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Greene MC, Wimer G, Larrea M, Mejia Jimenez I, Armijos A, Angulo A, Guevara ME, Vega C, Heard EW, Demis L, Benavides L, Corrales C, de la Cruz A, Lopez MJ, Moyano A, Murcia A, Noboa MJ, Rodriguez A, Solis J, Vergara D, Andersen LS, Cristobal M, Wainberg M, Bonz AG, Tol W. Strategies to improve the implementation and effectiveness of community-based psychosocial support interventions for displaced, migrant and host community women in Latin America. Glob Ment Health (Camb) 2024; 11:e32. [PMID: 38572247 PMCID: PMC10988141 DOI: 10.1017/gmh.2024.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/16/2023] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
As evidence supporting the effectiveness of mental health and psychosocial interventions grows, more research is needed to understand optimal strategies for improving their implementation in diverse contexts. We conducted a qualitative process evaluation of a multicomponent psychosocial intervention intended to promote well-being among refugee, migrant and host community women in three diverse contexts in Ecuador and Panamá. The objective of this study is to describe the relationships among implementation determinants, strategies and outcomes of this community-based psychosocial intervention. The five implementation strategies used in this study included stakeholder engagement, promoting intervention adaptability, group and community-based delivery format, task sharing and providing incentives. We identified 10 adaptations to the intervention and its implementation, most of which were made during pre-implementation. Participants (n = 77) and facilitators (n = 30) who completed qualitative interviews reported that these strategies largely improved the implementation of the intervention across key outcomes and aligned with the study's intervention and implementation theory of change models. Participants and facilitators also proposed additional strategies for improving reach, implementation and maintenance of this community-based psychosocial intervention.
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Keogan S, Alonso T, Sunday S, Hanafin J, Tigova O, Fernandez E, Lopez MJ, Gallus S, Semple S, Tzortzi A, Boffi R, Gorini G, Lopez-Nicolas A, Arvind DK, Radu-Loghin C, Soriano JB, Clancy L. Particle Exposure Hazards of Visiting Outdoor Smoking Areas for Patients with Asthma or COPD Even in EU Countries with Comprehensive Smokefree Laws. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5978. [PMID: 37297582 PMCID: PMC10252725 DOI: 10.3390/ijerph20115978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/19/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Smokefree laws are intended to protect against second-hand smoke (SHS) in outdoor areas. We examined if exposure to PM2.5 particles in outdoor smoking areas changed breathing rates in 60 patients with asthma (n = 30) or with COPD (n = 30), in an open, non-randomised, interventional study model in Czechia, Ireland and Spain. The patients wore a PM2.5 particle monitor (AirSpeck) and a breath monitor (RESpeck) for 24 h to determine changes in breathing rates (Br) at rest and during a visit to an outside smoking area. Spirometry and breath CO were measured before and the day after visiting an outdoor smoking area. The PM2.5 levels at the 60 venues were highly variable, ranging from ≥2000 µg/m3 (in 4 premises) to ≤10 µg/m3 (in 3 premises, which had only a single wall in the structure). At 39 venues, the mean PM 2.5 levels were ≥25 µg/m3. The breathing rate changed significantly in 57 of the 60 patients, resulting in an increase in some patients and a decrease in others. Comprehensive smokefree laws were ineffective in protecting asthma and COPD patients from exposure to high levels of SHS in outside areas of pubs and terraces, which should be avoided by these patients. These findings also support the extension of smokefree laws to outside areas.
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Greene MC, Bonz A, Isaacs R, Cristobal M, Vega C, Andersen LS, Angulo A, Armijos A, Guevara ME, Benavides L, Cruz ADL, Lopez MJ, Moyano A, Murcia A, Noboa MJ, Rodriguez A, Solis J, Vergara D, Wainberg M, Tol WA. Community-based participatory design of a psychosocial intervention for migrant women in Ecuador and Panama. SSM - MENTAL HEALTH 2022; 2. [DOI: 10.1016/j.ssmmh.2022.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Greene MC, Bonz A, Cristobal M, Vega C, Andersen LS, Angulo A, Armijos A, Guevara ME, Benavides L, de la Cruz A, Lopez MJ, Moyano A, Murcia A, Noboa MJ, Rodriguez A, Solis J, Vergara D, Scharf J, Dutt P, Wainberg M, Tol WA. Evaluating the feasibility of a group psychosocial intervention for migrant and host community women in Ecuador and Panamá: protocol for a multi-site feasibility cluster trial. Pilot Feasibility Stud 2022; 8:126. [PMID: 35706068 PMCID: PMC9198203 DOI: 10.1186/s40814-022-01085-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community- and strengths-based psychosocial interventions are central to mental health and psychosocial support guidelines, but rigorous evidence regarding the effectiveness of these interventions is limited. The complexity and variability that is inherent to many community-based psychosocial interventions requires innovative strategies in order to facilitate the comparability and synthesis across research studies without compromising the fit and appropriateness of interventions to specific study populations and context. Entre Nosotras is a community-based psychosocial intervention developed for migrant and host community women that is designed to be flexible enough to enable integration of external intervention components and adaptable