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Bukhari-Parlakturk N, Lutz M, Al-Khalidi HR, Unnithan S, Wang JEH, Scott B, Termsarasab P, Appelbaum LG, Calakos N. Suitability of Automated Writing Measures for Clinical Trial Outcome in Writer's Cramp. Mov Disord 2023; 38:123-132. [PMID: 36226903 PMCID: PMC9851940 DOI: 10.1002/mds.29237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/20/2022] [Accepted: 09/13/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Writer's cramp (WC) dystonia is a rare disease that causes abnormal postures during the writing task. Successful research studies for WC and other forms of dystonia are contingent on identifying sensitive and specific measures that relate to the clinical syndrome and achieve a realistic sample size to power research studies for a rare disease. Although prior studies have used writing kinematics, their diagnostic performance remains unclear. OBJECTIVE This study aimed to evaluate the diagnostic performance of automated measures that distinguish subjects with WC from healthy volunteers. METHODS A total of 21 subjects with WC and 22 healthy volunteers performed a sentence-copying assessment on a digital tablet using kinematic and hand recognition softwares. The sensitivity and specificity of automated measures were calculated using a logistic regression model. Power analysis was performed for two clinical research designs using these measures. The test and retest reliability of select automated measures was compared across repeat sentence-copying assessments. Lastly, a correlational analysis with subject- and clinician-rated outcomes was performed to understand the clinical meaning of automated measures. RESULTS Of the 23 measures analyzed, the measures of word legibility and peak accelerations distinguished subjects with WC from healthy volunteers with high sensitivity and specificity and demonstrated smaller sample sizes suitable for rare disease studies, and the kinematic measures showed high reliability across repeat visits, while both word legibility and peak accelerations measures showed significant correlations with the subject- and clinician-rated outcomes. CONCLUSIONS Novel automated measures that capture key aspects of the disease and are suitable for use in clinical research studies of WC dystonia were identified. © 2022 International Parkinson and Movement Disorder Society.
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Mitchell KT, Schmidt SL, Cooney JW, Grill WM, Peters J, Rahimpour S, Lee HJ, Jung SH, Mantri S, Scott B, Lad SP, Turner DA. Initial Clinical Outcome With Bilateral, Dual-Target Deep Brain Stimulation Trial in Parkinson Disease Using Summit RC + S. Neurosurgery 2022; 91:132-138. [PMID: 35383660 PMCID: PMC9514741 DOI: 10.1227/neu.0000000000001957] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) is an effective therapy in advanced Parkinson disease (PD). Although both subthalamic nucleus (STN) and globus pallidus (GP) DBS show equivalent efficacy in PD, combined stimulation may demonstrate synergism. OBJECTIVE To evaluate the clinical benefit of stimulating a combination of STN and GP DBS leads and to demonstrate biomarker discovery for adaptive DBS therapy in an observational study. METHODS We performed a pilot trial (n = 3) of implanting bilateral STN and GP DBS leads, connected to a bidirectional implantable pulse generator (Medtronic Summit RC + S; NCT03815656, IDE No. G180280). Initial 1-year outcome in 3 patients included Unified PD Rating Scale on and off medications, medication dosage, Hauser diary, and recorded beta frequency spectral power. RESULTS Combined DBS improved PD symptom control, allowing >80% levodopa medication reduction. There was a greater decrease in off-medication motor Unified PD Rating Scale with multiple electrodes activated (mean difference from off stimulation off medications -18.2, range -25.5 to -12.5) than either STN (-12.8, range -20.5 to 0) or GP alone (-9, range -11.5 to -4.5). Combined DBS resulted in a greater reduction of beta oscillations in STN in 5/6 hemispheres than either site alone. Adverse events occurred in 2 patients, including a small cortical hemorrhage and seizure at 24 hours postoperatively, which resolved spontaneously, and extension wire scarring requiring revision at 2 months postoperatively. CONCLUSION Patients with PD preferred combined DBS stimulation in this preliminary cohort. Future studies will address efficacy of adaptive DBS as we further define biomarkers and control policy.
