Michael Klowak

Mr. Michael Klowak


Research Focus & Metrics

Academic Career Length

3Years (2024-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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10 November 2024 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
MKMichael Klowak
Michael Klowak
RLRachel Lau
Rachel Lau
MMMariyam N. Mohammed
Mariyam N. Mohammed
ABAfia Birago
Afia Birago
BSBethel Samson
Bethel Samson
ABAndrea K Boggild
Andrea K Boggild
Background/Objectives: Chronic severe neuropathic pain (NP) affects one in 10 individuals over the age of 30 in North America. Standard pharmacological interventions are associated with significant side effects and have limited effectiveness. Diets seeking to improve physiological health, support gut barrier integrity, and decrease systemic inflammation have recently emerged as powerful tools conferring neuroprotective and anti-inflammatory effects, potentially reducing the overall morbidity and mortality of multiple neurological and metabolic diseases. This systematic review aimed to synthesize the literature around NP outcomes following dietary interventions compared to routine standard of care. Methods: Following PRISMA guidelines, an initial search yielded 15,387 records after deduplication. Six interventional trials specifically assessing dietary interventions for neuropathic pain were included and analyzed. The dietary lifestyle interventions included low-fat plant-based, plant-based fasting-mimicking, low-calorie, potassium-reduced, gluten-free, and intermittent high-protein/Mediterranean diets. Results: The included studies described some statistically significant improvements in pain severity on objective quantitative sensory testing, electrophysiology, imaging, and subjective questionnaires. The overall risk of bias was moderate, with only one trial demonstrating a low risk of bias across all assessed domains. No serious adverse events were identified, and dietary interventions were generally well tolerated. Conclusions: The data collected and synthesized in this systematic review indicate that dietary lifestyle interventions may offer a low-risk, low-cost, low-tech option for chronic neuropathic pain management, potentially improving quality of life and reducing overall morbidity. However, given substantial variability across studies and a moderate risk of bias, further research is warranted to substantiate these findings.

7 August 2025 in NeuroSci
Verified
Journal Article
Open access
PDF file
MKMichael Klowak
Michael Klowak
RLRachel Lau
Rachel Lau
MMMariyam N. Mohammed
Mariyam N. Mohammed
ABAfia Birago
Afia Birago
BSBethel Samson
Bethel Samson
ABAndrea K Boggild
Andrea K Boggild
Background: Neuropathic pain (NP), resulting from damage to the somatosensory nervous system, affects 7–10% of the global population and remains poorly managed despite available therapies. Smoking has been associated with increased pain severity and disease burden, yet its role in neuropathy/NP has not been systematically reviewed. This systematic review synthesizes the existing literature on smoking status and its relationship with neuropathy/NP incidence, prevalence, and severity. Methods: The review was conducted in accordance with PRISMA guidelines and included studies that assessed smoking consumption, dependency, quantity, and cessation in individuals with neuropathy/NP. Summary estimates were stratified by exposure type, and pooled odds ratios and relative risks were calculated. Results: Across 62 studies comprising cohort, case–control, and cross-sectional designs, smoking was consistently associated with greater NP prevalence and pain severity. Smoking dependency was linked to increased incidence, while cessation was associated with reduced risk of NP. Despite considerable heterogeneity and risk of bias, particularly from subjective exposure measurement and inconsistent classification, this relationship remained statistically significant. Conclusions: Findings support the role of smoking as a modifiable risk factor in various etiologies of neuropathy/NP. Cessation may represent a low-cost, low-risk, low-tech adjunctive therapy; however, further robust cessation interventional trials are needed, particularly for less common infectious causes of chronic NP such as leprosy.

9 November 2025 in Toxics
Verified
Journal Article
Open access
PDF file
MKMichael Klowak
Michael Klowak
GHGregory David Hawley
Gregory David Hawley
SASyed Zain Ahmad
Syed Zain Ahmad
CMCandice Madakadze
Candice Madakadze
ARAquilla Reid-John
Aquilla Reid-John
ABAndrea K Boggild
Andrea K Boggild
Treatment of aircraft with insecticide in a procedure referred to as ‘disinsection’ is recommended to prevent the conveyance of arthropod vectors internationally and to mitigate the globalization of vector-borne infectious diseases. However, the full spectrum of human-based outcomes related to disinsection of conveyances has not been recently synthesized. A systematic review was conducted to evaluate the human safety and toxicity of insecticides used during the process of disinsecting international aircraft, marine vessels, rail, and ground transportation of mosquitoes. The systematic review was conducted according to the PRISMA guidelines and was registered in PROSPERO (CRD42024543998). The certainty of the evidence was rated, and key primary outcomes, including human health effects of conveyance disinsection, were synthesized. A total of 21 studies that described human health effects of conveyance disinsection and reported outcomes of safety, toxicity, and tolerability were included, and were of generally limited quality and high risk of bias, with low to very low certainty of estimates of effect. No high-quality studies investigating the safety, toxicity, or tolerability of disinsection were identified. Human health effects, including morbidity, including work days lost, adverse events including hospitalization, objective measures of insecticide toxicity, detectable and elevated urinary metabolites, and subjective reporting of symptoms consistent with acute insecticide poisoning, were reported by the small number of uncontrolled observational studies and public health surveillance reports included. Given the reports of significant morbidity, adverse events, and toxicity putatively attributable to aircraft disinsection, well-designed studies in exposed populations investigating the full range of human health impacts of disinsection on passengers and crew are urgently needed.