to diverse study contexts and populations. This protocol describes a study that aims to evaluate the appropriateness, acceptability, and feasibility of integrating a standardized stress management intervention into Entre Nosotras. METHODS This study will evaluate the appropriateness, acceptability, feasibility, and safety of intervention and research procedures for a cluster randomized comparative effectiveness trial conducted in Ecuador and Panamá with migrant and host community women. In this feasibility trial, we will allocate communities nested within the three study sites to the integrated Entre Nosotras + stress management intervention versus Entre Nosotras alone through stratified randomization. Migrant and host community women residing in these study communities who report low to moderate levels of distress will be allocated to the intervention condition that their community is assigned (n = 220 total). We will collect quantitative measures of psychosocial wellbeing, psychological distress, coping, social support, and functioning from study participants. We will collect quantitative measures of fidelity and facilitator competencies through observation and facilitator self-assessment. Data on appropriateness, acceptability, feasibility, and safety will be gathered from participants and facilitators through quantitative assessments at 0, 5, and 10 weeks post-enrollment and qualitative interviews conducted with all facilitators and a subset of 70 study participants during the post-intervention follow-up period. DISCUSSION Results from this feasibility trial will determine whether a multi-site cluster randomized comparative effectiveness trial of an adaptable community-based psychosocial intervention for migrant and host community women is relevant, acceptable, and feasible. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05130944 . Registered November 23, 2021-retrospectively registered.
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Sutphin D, Meacham S, Di Mucci-Ward J, Kirby A, Lopez MJ, Recinos F, Erazo X, Cruz D, Reynolds C, Saggio M, Franklin JM. Waist Circumference Complementing Body Mass Index Measures Assessed as Disease Risk Indicators in Adult Women; A Comparison Study in the Dominican, Honduras and El Salvador. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa053_119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To determine differences in nutritional status to guide the culturally specific education interventions.
Methods
Pilot training occurred in each country using consistent equipment and measurement protocols. The IRB approved protocol for pretesting and educational interventions was conducted daily for a month at each location. Descriptive statistics and Pearson 2-tailed correlations were performed.
Results
Subjects, all non-pregnant, non-lactating women (n = 126 DR, n = 101 ES, n = 132 HN), ranged in age from 18 to 78 yrs with 30% in their 30’s; mean ages 32.9 DR, ES 37.0, HN 42.8 (all differed, P ≤ 0.05). Most reported their ethnicity as Hispanic/Latino-Americano. At pre-testing, subjects (%) with normal BMI distributions = DR 5.6, ES 18.8, HN 15.9; obese/overweight = DR 88.8, ES 75.3, HN 62.9 (all differed, P ≤ 0.05). Mean (SD) for WC (in) = DR 38.3 ± 5.6, ES 37.4 ± 5.1, HN 36.3 ± 5.7; waist: height ratios in HN 14% lower than mean measures for DR and ES. BMI and WC were closely correlated (r = 0.70, P ≤ 0.01). Self-reported data on physical activity, weekly household income, health insurance and level of education provided insight on factors contributing to nutritional status.
Conclusions
BMI and WC measures were convenient, noninvasive, inexpensive and available for comparative assessments. Pre-testing data indicate subjects, the majority in their 20’s and 30’s in all three countries, had BMI and waist measures higher than recommended indicating greater risk for disease. Physical activity and socioeconomic factors highlight disparities, particularly the lack of health insurance. Our findings support the need for country specific educational interventions in future research protocols to support weight management programs. This study highlights the valuable uniqueness of the VCOM international service area clinic model.
Funding Sources
VCOM REAP Program FY19.
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Figueroa J, Pedraza E, Peña O, Mora E, Ardila S, Guarin A, Diaz D, Villamizar L, Lopez MJ. Comparison between Allogeneic Stem Cell Transplantation from Unmanipulated Haploidentical, Unrelated and Matched Related Donors for Acute Lymphoblastic Leukemia and Acute Myeloid Leukemia: Experience in a Single Center in Colombia. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dimucci-Ward J, Meacham S, Kirby A, Sutphin D, Lopez MJ, Benner T, Dowis A, Quade L, Reynolds C, Trent A, Saggio M. Waist Circumference Complementing Body Mass Index Assessed as Non-Communicable Disease Risk Indicators in Adult Women in El Salvador; A Comparative International Study (P10-076-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz034.p10-076-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The objective is to confirm waist circumference measures as practical complementary measures to BMI to identify those at risk for obesity and non-communicable diseases in Salvadoran women in an international nutrition study.
Methods
Anthropometric data was collected during the pre-testing and educational intervention phase of an international comparative study. Data collection on 128 Latina women 18 years and older occurred during one month at the Shalom Clinic in El Salvador. In-country doctors and osteopathic medical students were pre-trained using videos, pilot testing, standardized equipment and measurement protocols.
