dysbiosis In A Murine Model Of Ulcerative Colitis, Sp Singh, Hitendra S. Chand, S. Banerjee, H. Agarwal, V. Raizada, S. Roy, M. Sopori

HWCOM Faculty Publications

Abstract Background Ulcerative colitis (UC) is a Th2 infammatory bowel disease characterized by increased IL-5 and IL-13 expression, eosinophilic/neutrophilic infltration, decreased mucus production, impaired epithelial barrier, and bacterial dysbiosis of the colon. Acetylcholine and nicotine stimulate mucus production and suppress Th2 infammation through nicotinic receptors in lungs but UC is rarely observed in smokers and the mechanism of the protection is unclear. Methods In order to evaluate whether acetylcholine can ameliorate UC-associated pathologies, we employed a mouse model of dextran sodium sulfate (DSS)-induced UC-like conditions, and a group of mice were treated with Pyridostigmine bromide (PB) to increase acetylcholine availability. …

Stimulated Raman Histology For Intraoperative Guidance In The Resection Of A Recurrent Atypical Spheno-Orbital Meningioma: A Case Report And Review Of Literature, Evan Luther, Alejandro Matus, Daniel G. Eichberg, Ashish H. Shah, Michael Ivan

HWCOM Faculty Publications

Meningiomas are the most common intracranial, extra-axial neoplasms and account for a significant proportion of all central nervous system (CNS) tumors. Regardless of the grade, treatment typically involves upfront surgical resection. However, in many instances, especially in meningiomas arising from the skull base, complete removal is often difficult given the close proximity to important anatomic structures. In this report, we discuss the use of stimulated Raman histology as a means to identify tissue boundaries during the resection of an extensive, recurrent, atypical spheno-orbital meningioma. We report a 75-year-old male with a history of a prior left frontotemporal craniotomy for a …

The Association Between Serum Lipids And Risk Of Premature Mortality In Latin America: A Systematic Review Of Population-Based Prospective Cohort Studies, Rodrigo M. Carrillo-Larco, Leonardo Albitres-Flores, Noel C. Barengo, Antonio Bernabe-Ortiz

HWCOM Faculty Publications

Objective

To synthetize the scientific evidence on the association between serum lipids and premature mortality in Latin America (LA).

Methods

Five data bases were searched from inception without language restrictions: Embase, Medline, Global Health, Scopus and LILACS. Population-based studies following random sampling methods were identified. The exposure variable was lipid biomarkers (e.g., total, LDL- or HDL- cholesterol). The outcome was all-cause and cause-specific mortality. The risk of bias was assessed following the Newcastle-Ottawa criteria. Results were summarized qualitatively.

Results

The initial search resulted in 264 abstracts, five (N = 27,903) were included for the synthesis. Three papers reported on …

Quantitative Spatial Upscaling Of Categorical Information: The Multi‐Dimensional Grid‐Point Scaling Algorithm, Daniel Gann

HWCOM Faculty Publications

1. Categorical raster datasets often require upscaling to a lower spatial resolution to make them compatible with the scale of ecological analysis. When aggregating categorical data, two critical issues arise: (a) ignoring compositional information present in the high‐resolution grid cells leads to high and uncontrolled loss of information in the scaled dataset; and (b) restricting classes to those present in the high‐resolution dataset assumes validity of the classification scheme at the lower, aggregated resolution.
2. I introduce a new scaling algorithm that aggregates categorical data while simultaneously controlling for information loss by generating a non‐hierarchical, representative, classification system for the aggregated scale. …

Selective Disruption Of The Blood–Brain Barrier By Zika Virus, Ana Rachel Leda, Luc Bertrand, Ibolya Edit Andras, Nazira El-Hage, Madhavan Nair, Michael Toborek