1 September 2025 in Insects
Verified
Journal Article
Open access
PDF file
GHGregory David Hawley
Gregory David Hawley
MKMichael Klowak
Michael Klowak
SASyed Zain Ahmad
Syed Zain Ahmad
CMCandice Madakadze
Candice Madakadze
JHJahmar Hewitt
Jahmar Hewitt
ABAndrea K Boggild
Andrea K Boggild
Disinsection of aircraft and other conveyances is recommended to prevent the international spread of disease-carrying mosquitoes. A systematic review synthesized the effectiveness of adult mosquito disinsection aboard international air, marine, and land conveyances, using literature available up to 31 May 2025. Nineteen experimental trials, nine of which included an unexposed control arm, were synthesized. The studies were generally of poor quality with high risk of bias, and adherence to WHO guidelines was 33.30% (range: 18.20–60.5%). Across comparator trials of aircraft disinsection, the odds of mosquito mortality in the treated groups compared to control groups was 163.60 (95% CI 147–182), and the relative risk of mosquito death was 14.24 (95% CI 12.99–15.63). The direction of effect was consistent across mosquito species, methods of disinsection, types of aircraft, and insecticides, though the magnitude of the effect varied widely. The only WHO-recommended insecticide tested in a controlled trial was 2% d-phenothrin, which demonstrated an odds ratio of 171.70 (95% CI 139.10–212) and a relative risk of 20.08 (95% CI 16.53–24.43) for mosquito mortality. The lack of adherence to WHO guidelines raises uncertainty about the real-world effectiveness of disinsection.

Verified
Journal Article
Open access
PDF file
GHGregory David Hawley
Gregory David Hawley
MKMichael Klowak
Michael Klowak
AHAmanda Hempel
Amanda Hempel
JTJamal William Tarrabain
Jamal William Tarrabain
CWChu Sandy Wang
Chu Sandy Wang
ABAndrea K Boggild
Andrea K Boggild
Background: Viral hemorrhagic fevers (VHFs) are severe, often high-consequence, life-threatening illnesses characterized by systemic disease, hemorrhage, and high mortality. The American Society of Tropical Medicine and Hygiene (ASTMH) Annual Meeting functions as a major international forum for the presentation of emerging data on infectious diseases, including novel pharmacologic and biologic interventions for VHF. However, while ASTMH presentations provide timely and high-impact insights, there is no efficient, consolidated synthesis of this rapidly evolving evidence base. Given the acute, outbreak-prone nature of VHF and the need for rapid translation of emerging data into clinical and public health practice, a structured synthesis of these data is warranted. Methods: This systematic review follows PRISMA guidelines and is limited to presentations delivered at the ASTMH Annual Meeting in Toronto (9–13 November 2025) in order to capture evolving evidence as it has emerged. Studies of all designs evaluating vaccines, chemoprophylactic agents, or targeted biological therapies for the prevention or treatment of VHF in adults and children were included. Data were extracted on incidence of VHF among exposed populations, safety, toxicity, and tolerability of preventive and therapeutic interventions, and morbidity and mortality outcomes among treated individuals. Secondary outcomes include hospitalization length-of-stay, economic outcomes, and measures of feasibility, acceptability, accessibility, and health equity. Results: Nine studies (four oral presentations, two poster presentations, and three hand-searched references) were included in the final synthesis. Seven studies evaluated pharmacologic preventive interventions and two evaluated experimental pharmacotherapeutics, with two studies contributing evidence to both categories. One observational study and one narrative review provided contextual evidence on vaccine readiness and outbreak preparedness. Discussion/Conclusions: This systematic review provides a rapid, structured synthesis of targeted medical interventions as emerging evidence at an expert scientific venue, while addressing the current lack of a consolidated, accessible summary of emerging VHF evidence. By rapidly organizing and evaluating these data, this work facilitates timely interpretation and application in clinical and public health settings where rapid decision-making is critical.

14 November 2024 in Zoonotic Diseases
Verified
Journal Article
Open access
PDF file
CRCamille Renee
Camille Renee
SISonia Igboanugo
Sonia Igboanugo
DKDylan Kain
Dylan Kain
APAndrew Seaton Peregrine
Andrew Seaton Peregrine
MKMichael Klowak
Michael Klowak
ABAndrea K Boggild
Andrea K Boggild
Halicephalobus gingivalis (H. gingivalis) is a very rare opportunistic cause of fatal meningoencephalomyelitis in equids but may also cause parasitic infections in exposed humans via zoonotic transmission (from animals to humans). We herein report a 39-year-old veterinarian who was exposed to aspirated gastric contents while inserting a nasogastric tube into a horse with signs of uveitis. This procedure requires application of oral suction to the end of the tube to ensure correct placement. Histopathology of the horse’s enucleated eye later revealed H. gingivalis infection, and the horse developed acute kidney injury, ataxia, and other signs of neurological disease. The horse later progressed to death despite supportive care and administration of the broad-spectrum antiparasitic, ivermectin. Two months later, the veterinarian received prophylactic ivermectin consisting of two 200-mcg/kg doses. The patient reported feeling well and was without any systemic or focal signs or symptoms prior to this prophylactic treatment and continued feeling well when followed up at 4 months post exposure. Blood work was unremarkable, with no eosinophilia (eosinophils 0.1 × 109/L, normal <0.4 × 109/L). Meticulous hand hygiene and alternatives to unprotected oral suction should be considered in veterinary medicine as the potentially increasing risk of occupational exposure to zoonotic helminthiases makes this a public health concern.