Results
The subjects ranged in age with most, 37%, in their 20 s, 25% in their 30 s, and 21% in their 40 s. Most (n = 97) were non-pregnant, non-lactating with average weights = 147.2 lbs. (17.9, standard deviation, SD); average heights 60.04 inches (2.3, SD); average waist circumferences 37.0 inches (4.39 SD) and average BMI 28.47 (3.36 SD). BMI distributions indicated no subjects were underweight, 21% were normal, 43% overweight (national average, 38%) and 27% considered obese with one subject with BMI 40.6. Both waist circumference and BMI averages for this clinic population were approximately 25% over desired recommendations. Initial relationships relating BMI to several subject characteristics using Pearson correlations resulted in the highest positive coefficient for waist circumferences (r, 0.76) and weaker correlations with age (r, 0.14), physical activity (r, -0.34), education (r, -0.03) and income (r, – 0.11).
Conclusions
BMI and WC measures identified overweight and obesity rates exceeding or similar, respectively, to national rates in this clinic population of Salvadoran adult women. WC measures are convenient, noninvasive and inexpensive and available to clinicians yet must be accurate to be of value. WC complimenting BMI as part of a clinical exam provides valuable insight to identify those at risk of NCD and enable clinicians to provide precision nutrition education to patients.
Funding Sources
Competitive Internal Institutional Research Office Award.
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Meacham S, Sutphin D, Dimucci-Ward J, Kirby A, Erazo X, Lopez MJ, Rojas D, Cruz D, Cockrell C, Vaquedano I. Nutritional Status in Osteopathic Medical School International Service Areas: A Comparative Analysis in the Dominican Republic, El Salvador and Honduras (P10-040-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz034.p10-040-19] [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
Objectives
There are differences in documented nutrition sensitive conditions and different barriers to obtaining adequate nutrition influencing health in the Dominican Republic, El Salvador and Honduras.
Methods
The research protocol is to be conducted in permanent osteopathic medical clinics in the Dominican Republic, El Salvador and Honduras with a pilot and time series study performed over 18 months. The baseline data collected general demographic information, nutrition knowledge scores, food frequency responses and use of nutrition physical assessments and ICD-10 codes documented when available by clinical students. A sample size of 120 clinic patients was determined for each country as per a power analysis (0.95) for a single variable, mean baseline body mass index (BMI). The pilot test period conducted during the three week mission trips (Fall 2018) allowed for adjustments in Qualtrics survey design, major steps forward in multi-country communication with ZOOM technology, editing survey instruments to strengthen network collaborations and accommodate culturally appropriate questions regarding demographic information, food frequencies, and health status documentation.
Results
The pilot surveys (approximately n = 40) were beneficial to refine the protocol implementation and improve data quality. Preliminary results from 133 respondents revealed a greater concern for overweight/obese (>80% of respondents) than underweight nutrition status. Examples of nutrition knowledge quiz responses indicated that approximately 68% correctly identified that maintaining a healthy weight can prevent heart diseases and some forms of cancer. Most respondents (80%) identified saturated fat as the dietary factor most responsible for raising serum cholesterol. Nearly 60% or respondents recognized a healthy weekly weight loss of 1–2 pounds. Quantitative data analyses will be performed using SPSS for country comparisons at the completion of the study.
Conclusions
Preliminary findings confirm nuances in food preferences between countries that influence food frequency responses. Responses to selected questions indicated variable levels of nutrition knowledge and literacy levels. These findings will inform future nutrition education modules and improve the efficacy of future intervention programs, policy development and overall health specific to the Dominican, Salvadoran and Honduran communities.
Funding Sources
Internal funding was provided by the institutional Office of Research.
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Stillman FA, Soong A, Pang Y, Zheng L, Garcia-Esquinas E, Lopez MJ, Navas-Acien A. Tobacco Smoke Exposure in Indoor and Outdoor Locations in Airports Across Europe and the United States: A Cross-Sectional Study. Nicotine Tob Res 2017; 19:1482-1490. [PMID: 27629279 DOI: 10.1093/ntr/ntw238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 09/05/2016] [Indexed: 11/13/2022]
Abstract
Objective Conduct a systematic evaluation of indoor and outdoor areas of selected airports, assess compliance and identify areas of improvement with smoke-free policies in airports. Methods Cross-sectional observational study conducted at 21 airports in Europe (11) and the United States (10). Using a standardized protocol, we assessed compliance (smoking, cigarette butts, smoke smell), and the physical environment (signage, ashtrays, designated smoking rooms [DSRs], tobacco sales). Results Cigarette butts (45% vs. 0%), smoke smell (67% vs. 0%), ashtrays (18% vs. 10%), and DSRs (63% vs. 30%) were observed more commonly indoors in Europe than in the United States. Poor compliance indoors was related to the presence of DSRs (OR 4.8, 95% CI 0.69, 33.8) and to cigarettes sales in pre-security areas (OR 6.0, 95% CI 0.57, 64.7), although not significantly different. Smoking was common in outdoor areas of airports in Europe and the United States (mean (SD) number of smokers 27.7 (23.6) and 6.3 (7.7), respectively, p value < .001). Around half (55%) of airports in Europe and all airports in the United States had some/partial outdoor smoking restrictions. Conclusions Exposure to secondhand smoke (SHS) remains a public health problem in major airports across Europe and in some airports in the United States, specifically related to the presence of DSRs and SHS exposure in outdoor areas. Airports must remove DSRs. Research is needed in low- and middle-income countries and on the effectiveness of outdoor smoking-restricted areas around entryways. Eliminating smoking at airports will protect millions of people from SHS exposure and promote social norms that discourage smoking. Implications Airports are known to allow exceptions to smoke-free policy by providing DSRs. We found that smoking still occurs in indoor areas in airports, particularly in the context of DSRs. Smoking, moreover, is widespread in outdoor areas and compliance with smoking restrictions is limited. Advancing smoke-free policy requires improvements to the physical environment of airports, including removal of DSRs and implementation of stricter outdoor smoking restrictions.