HWCOM Faculty Publications

The blood–brain barrier (BBB) selectively regulates the cellular exchange of macromolecules between the circulation and the central nervous system (CNS). Here, we hypothesize that Zika virus (ZIKV) infects the brain via a disrupted BBB and altered expression of tight junction (TJ) proteins, which are structural components of the BBB. To assess this hypothesis, in vitro and in vivo studies were performed using three different strains of ZIKV: Honduras (ZIKV-H), Puerto Rico (ZIKV-PR), and Uganda (ZIKV-U). Primary human brain microvascular endothelial cells (BMECs) were productively infected by all studied ZIKV strains at MOI 0.01, and were analyzed by plaque assay, immunofluorescence …

Hemorrhagic Stroke In A Young Adult With Undiagnosed Asymptomatic Dandy–Walker Malformation, Haleem Abdul, Joseph Burns, Andrea Estevez, Carlos Nasr El-Nimer, Brinsley Ekinde, Sherard Lacaille

HWCOM Faculty Publications

No abstract provided.

Signal From The Noise: Model‐Based Interpretation Of Variable Correspondence Between Active And Passive Samplers, Joseph Parkos Iii, Jeffrey L. Kline, Joel C. Trexler

HWCOM Faculty Publications

Combining information from active and passive sampling of mobile animals is challenging because active‐sampling data are affected by limited detection of rare or sparse taxa, while passive‐sampling data reflect both density and movement. We propose that a model‐based analysis allows information to be combined between these methods to interpret variation in the relationship between active estimates of density and passive measurements of catch per unit effort to yield novel information on activity rates (distance/time). We illustrate where discrepancies arise between active and passive methods and demonstrate the model‐based approach with seasonal surveys of fish assemblages in the Florida Everglades, where …

Does Health Insurance Modify The Association Between Race And Cancer-Specific Survival In Patients With Urinary Bladder Malignancy In The U.S.?, Juliana Morales, Aaron Malles, Marrell Kimbell, Pura Rodríguez De La Vega, Grettel Castro, Alan M. Nieder, Noel C. Barengo

HWCOM Faculty Publications

Background: Scientific evidence on the effect of health insurance on racial disparities in urinary bladder cancer patients’ survival is scant. The objective of our study was to determine whether insurance status modifies the association between race and bladder cancer specific survival during 2007–2015. Methods: The 2015 database of the cancer surveillance program of the National Cancer Institute (n = 39,587) was used. The independent variable was race (White, Black and Asian Pacific Islanders (API)), the main outcome was cancer specific survival. Health insurance was divided into uninsured, any Medicaid and insured. An adjusted model with an interaction term for race …

A Model For Point Of Care Testing For Non-Communicable Disease Diagnosis In Resource-Limited Countries, Stuart Malcolm, Joane Cadet, Lindsay Crompton, Vincent Degennaro

HWCOM Faculty Publications

Non-communicable disease diagnosis frequently relies on biochemical measurements but laboratory infrastructure in low-income settings is often insufficient and distances to clinics may be vast. We present a model for point of care (POC) epidemiology as used in our study of chronic disease in the Haiti Health Study, in rural and urban Haiti. Point of care testing (POCT) of creatinine, cholesterol, and hemoglobin A1c as well as physical measurements of weight, height, and waist circumference allowed for diagnosis of diabetes, chronic kidney disease, dyslipidemias, and obesity. Methods and troubleshooting techniques for the data collection of this study are presented. We discuss …

Tgf-Β1 Increases Viral Burden And Promotes Hiv-1 Latency In Primary Differentiated Human Bronchial Epithelial Cells, S. Chinnapaiyan, R. K. Dutta, Madhavan Nair, Hitendra S. Chand, I. Rahman, H. J. Unwalla

HWCOM Faculty Publications

Combination antiretroviral therapy (cART) has increased the life expectancy of HIV patients. However, the incidence of non-AIDS associated lung comorbidities, such as COPD and asthma, and that of opportunistic lung infections have become more common among this population. HIV proteins secreted by the anatomical HIV reservoirs can have both autocrine and paracrine effects contributing to the HIV-associated comorbidities. HIV has been recovered from cell-free bronchoalveolar lavage fluid, alveolar macrophages, and intrapulmonary lymphocytes. We have recently shown that ex-vivo cultured primary bronchial epithelial cells and the bronchial brushings from human subjects express canonical HIV receptors CD4, CCR5 and CXCR4 …

Risk Scores For Type 2 Diabetes Mellitus In Latin America: A Systematic Review Of Population‐Based Studies, R.M. Carrillo, D. J. Aparcana-Granda, J. R. Mejia, Noel C. Barengo, A. Bernabe-Ortiz

HWCOM Faculty Publications

Aim

To summarize the evidence on diabetes risk scores for Latin American populations.