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Gargesha M, Tomcik K, Scott B, Al-husaini N, Tilton J, Roy D. Immunotherapy: Late Breaking Abstract: 3D BIODISTRIBUTION OF SUPT1 CELLS IN WHOLE MICE USING CRYOVIZ™ IMAGING. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Galloo X, Carmeliet T, Prihadi EA, Lochy S, Scott B, Verheye S, Schoors D, Vermeersch P. Left atrial appendage occlusion in recurrent ischaemic stroke, a multicentre experience. Acta Clin Belg 2022; 77:255-260. [PMID: 32951514 DOI: 10.1080/17843286.2020.1821494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Oral anticoagulation therapy (OAC) remains the gold standard for ischaemic stroke prevention in patients with non-valvular atrial fibrillation (NVAF) and elevated stroke risk. Percutaneous left atrial appendage occlusion (LAAO) has emerged as a potential alternative for stroke prevention in patients who cannot tolerate OAC. Although no randomized data is available, recurrent stroke in NVAF-patients, while on adequate OAC, is regarded as a treatment failure and therefore is considered as a potential indication for LAAO, based upon expert opinion. METHODS/OBJECTIVES A multicentre retrospective cohort study evaluating efficacy, safety and mortality of LAAO in NVAF-patients presenting with recurrent ischaemic stroke, after excluding other plausible causes. RESULTS Fifteen LAAO have been performed in NVAF-patients with recurrent stroke despite ongoing OAC, after exclusion of other plausible causes. Mean age was 78.1 ± 5.8 years, mean CHA2DS2-VASc-score = 6 ± 1.2 and mean HAS-BLED-score = 5 ± 1.2. Successful implantation was achieved in all patients (73% Amplatzer device and 27% Watchman device), without any access-related complications and only one procedure/device-related complication (device embolization) was reported. In all but four patients, OAC was continued at long term after LAAO. No haemorrhagic strokes and only two ischaemic strokes were observed. During follow-up three patients died, all due to non-atrial fibrillation or non-device-related causes. CONCLUSIONS In NVAF-patients at high risk for stroke presenting with recurrent stroke despite adequate OAC, LAAO may be considered an adjunctive, but not alternative treatment to OAC with high feasibility and safety. Abbreviations: AF: atrial fibrillation; ESC: European Society of Cardiology; INR: international normalized ratio; LAA: left atrial appendage; LAAO: left atrial appendage occlusion; NOAC: non-vitamin K oral anticoagulants; NVAF: non-valvular atrial fibrillation; OAC: oral anticoagulation; RS: recurrent (ischaemic) stroke; SD: standard deviation; TIA: transient ischaemic attack; TOE: transoesophageal echocardiography; TTE: transthoracic echocardiography; VKA: vitamin K antagonists.
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McIntosh P, Scott B. Clinical Reasoning: A 55-Year-Old Man With Odd Behavior and Abnormal Movements. Neurology 2021; 97:1090-1093. [PMID: 34400586 DOI: 10.1212/wnl.0000000000012663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chambers S, Dunn J, Scott B, Ball D. PL04.04 Psychological Distress and Stigma for People with Lung Cancer: Time to Act. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Schwarzschild MA, Ascherio A, Casaceli C, Curhan GC, Fitzgerald R, Kamp C, Lungu C, Macklin EA, Marek K, Mozaffarian D, Oakes D, Rudolph A, Shoulson I, Videnovic A, Scott B, Gauger L, Aldred J, Bixby M, Ciccarello J, Gunzler SA, Henchcliffe C, Brodsky M, Keith K, Hauser RA, Goetz C, LeDoux MS, Hinson V, Kumar R, Espay AJ, Jimenez-Shahed J, Hunter C, Christine C, Daley A, Leehey M, de Marcaida JA, Friedman JH, Hung A, Bwala G, Litvan I, Simon DK, Simuni T, Poon C, Schiess MC, Chou K, Park A, Bhatti D, Peterson C, Criswell SR, Rosenthal L, Durphy J, Shill HA, Mehta SH, Ahmed A, Deik AF, Fang JY, Stover N, Zhang L, Dewey RB, Gerald A, Boyd JT, Houston E, Suski V, Mosovsky S, Cloud L, Shah BB, Saint-Hilaire M, James R, Zauber SE, Reich S, Shprecher D, Pahwa R, Langhammer A, LaFaver K, LeWitt PA, Kaminski P, Goudreau J, Russell D, Houghton DJ, Laroche A, Thomas K, McGraw M, Mari Z, Serrano C, Blindauer K, Rabin M, Kurlan R, Morgan JC, Soileau M, Ainslie M, Bodis-Wollner I, Schneider RB, Waters C, Ratel AS, Beck CA, Bolger P, Callahan KF, Crotty GF, Klements D, Kostrzebski M, McMahon GM, Pothier L, Waikar SS, Lang A, Mestre T. Effect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial. JAMA 2021; 326:926-939. [PMID: 34519802 PMCID: PMC8441591 DOI: 10.1001/jama.2021.10207] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 06/05/2021] [Indexed: 01/13/2023]
Abstract