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Soong A, Navas-Acien A, Pang Y, Lopez MJ, Garcia-Esquinas E, Stillman FA. A Cross-Sectional Study of Tobacco Advertising, Promotion, and Sponsorship in Airports across Europe and the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100959. [PMID: 27690072 PMCID: PMC5086698 DOI: 10.3390/ijerph13100959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/19/2016] [Accepted: 09/20/2016] [Indexed: 11/29/2022]
Abstract
Tobacco advertising, promotion, and sponsorship (TAPS) bans are effective and are increasingly being implemented in a number of venues and countries, yet the state of TAPS in airports and their effect on airport smoking behavior is unknown. The objective of this study was to evaluate the presence of TAPS in airports across Europe and the US, and to begin to examine the relationship between TAPS and smoking behaviors in airports. We used a cross-sectional study design to observe 21 airports in Europe (11) and the US (10). Data collectors observed points of sale for tobacco products, types of products sold, advertisements and promotions, and branding or logos that appeared in the airport. Tobacco products were sold in 95% of all airports, with significantly more sales in Europe than the US. Advertisements appeared mostly in post-security areas; however, airports with advertisements in pre-security areas had significantly more smokers observed outdoors than airports without advertisements in pre-security areas. Tobacco branding appeared in designated smoking rooms as well as on non-tobacco products in duty free shops. TAPS are widespread in airports in Europe and the US and might be associated with outdoor smoking, though further research is needed to better understand any relationship between the two. This study adds to a growing body of research on tobacco control in air transit and related issues. As smoke-free policies advance, they should include comprehensive TAPS bans that extend to airport facilities.
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Lopez MJ, Continente X. Secondhand smoke exposure in children: It is time to move forward. REVISTA PORTUGUESA DE PNEUMOLOGIA 2016; 22:187-8. [PMID: 27255785 DOI: 10.1016/j.rppnen.2016.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Perez-Rios M, Fernandez E, Schiaffino A, Nebot M, Lopez MJ. Changes in the Prevalence of Tobacco Consumption and the Profile of Spanish Smokers after a Comprehensive Smoke-Free Policy. PLoS One 2015; 10:e0128305. [PMID: 26066497 PMCID: PMC4465936 DOI: 10.1371/journal.pone.0128305] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 04/27/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A partial smoke-free regulation in Spain was introduced on January 1, 2006, which was subsequently amended to introduce a comprehensive smoke-free policy from 2 January 2011 onward. The objective of this study was to compare the prevalence of tobacco consumption in Spain and the profile of smokers before (2006) and after (2011) the comprehensive smoking ban passed in 2010. METHODS Two independent, cross-sectional, population-based surveys were carried out among the adult (≥ 18 years old) Spanish population in 2006 and 2011 through telephone interviews. Both surveys used the same methods and questionnaire. Nicotine dependence was assessed with the Fagerström Test for nicotine dependence and readiness to quit according to the stages of change. RESULTS The prevalence of tobacco consumption showed a nonsignificant decrease from 23.4% in 2006 to 20.7% in 2011. No changes were observed in nicotine dependence or readiness to quit. In 2011, most smokers (76%) showed low nicotine dependence and were mainly in the precontemplation stage (72%). CONCLUSIONS The prevalence of smokers has slightly decreased since the introduction of the total smoking ban in Spain. No differences were found in nicotine dependence or readiness to quit.