Methods

A systematic review was conducted (CRD42019122306) looking for diagnostic and prognostic models for type 2 diabetes mellitus among randomly selected adults in Latin America. Five databases (LILACS, Scopus, MEDLINE, Embase and Global Health) were searched. type 2 diabetes mellitus was defined using at least one blood biomarker and the reports needed to include information on the development and/or validation of a multivariable regression model. Risk of bias was assessed using the PROBAST guidelines.

Results

Of the 1500 reports identified, 11 were studied in detail and five …

Adapting Flint For Calculating Bacterial Replication Rates In Microbiomes, Vitalii Stebliankin, Camilo Valdes, Kalai Mathee, Giri Narasimhan

HWCOM Faculty Publications

We extend Flint, a Spark-based metagenomic profiling tool, to efficiently measure bacterial growth rates for large data sets. The tool bPTR for bacterial growth rate measurement from metagenomic samples [Brown et al., Nat Biotech, 2016] was adapted and integrated into Flint’s MapReduce framework in order to take advantage of Flint's efficient read alignments and mapping, thus enabling the creation of bacterial abundance profiles that are enhanced with growth-rate information.
To show the viability of our method we analyzed whole metagenome sequence data from a longitudinal study of sampled preterm infants [Gibson et al., Nat Micro, 2016], computing the abundance profile …

Association Between Giant Cell Glioblastoma And Glioblastoma Multiforme In The United States: A Retrospective Cohort Study, Amro K. Bin Abdulrahman, Khalid A. Bin Abdulrahman, Yousef R. Bukhari, Abdulaziz M. Faqihi, Juan Gabriel Ruiz

HWCOM Faculty Publications

No abstract provided.

Results And Challenges Of Cytochrome P450 2d6 (Cyp2d6) Testing In An Ethnically Diverse South Florida Population, Daria Salyakina, Sharmeen Roy, Weize Wang, Mailin Oliva, Rohan Akhouri, Ileana Sotto, Nicole Mulas, Rafaela Solano, Jose R. Fernandez, Stephanie Sanchez, Uzma Shamshad, Chad Perlyn, Jennifer Mccafferty Fernandez

HWCOM Faculty Publications

Background

This study focuses on the implementation of CYP2D6 genetic test profiling and the challenges associated with using standard pharmacogenetics panels in a diverse South Florida population.

Methods

A total of 413 participants were recruited to participate in this study through Nicklaus Children's Hospital. Buccal swabs were collected and tested using an extended CYP2D6 panel including 22 alleles. Phenotype, genotype, and allelic frequencies were compared among different racial and ethnic groups.

Results

The majority of participants (75.0%) self‐identified as Hispanics. Four alleles, CYP2D6*4, *17, *41, and *2A, showed a statistically significant difference between White Hispanics and Black Non‐Hispanics. Aggregate frequency …

Radiobiological And Dosimetric Impact Of Raystation Pencil Beam And Monte Carlo Algorithms On Intensity‐Modulated Proton Therapy Breast Cancer Plans, Suresh Rana, Keven Greco, E. James Jebaseelan Samuel, Jaafar Bennouna

HWCOM Faculty Publications

Purpose

RayStation treatment planning system employs pencil beam (PB) and Monte Carlo (MC) algorithms for proton dose calculations. The purpose of this study is to evaluate the radiobiological and dosimetric impact of RayStation PB and MC algorithms on the intensity‐modulated proton therapy (IMPT) breast plans.