Importance Urate elevation, despite associations with crystallopathic, cardiovascular, and metabolic disorders, has been pursued as a potential disease-modifying strategy for Parkinson disease (PD) based on convergent biological, epidemiological, and clinical data. Objective To determine whether sustained urate-elevating treatment with the urate precursor inosine slows early PD progression. Design, Participants, and Setting Randomized, double-blind, placebo-controlled, phase 3 trial of oral inosine treatment in early PD. A total of 587 individuals consented, and 298 with PD not yet requiring dopaminergic medication, striatal dopamine transporter deficiency, and serum urate below the population median concentration (<5.8 mg/dL) were randomized between August 2016 and December 2017 at 58 US sites, and were followed up through June 2019. Interventions Inosine, dosed by blinded titration to increase serum urate concentrations to 7.1-8.0 mg/dL (n = 149) or matching placebo (n = 149) for up to 2 years. Main Outcomes and Measures The primary outcome was rate of change in the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS; parts I-III) total score (range, 0-236; higher scores indicate greater disability; minimum clinically important difference of 6.3 points) prior to dopaminergic drug therapy initiation. Secondary outcomes included serum urate to measure target engagement, adverse events to measure safety, and 29 efficacy measures of disability, quality of life, cognition, mood, autonomic function, and striatal dopamine transporter binding as a biomarker of neuronal integrity. Results Based on a prespecified interim futility analysis, the study closed early, with 273 (92%) of the randomized participants (49% women; mean age, 63 years) completing the study. Clinical progression rates were not significantly different between participants randomized to inosine (MDS-UPDRS score, 11.1 [95% CI, 9.7-12.6] points per year) and placebo (MDS-UPDRS score, 9.9 [95% CI, 8.4-11.3] points per year; difference, 1.26 [95% CI, -0.59 to 3.11] points per year; P = .18). Sustained elevation of serum urate by 2.03 mg/dL (from a baseline level of 4.6 mg/dL; 44% increase) occurred in the inosine group vs a 0.01-mg/dL change in serum urate in the placebo group (difference, 2.02 mg/dL [95% CI, 1.85-2.19 mg/dL]; P<.001). There were no significant differences for secondary efficacy outcomes including dopamine transporter binding loss. Participants randomized to inosine, compared with placebo, experienced fewer serious adverse events (7.4 vs 13.1 per 100 patient-years) but more kidney stones (7.0 vs 1.4 stones per 100 patient-years). Conclusions and Relevance Among patients recently diagnosed as having PD, treatment with inosine, compared with placebo, did not result in a significant difference in the rate of clinical disease progression. The findings do not support the use of inosine as a treatment for early PD. Trial Registration ClinicalTrials.gov Identifier: NCT02642393.
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Scott B, LeJeune T, Gary A. Assessment of Perceptions and Nutrition Knowledge of Medical Students Participating in a Culinary Medicine Rotation. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Slavish DC, Asbee J, Veeramachaneni K, Messman B, Scott B, Walker J, Sin NL, Taylor DJ, Dietch J. 0178 The Cycle of Daily Stress and Sleep: Sleep Measurement Matters. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Disturbed sleep can be both a cause and a consequence of increased stress. Yet intensive longitudinal studies have demonstrated that sleep assessed via sleep diaries and actigraphy is inconsistently associated with daily stress. We expanded this research by examining daily associations between sleep and stress using a three-fold approach to assess sleep: sleep diaries, actigraphy, and ambulatory single-channel electroencephalography [EEG].
Methods
Participants were 80 adults (M age = 32.65 years, 63% female) who completed 7 days of sleep and perceived stress assessments in a naturalistic setting (resulting in 560 possible measurement occasions). Multilevel models were used to examine bidirectional associations between daily stressor occurrence (0 = stressor did not occur, 1 = stressor occurred) and stressor severity (0 = not at all severe to 3 = very severe) and sleep parameters assessed via diary, actigraphy, and EEG (e.g. total sleep time [TST], sleep efficiency [SE], and sleep onset latency [SOL], wake after sleep onset [WASO]).
Results
Participants reported at least one stressor on 37% of days. Compared to days without a stressor experienced, days with a stressor were associated with a 14.4-minute reduction in actigraphy-determined TST the subsequent night (β = -0.24, p = 0.030). Nights with greater sleep-diary determined WASO were associated with greater next-day stressor severity (β = 0.01, p = .026). No EEG-determined sleep parameters were associated with next-day stressor occurrence or severity, or vice versa.