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Lopez MJ, Jarazo J. State of the art: stem cells in equine regenerative medicine. Equine Vet J 2014; 47:145-54. [PMID: 24957845 DOI: 10.1111/evj.12311] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 06/01/2014] [Indexed: 12/20/2022]
Abstract
According to Greek mythology, Prometheus' liver grew back nightly after it was removed each day by an eagle as punishment for giving mankind fire. Hence, contrary to popular belief, the concept of tissue and organ regeneration is not new. In the early 20th century, cell culture and ex vivo organ preservation studies by Alexis Carrel, some with famed aviator Charles Lindbergh, established a foundation for much of modern regenerative medicine. While early beliefs and discoveries foreshadowed significant accomplishments in regenerative medicine, advances in knowledge within numerous scientific disciplines, as well as nano- and micromolecular level imaging and detection technologies, have contributed to explosive advances over the last 20 years. Virtually limitless preparations, combinations and applications of the 3 major components of regenerative medicine, namely cells, biomaterials and bioactive molecules, have created a new paradigm of future therapeutic options for most species. It is increasingly clear, however, that despite significant parallels among and within species, there is no 'one-size-fits-all' regenerative therapy. Likewise, a panacea has yet to be discovered that completely reverses the consequences of time, trauma and disease. Nonetheless, there is no question that the promise and potential of regenerative medicine have forever altered medical practices. The horse is a relative newcomer to regenerative medicine applications, yet there is already a large body of work to incorporate novel regenerative therapies into standard care. This review focuses on the current state and potential future of stem cells in equine regenerative medicine.
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Lopez MJ, García del Busto N, Carrascosa O, Mejía L, Antonino G, De la Vega I, Casamada L, Cuenca M, Quintana B, Sánchez A. CP-096 Biosimilar epoetin zeta in the treatment of chemotherapy-induced anaemia. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.94] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gorini G, Moshammer H, Sbrogiò L, Gasparrini A, Nebot M, Neuberger M, Tamang E, Lopez MJ, Galeone D, Serrahima E. Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban. INDOOR AIR 2008; 18:328-334. [PMID: 18429994 DOI: 10.1111/j.1600-0668.2008.00534.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED The aim of this paper was to compare nicotine concentration in 28 hospitality premises (HPs) in Florence and Belluno, Italy, where a smoking ban was introduced in 2005, and in 19 HPs in Vienna, Austria, where no anti-smoking law entered into force up to now. Airborne nicotine concentrations were measured in the same HPs in winter 2002 or 2004 (pre-ban measurements) and winter 2007 (post-ban measurements). In Florence and Belluno, medians decreased significantly (P < 0.001) from 8.86 [interquartile range (IQR): 2.41-45.07)] before the ban to 0.01 microg/m3 (IQR: 0.01-0.41) afterwards. In Austria (no smoking ban) the medians collected in winters 2004 and 2007 were, respectively, 11.00 (IQR: 2.53-30.38) and 15.76 microg/m3 (IQR: 2.22-31.93), with no significant differences. Measurements collected in winter 2007 in 28 HPs located in Naples, Turin, Milan (0.01 microg/m3; IQR: 0.01-0.16) confirmed post-ban results in Florence and Belluno. The medians of nicotine concentrations in Italy and Austria before the Italian ban translates, using the risk model of Repace and Lowery, into a lifetime excess lung cancer mortality risk for hospitality workers of 11.81 and 14.67 per 10,000, respectively. Lifetime excess lung cancer mortality risks for bar and disco-pub workers were 10-20 times higher than that calculated for restaurant workers, both in Italy and Austria. In winter 2007, it dropped to 0.01 per 10,000 in Italy, whereas in Austria it remained at the same levels. The drop of second-hand smoke exposure indicates a substantial improvement in air quality in Italian HPs even after 2 years from the ban. PRACTICAL IMPLICATIONS The nation-wide smoking ban introduced in Italy on January 10, 2005, resulted in a drop in second-hand smoke exposure in hospitality premises, whereas in Austria, where there is no similar nation-wide smoking ban, the exposure to second-hand smoke in hospitality premises remains high. Given that second-hand smoke is considered a group 1 carcinogen according to the International Agency for Research on Cancer classification, the World Health Organization Framework Convention on Tobacco Control strongly recommends the implementation of nation-wide smoke-free policies in order to improve the indoor air quality of hospitality premises and workplaces. Results from our study strongly supports this recommendation.
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Fredericks EM, Lopez MJ, Magee JC, Shieck V, Opipari-Arrigan L. Psychological functioning, nonadherence and health outcomes after pediatric liver transplantation. Am J Transplant 2007; 7:1974-83. [PMID: 17617862 DOI: 10.1111/j.1600-6143.2007.01878.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The present study empirically assessed the relationships between adherence behaviors and HRQOL, parent and child psychological functioning and family functioning, and investigated the relationship between adherence behaviors and health outcomes in children who were within 5 years of their liver transplantation. Participants included 38 children (mean = 8.5 years, range 28 months to 16 years) and their parent/guardian(s). HRQOL and psychological functioning were examined using well-validated assessment measures. Measures of adherence included the rate of clinic attendance and standard deviations (SDs) of consecutive tacrolimus blood levels, which were collected and evaluated retrospectively. Measures of child health status included the frequency of hospital admissions, liver biopsies, episodes of rejection and graft function for the year prior to study participation. Results indicated that nonadherence was related to lower physical HRQOL, more limitations in social and school activities related to emotional and behavioral problems, parental emotional distress and decreased family cohesion. Nonadherence was also related to frequency and duration of hospitalizations, liver biopsies and rejection episodes. These results suggest that empirically based assessment of HRQOL, parenting stress and family functioning may help identify patients at risk for nonadherence, and may allow for the need-based delivery of appropriate clinical interventions.