Methods

The current study included ten breast cancer patients, and each patient was treated with 1–2 proton beams to the whole breast/chestwall (CW) and regional lymph nodes in 28 fractions for a total dose of 50.4 Gy relative biological effectiveness (RBE). A total clinical target volume (CTV_Total) was generated by combining individual CTVs: AxI, AxII, …

Pax 6 Controls Neural Crest Potential Of Limbal Niche Cells To Support Self-Renewal Of Limbal Epithelial Stem Cells, Szu-Yu Chen, Anny M.S. Cheng, Yuan Zhang, Ying-Ting Zhu, Hua He, Megha Mahabole, Scheffer C.G. Tseng

HWCOM Faculty Publications

On ocular surface, corneal epithelial stem cells (SC) reside in limbus between cornea and conjunctiva. Pax6, an evolutionally conserved transcription factor essential for eye development, is expressed in post-natal corneal and limbal epithelia progenitors (LEPC) but not in underlying stroma. Because Pax6 is transiently expressed in developing corneal stroma and a subset of limbal and corneal stromal progenitors, we examined the role of Pax6 in limbal niche cells (LNC) in maintaining the phenotype of neural crest (NC) progenitors to support LEPC. Our results showed that nuclear Pax6 staining was found in freshly isolated LNC but not corneal stromal cells. Serial …

Cost-Effective, Safe, And Personalized Cell Therapy For Critical Limb Ischemia In Type 2 Diabetes Mellitus, Barbara Soria-Juan, Natalia Escacena, Vivian Capilla-Gonzalez, Yolanda Aguilera, Lucia Llanos, Juan R. Tejedo, Francisco J. Bedoya, Veronica Juan, Antonio De La Cuesta, Rafael Ruiz-Salmeron, Enrique Andreu, Lukas Grochowicz, Felipe Prosper, Fermin Sanchez-Guijo, Francisco S. Lozano, Manuel Miralles, Lourdes Del Rio-Sola, Gregorio Castellanos, Jose M. Moraleda, Robert Hackstein, Mariano Garcia-Arranz, Damian Garcia-Olmo, Franz Martin, Abdelkrim Hmadcha, Bernat Soria

HWCOM Faculty Publications

Cell therapy is a progressively growing field that is rapidly moving from preclinical model development to clinical application. Outcomes obtained from clinical trials reveal the therapeutic potential of stem cell-based therapy to deal with unmet medical treatment needs for several disorders with no therapeutic options. Among adult stem cells, mesenchymal stem cells (MSCs) are the leading cell type used in advanced therapies for the treatment of autoimmune, inflammatory and vascular diseases. To date, the safety and feasibility of autologous MSC-based therapy has been established; however, their indiscriminate use has resulted in mixed outcomes in preclinical and clinical studies. While MSCs …

Neurodevelopmental Outcome Of Monochorionic Twins With Selective Intrauterine Growth Restriction (Siugr) Type Ii: Laser Versus Expectant Management, Ruben Quintero, Eftichia Kontopoulos, Marian E. Williams, Judy Sloop, Douglas Vanderbilt, Raman H. Chmait

HWCOM Faculty Publications

No abstract provided.

The Experimental Oxime K027—A Promising Protector From Organophosphate Pesticide Poisoning. A Review Comparing K027, K048, Pralidoxime, And Obidoxime, Dietrich E. Lorke, Georg A. Petroianu

HWCOM Faculty Publications

Poisoning with organophosphorus compounds (OPCs) is a major problem worldwide. Standard therapy with atropine and established oxime-type enzyme reactivators (pralidoxime, obidoxime) is unsatisfactory. In search of more efficacious broad-spectrum oximes, new bispyridinium (K-) oximes have been synthesized, with K027 being among the most promising. This review summarizes pharmacokinetic characteristics of K027, its toxicity and in vivo efficacy to protect from OPC toxicity and compares this oxime with another experimental bisquaternary asymmetric pyridinium aldoxime (K048) and two established oximes (pralidoxime, obidoxime). After intramuscular (i.m.) injection, K027 reaches maximum plasma concentration within ∼30 min; only ∼2% enter the brain. Its intrinsic cholinesterase …