Conclusion
Daily stress and sleep disturbances occurred in a bidirectional fashion, though specific results varied by sleep measurement technique and sleep parameter. Together, our results highlight that type of sleep measurement matters for examining associations with daily stress. We urge future researchers to treat sleep diaries, actigraphy, and EEG as complementary — not redundant — sleep measurement approaches.
Support
Funding for this study included NIH/NIAID R01AI128359-01; DoD-VA 1I01CU000144-01; the Foundation for Rehabilitation Psychology; and General Sleep Corporation.
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Scott B, Crawford M, Slavish D, Messman B, Wardle-Pinkston S, Dietch J, Kelly K, Ruggero C, Taylor D. 0398 Demographic Differences in the Degree of Discrepancy Between Sleep Diary and Actigraphy Measures of Sleep. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The accurate estimation of sleep is critical for understanding who is most at risk for sleep disorders and associated disease outcomes. Individuals who overestimate sleep disturbances may be at increased risk for insomnia. A few studies have shown demographic differences in the accuracy of sleep estimation when comparing subjective and objective measures; however, the previous literature is inconsistent and focuses primarily on older adults. We sought to replicate these studies in a large sample of nurses using 14 days of sleep diary and actigraphy measures.
Methods
Participants were 392 nurses (91.8% female; 77.8% white, mean age = 39.54) recruited for a larger study. Participants completed 14 days of actigraphy and sleep diaries to prospectively assess total sleep time (TST) and sleep efficiency (SE). Discrepancy between diary and actigraphy measures was calculated by subtracting actigraphy measures from diary measures. Linear regression was used to examine how age, race (0 = race other than white, 1 = white), gender (1 = male, 2 = female), ethnicity (1= non-Hispanic/Latinx, 2 = Hispanic/Latinx) predicted degree of sleep discrepancy.
Results
The average discrepancy between diary and actigraphy TST was 30.29 minutes (SD = 29.28), and the average discrepancy between diary and actigraphy SE was 4.16% (SD = 5.66). Race and ethnicity did not predict amount of TST or SE discrepancy. However, younger individuals had more discrepancy in both TST (b = -0.48, p < .001) and SE (b = -0.09, p < .001). Men also had a greater discrepancy in both TST (b = -10.90, p < .05) and SE (b = -2.56, p < .05).
Conclusion
Men and younger individuals had greater discrepancies between diary and actigraphy measures of sleep. This is in contrast to some previous research showing that elderly women tend to display greater discrepancies between subjective and objective measures of sleep. It is essential that future research explore the discrepancies between subjective and objective measures of sleep in larger and more demographically diverse samples. Establishing a better understanding of this relationship is crucial, as it may have significant implications for the diagnosis and treatment of insomnia.
Support
NIH/NIAID R01AI128359-01
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Vervaecke A, Van De Vyver G, Scott B, Vermeersch P. 3327Increasing incidence of cardiac device related endocarditis over the past ten years: a single center analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac device related infective endocarditis (CDIE) is an increasing problem in the current cardiology practice, related to high mortality and morbidity. Recent trends have shown an increase in cardiac device placement, which remains a risk factor for developing CDIE. We performed a retrospective analysis of all patients admitted to our hospital. The aim of our study was to identify a possible correlation between the amount of device placements and the incidence of CDIE.
Methods
All patients, aged 18 years or above, diagnosed and treated for IE in our hospital in the 11 years between January 1st 2007 and December 31st 2017 were retrospectively identified. The amount of cardiac device placements was meticulously kept up to date by the administrative department. Due to the retrospective nature of our study no approval of the local ethics committee was required.
Results
A total of 33 patients with proven CDIE were identified There were no CDIE documented in 2007,2009 and 2010. 2008 showed 2 CDIE (16.7%) whereas the last 4 years of the study showed a mean incidence of 5.75 IE per year. Our population was predominantly male (84.8%) and nearly a third of the population died during hospital stay. The mean age of the population was 73.9 years old. Three quarters of the population underwent surgery and 24 patients out of these underwent device removal, the remaining 2 patients underwent valve replacement or catheter removal.
Half of the patients had early-onset or procedure-related IE (<12 months post procedure). The remaining cases were defined as late onset IE. Overall, 80% of CDIE developed within 3 years after the procedure.
The most prevalent causative organisms in our CDIE population were Staphylococci (68%) followed by Streptococci (20%). Eight out of 33 cases appeared to be culture negative (24.2%).