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Oyarzabal M, Chueca M, Lopez MJ. Implications for adulthood and therapeutic optimization in diabetes mellitus. J Pediatr Endocrinol Metab 2004; 17 Suppl 3:423-5. [PMID: 15134302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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De la Revilla NJ, Moreno JM, Rubio E, de Herreros TA, Navarrete E, Lopez MJ, Turrion VS, Jimenez M, Lucena M, Cuervas-Mons V. Usefulness of chemotherapy as prophylaxis of tumor recurrence after liver transplantation in advanced hepatocellular carcinomas. Transplant Proc 2003; 35:1830-1. [PMID: 12962812 DOI: 10.1016/s0041-1345(03)00583-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The effectiveness of chemotherapy as prophylaxis of tumor recurrence after liver transplantation in patients with advanced hepatocellular carcinoma is controversial. AIM Our goal was to assess the outcomes of patients with advanced hepatocellular carcinoma treated with chemotherapy after liver transplant. METHODS Ten patients with liver transplants performed between 1993-2002 were men of mean age 55 years. The etiology of cirrhosis was hepatitis C in four patients, alcoholic cirrhosis in four, and cryptogenic cirrhosis in two. Immunosuppressive therapy was cyclosporine in five patients and tacrolimus in five. The chemotherapy regimen used adriamycin (20 mg/m2 weekly for 20 weeks). Six patients were stage IVA and four stage III. Hepatocellular carcinoma was known in five patients and incidental in the other five. Pathology revealed well-differentiated hepatocellular carcinoma in six patients and moderately differentiated hepatocellular carcinoma in four. Five patients had vascular invasion. RESULTS After a mean posttransplant follow-up of 28 months, six patients (60%) were alive without tumor recurrence, three (30%) had died from tumor recurrence and one due to P. carinii pneumonia. Disease-free survival among patients with stage III was 50% and 80% for stage IVA. Three patients with vascular invasion died of tumor recurrence, and the other two are alive and free of disease. Disease-free survival rates were 83% in patients with well-differentiated hepatocellular carcinoma and 25% in those with moderately differentiated hepatocellular carcinoma. Tolerance of chemotherapy was good with two withdrawals due to nephrotoxicity and myelotoxicity and one death from pneumonia. CONCLUSION The use of adriamycin in patients undergoing liver transplant due to advanced hepatocellular carcinoma may be useful to prevent tumor recurrence; it is well tolerated. The presence of vascular tumor invasion and a lower grade of histologic differentiation were associated with a poor prognosis.
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Vargas-Garcia MC, Lopez MJ, Elorrieta MA, Suarez F, Moreno J. Properties of polysaccharide produced by Azotobacter vinelandii cultured on 4-hydroxybenzoic acid. J Appl Microbiol 2003; 94:388-95. [PMID: 12588547 DOI: 10.1046/j.1365-2672.2003.01842.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Characterization of the exopolysaccharide produced by Azotobacter vinelandii grown on 4-hydroxybenzoic acid (EPS I), and the comparison between this exopolysaccharide and commercial alginate, constituted the main objective of this work. METHODS AND RESULTS Total carbohydrates, uronic acids, acetyl and pyruvyl groups and proteins were determined by colorimetric methods and composition was confirmed by Nuclear Magnetic Resonance studies. Rheological properties were analysed under different physical and chemical conditions. Results showed differences between EPS I and commercial alginate, in relation to both composition and viscosity. Higher amount of guluronnosyl residues were found in EPS I, whereas commercial alginate contained the same proportion of mannuronosyl and guluronnosyl residues. In accordance with this result, EPS I gave rise to solutions of higher viscosity than commercial alginate, although solutions of this polysaccharide showed greater stability when conditions were altered. CONCLUSIONS The exopolysaccharide produced by A. vinelandii grown on 4-hydroxybenzoic acid showed a different composition in comparison with commercial alginate, which leads to higher viscosity values for the aqueous solutions of EPS I. SIGNIFICANCE AND IMPACT OF STUDY This work describes for the first time the characteristics of an exopolysaccharide produced by A. vinelandii from 4-hydroxybenzoic acid, a substrate rarely used as sole carbon source.
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Molmenti EP, Nagata DE, Roden JS, Squires RH, Molmenti H, Fasola CG, Winick N, Tomlinson G, Lopez MJ, D'Amico L, Dyer HL, Savino AC, Sanchez EQ, Levy MF, Goldstein RM, Andersen JA, Klintmalm GB. Post-transplant lymphoproliferative syndrome in the pediatric liver transplant population. Am J Transplant 2001; 1:356-9. [PMID: 12099380 DOI: 10.1034/j.1600-6143.2001.10411.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Post-transplant lymphoproliferative disease remains a complication with a high morbidity and mortality. The present study examined 291 pediatric liver transplants performed in 263 children from October 1984 to December 1999. Post-transplant lymphoproliferative disease has an overall incidence of 12%. Tacrolimus and cyclosporine had a similar incidence of post-transplant lymphoproliferative disease. Fifty-six per cent of patients who developed post-transplant lymphoproliferative disease were Epstein-Barr virus negative at the time of transplantation. Mean time of conversion to Epstein-Barr virus positivity was 1.1 years after liver transplantation. Ten per cent of those who developed post-transplant lymphoproliferative disease never had Epstein-Barr virus detected. Mean time from Epstein-Barr virus positivity to detection of post-transplant lymphoproliferative disease was 2.68 years, and 3.13 years from liver transplantation (OLTx) to post-transplant lymphoproliferative disease. There was a 35% incidence of mortality. Deaths occurred a mean of 0.76 years after diagnosis of post-transplant lymphoproliferative disease. Most cases of post-transplant lymphoproliferative disease had extranodal location. There was one recurrence in 10% of patients, and two in 3%. All recurrent cases were seen in recipients who became Epstein-Barr virus positive after transplantation. There has been a decrease in the incidence of post-transplant lymphoproliferative disease from 15% to 9% to 4%. Post-transplant lymphoproliferative disease should be diagnosed promptly and treated aggressively. The best treatment, however, seems to be prevention, starting in the immediate postoperative period. Survivors should be monitored for both recurrence of post-transplant lymphoproliferative disease and acute cellular rejection.
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Lopez MJ, DeTemple LA, Lu Y, Markel MD. The effects of monopolar radiofrequency energy on intact and lacerated ovine menisci. Arthroscopy 2001; 17:613-9. [PMID: 11447549 DOI: 10.1053/jars.2001.24855] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the effect of monopolar radiofrequency energy (RFE) on intact and lacerated meniscal tissue. TYPE OF STUDY In vitro study. Application of monopolar RFE to soft tissue for treatment of various musculoskeletal disorders has been explored recently, although its effect on meniscal tissue has not been critically evaluated. Monopolar RFE denatures and fuses collagen. Given that menisci are composed primarily of type I collagen, we proposed that RFE could be applied to meniscal tears with minimal effect on healthy meniscal tissue. METHODS Adult sheep menisci were given 1 of 2 treatments (65 degrees C, 15 W or 75 degrees C, 10 W) with a monopolar RFE generator. Specimens were processed for scanning electron microscopy (SEM), transmission electron microscopy (TEM), light microscopy, and confocal laser microscopy. A computer-based area-determination program was used to calculate the treated area in confocal laser images. RESULTS SEM changes in treated tissue consisted of surface smoothing with collagen fibril fusion. Changes apparent with TEM included tissue homogenization with loss of cross-striations and fusion of collagen fibrils. Histologic changes consisted of fusion and loss of collagen fiber individualization, pyknosis of fibrochondrocyte nuclei, and loss of lacunae surrounding fibrochondrocytes. There were clear demarcations between treated and untreated tissue with both treatments. There were no discernible differences between treatment groups on SEM, TEM, or histologic examination. Confocal laser microscopic evaluations showed distinct treatment areas. The mean area affected ranged from 6.6% for 65 degrees C, 15 W to 8.8% for 75 degrees C, 10 W. CONCLUSIONS The primary effects of monopolar RFE treatment of menisci in this study were consistent with thermal tissue damage limited to the treatment area. Monopolar RFE treatment of a meniscal laceration may stabilize the tear by fusing collagenous tissue in the surrounding area and prevent propagation along tissue lines. This study presents preliminary in vitro results. Further studies are necessary before clinical applications can be recommended.