We sought to correlate these findings to the amount of cardiac device procedures (de novo implantations and replacements) as of 2004 (to compensate for the possible 3-year delay). The number of CD procedures increased by nearly 400% over the course of these 14 years.
Patient demographics
Conclusions
The incidence of CDIE has increased in our population over the past 11 years. This increase runs parallel with the expansion of the number of devices implanted. About half of CDIE occur within 1 year of the procedure defined as early onset CDIE, but the presence of a cardiac device remains a risk factor for IE even thereafter. Causative organisms in our study for CDIE specifically appear to coincide with the results from other studies done in more general populations, with Staphylococci remaining the most prevalent organisms. As patients with cardiac devices implanted appear to be at increased risk for IE, one might add these to the group of patients requiring IE-prophylaxis, especially because of the high mortality rate of IE, which appears to be even higher for CDIE.
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McGavock R, Gough J, Scott B. 40FALLS RESPONSE SERVICE: A NOVEL MULTIDISCIPLINARY APPROACH IMPROVING PATIENT-CENTRED CARE FOLLOWING AN ACUTE FALL. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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OSMAN M, Ronksley P, Tangri N, Kurzawa J, Grill A, James W, Lindeman C, Soos B, Tuot D, Scott B, Drummond N, Bello A. SUN-233 The state of CKD care in Canadian primary care: a retrospective analysis of a national database. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Bailey A, Dempsey A, Scott B, Hiscock D. Can low dose Nordic hamstring exercises reduce the risk of hamstring injury? A randomised control study. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Roeck F, Scott B, Convens C, Vermeersch P. P1569Spontaneous coronary artery dissection in young female acute coronary syndrome patients; a single-centre retrospective data analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wilkins B, Simmonds M, Matsis P, Scott B, Gaskin D, Harding S, Larsen P. Effect of Reduced Frame-Rate Protocol on Radiation Dose During Cardiac Catheterisation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vermeersch G, Azzano A, Verheye S, Scott B, Vermeersch P. P6102Percutaneous closure of patent foramen ovale for platypnoea-orthodeoxia syndrome: a single centre study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hickey PT, Kuchibhatla M, Scott B, Gauger L, Stacy MA. Dopamine Transporter Imaging has no Impact on Functional Outcomes in de Novo Probable Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2017; 7:279-287. [PMID: 28339403 DOI: 10.3233/jpd-160937] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is among the most prevalent neurodegenerative conditions. While motor and non-motor aspects of this disease have been well characterized, no objective biomarker exists to support an accurate clinical diagnosis. However, newer imaging techniques, including [123I]-FP-CIT (DaTSCAN), have demonstrated utility in differentiating between PD and non-neurodegenerative tremor disorders. OBJECTIVE DaTSCAN has been primarily investigated in situations where diagnostic confusion exists, and in these instances has been shown to significantly impact clinical management. The goal of this pilot study was to evaluate the impact of DaTSCAN on the clinical management of patients with early probable PD, where no diagnostic uncertainty exists. METHODS This was a prospective, 54-week, comparative pilot study, in which twenty subjects with de novo PD were randomly assigned to DaTSCAN either immediately upon diagnosis (and again at 6 and 12 months) or delayed to 6 months (and again at 12 months). The primary outcome measure was the frequency of deviation from the initial treatment plan from baseline to 54 weeks between the two groups. Secondary outcomes included motor and non-motor assessments. RESULTS There was no significant difference in the number of treatment changes over the course of the study between the two groups: initial imaging group = 4.2 (SD:2.74) vs. delayed imaging group = 2.3 (SD:2.0, p = 0.11). In addition, there were no group differences in medication requirements, motor performance, or patient expectations of disease. CONCLUSIONS In patients with early, probable PD, DaTSCAN contributes no additional impact on clinical management or functional outcomes when added to the diagnostic algorithm.
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Rittiner JE, Caffall ZF, Hernández-Martinez R, Sanderson SM, Pearson JL, Tsukayama KK, Liu AY, Xiao C, Tracy S, Shipman MK, Hickey P, Johnson J, Scott B, Stacy M, Saunders-Pullman R, Bressman S, Simonyan K, Sharma N, Ozelius LJ, Cirulli ET, Calakos N. Functional Genomic Analyses of Mendelian and Sporadic Disease Identify Impaired eIF2α Signaling as a Generalizable Mechanism for Dystonia. Neuron 2016; 92:1238-1251. [PMID: 27939583 DOI: 10.1016/j.neuron.2016.11.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/27/2016] [Accepted: 11/04/2016] [Indexed: 01/09/2023]
Abstract
Dystonia is a brain disorder causing involuntary, often painful movements. Apart from a role for dopamine deficiency in some forms, the cellular mechanisms underlying most dystonias are currently unknown. Here, we discover a role for deficient eIF2α signaling in DYT1 dystonia, a rare inherited generalized form, through a genome-wide RNAi screen. Subsequent experiments including patient-derived cells and a mouse model support both a pathogenic role and therapeutic potential for eIF2α pathway perturbations. We further find genetic and functional evidence supporting similar pathway impairment in patients with sporadic cervical dystonia, due to rare coding variation in the eIF2α effector ATF4. Considering also that another dystonia, DYT16, involves a gene upstream of the eIF2α pathway, these results mechanistically link multiple forms of dystonia and put forth a new overall cellular mechanism for dystonia pathogenesis, impairment of eIF2α signaling, a pathway known for its roles in cellular stress responses and synaptic plasticity.
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McGarry A, McDermott M, Kieburtz K, de Blieck EA, Beal F, Marder K, Ross C, Shoulson I, Gilbert P, Mallonee WM, Guttman M, Wojcieszek J, Kumar R, LeDoux MS, Jenkins M, Rosas HD, Nance M, Biglan K, Como P, Dubinsky RM, Shannon KM, O'Suilleabhain P, Chou K, Walker F, Martin W, Wheelock VL, McCusker E, Jankovic J, Singer C, Sanchez-Ramos J, Scott B, Suchowersky O, Factor SA, Higgins DS, Molho E, Revilla F, Caviness JN, Friedman JH, Perlmutter JS, Feigin A, Anderson K, Rodriguez R, McFarland NR, Margolis RL, Farbman ES, Raymond LA, Suski V, Kostyk S, Colcher A, Seeberger L, Epping E, Esmail S, Diaz N, Fung WLA, Diamond A, Frank S, Hanna P, Hermanowicz N, Dure LS, Cudkowicz M. A randomized, double-blind, placebo-controlled trial of coenzyme Q10 in Huntington disease. Neurology 2016; 88:152-159. [PMID: 27913695 DOI: 10.1212/wnl.0000000000003478] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 09/21/2016] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To test the hypothesis that chronic treatment of early-stage Huntington disease (HD) with high-dose coenzyme Q10 (CoQ) will slow the progressive functional decline of HD. METHODS We performed a multicenter randomized, double-blind, placebo-controlled trial. Patients with early-stage HD (n = 609) were enrolled at 48 sites in the United States, Canada, and Australia from 2008 to 2012. Patients were randomized to receive either CoQ 2,400 mg/d or matching placebo, then followed for 60 months. The primary outcome variable was the change from baseline to month 60 in Total Functional Capacity score (for patients who survived) combined with time to death (for patients who died) analyzed using a joint-rank analysis approach. RESULTS An interim analysis for futility revealed a conditional power of <5% for the primary analysis, prompting premature conclusion in July 2014. No statistically significant differences were seen between treatment groups for the primary or secondary outcome measures. CoQ was generally safe and well-tolerated throughout the study. CONCLUSIONS These data do not justify use of CoQ as a treatment to slow functional decline in HD. CLINICALTRIALSGOV IDENTIFIER NCT00608881. CLASSIFICATION OF EVIDENCE This article provides Class I evidence that CoQ does not slow the progressive functional decline of patients with HD.
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Thompson M, Portmann M, Scott B, Kelly M, Tucker M, Sasson I, Avella M. Frozen embryo transfer (FET) outcomes from day 4 euploid blastocysts. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Whelan B, Keall P, Holloway L, Gierman S, Schmerge J, Tantawi S, Tremaine A, Trautwein A, Scott B, Fahrig R. TU-H-BRA-07: Design, Construction, and Installation of An Experimental Beam Line for the Development of MRI-Linac Compatible Electron Accelerator. Med Phys 2016. [DOI: 10.1118/1.4957629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
A 65-year-old female patient with metastatic neuroendocrine tumour of the small intestine developed carcinoid valve disease and intractable right heart failure. She underwent successful cardiac valve replacement of both tricuspid and pulmonary valves. One year after surgery, she has regained full functional capacity.
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El-Zeftawi BM, Brohier L, Dooley L, Goubran FH, Holmes R, Scott B. Some maturity indices for tamarillo and pepino fruits. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/14620316.1988.11515842] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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