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Lopez MJ, Wilson DG, Trostle SS, Markel MD. An in vitro biomechanical comparison of two interlocking-nail systems for fixation of ostectomized equine third metacarpal bones. Vet Surg 2001; 30:246-52. [PMID: 11340556 DOI: 10.1053/jvet.2001.23346] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the mechanical properties of 2 interlocking-nail systems for fixation of ostectomized equine third metacarpi (MC3): (1) a standard interlocking nail with 2 parallel screws proximal and distal to a 1-cm ostectomy; and (2) a modified interlocking nail with 2 screws proximal and distal to a 1-cm ostectomy with the screws offset by 30 degrees. ANIMAL OR SAMPLE POPULATION Twelve pairs of adult equine forelimbs intact from the midradius distally. METHODS Twelve pairs of equine MC3 were divided into 2 test groups (6 pairs each): torsion and caudocranial 4-point bending. Standard interlocking nails (6-hole, 13-mm diameter, 230-mm length) were placed in 1 randomly selected bone from each pair. Modified interlocking nails (6-hole, 13-mm, 230-mm length, screw holes offset by 30 degrees) were placed in the contralateral bone from each pair. All bones had 1-cm mid-diaphyseal ostectomies. Six construct pairs were tested in caudocranial 4-point bending to determine stiffness and failure properties. The remaining 6 construct pairs were tested in torsion to determine torsional stiffness and yield load. Mean values for each fixation method were compared using a paired t test within each group. Significance was set at P <.05. RESULTS Mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite, respectively, in 4-point bending were: composite rigidity, 3,119 +/- 334.5 Nm/rad (newton. meter/radian) and 3,185 +/- 401.2 Nm/rad; yield bending moment, 205.0 +/- 18.46 Nm and 186.7 +/- 6.17 Nm; and failure bending moment, 366.4 +/- 21.82 Nm and 378.1 +/- 20.41 Nm. There were no significant differences in the biomechanical values for bending between the 2 fixation methods. In torsion, mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite were: composite rigidity, 135.5 +/- 7.128 Nm/rad and 112.5 +/- 7.432 Nm/rad; gap stiffness, 207.6 +/- 10.57 Nm/rad and 181.7 +/- 12.89 Nm/rad; and yield load, 123.3 +/- 2.563 Nm and 107.5 +/- 8.353 Nm, respectively. Composite rigidity and gap stiffness for standard interlocking-nail fixations were significantly higher than the modified interlocking-nail fixation technique in torsion. Yield load had a tendency to be higher for the standard interlocking-nail fixation (P =.15). CONCLUSIONS No significant differences in biomechanical properties were identified between a standard interlocking nail and one with the screw holes offset by 30 degrees in caudocranial 4-point bending. The standard interlocking nail was superior to the modified interlocking nail in torsional gap stiffness and composite rigidity. The torsional yield load also tended to be higher for the standard interlocking nail. CLINICAL RELEVANCE The standard interlocking nail with parallel screw holes is superior to a modified interlocking nail with the screw holes offset by 30 degrees in ostectomized equine MC3 bones in vitro when tested in torsion.
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Radcliffe RM, Lopez MJ, Turner TA, Watkins JP, Radcliffe CH, Markel MD. An in vitro biomechanical comparison of interlocking nail constructs and double plating for fixation of diaphyseal femur fractures in immature horses. Vet Surg 2001; 30:179-90. [PMID: 11230773 DOI: 10.1053/jvet.2001.21396] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the biomechanical properties of intact immature horse femurs and 3 stabilization methods in ostectomized femurs. ANIMAL OR SAMPLE POPULATION Eighteen pairs of femurs from immature horses aged 1 to 15 months, and weighing 68 to 236 kg. METHODS Thirty-four immature horse femurs were randomly assigned to 1 of 5 test groups: 1) interlocking intramedullary nail (IIN) (n = 6); 2) IIN with a cranial dynamic compression plate (I/DCP) (n = 6); 3) 2 dynamic compression plates (2DCP) (n = 8); 4) intact femurs tested to failure in lateromedial (LM) bending (n = 6); and 5) intact femurs tested to failure in caudocranial (CaCr) bending (n = 8). Mid-diaphyseal ostectomies (1 cm) were performed in all fixation constructs. Biomechanical testing consisted of 4 nondestructive tests: CaCr bending, LM bending, compression, and torsion, followed by bending to failure. All groups were tested to failure in LM bending with the exception of 1 group of intact femurs tested to failure in CaCr bending. Stiffness and failure properties were compared among groups. RESULTS The 2DCP-femur construct had greater structural stiffness in nondestructive bending than the IIN-femur construct in either LM or CaCr bending, and the I/DCP-femur construct in LM bending. Only the I/DCP and 2DCP fixations were similar to intact bone in nondestructive-bending tests. In addition, the 2DCP-femur construct had greater structural and gap torsional stiffness than the I/DCP-femur construct, and greater gap torsional stiffness than the IIN-femur construct. However, all of the fixation methods tested, including the 2DCP-femur construct, had lower structural stiffness in torsional loading compared with intact bone. No significant differences in structural stiffness were found between intact bones and femur constructs tested nondestructively in compression. In resistance to LM bending to failure, the 2DCP-femur construct was superior to the IIN-femur construct, yet similar to the I/DCP-femur construct. Also, evaluation of yield and failure loads revealed no significant differences between intact bone and any of the femur constructs tested to failure in LM bending. CONCLUSIONS In general, the 2DCP-femur construct provided superior strength and stiffness compared with the IIN and I/DCP-femur constructs under bending and torsion. CLINICAL RELEVANCE Double plating of diaphyseal comminuted femoral fractures in immature horses may be the best method of repair, because in general, it provides the greatest strength and stiffness in bending and torsion.
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Molmenti EP, Nagata D, Roden J, Squires R, Molmenti H, Casey D, Fasola C, Lopez MJ, Winick N, McPhail W, D'Amico L, Goldstein R, Levy M, Fasola C, Andersen J, Klintmalm G. Incidence, management, and outcome of posttransplant lymphoproliferative disease in pediatric liver transplant recipients. Transplant Proc 2001; 33:1727. [PMID: 11267487 DOI: 10.1016/s0041-1345(00)02824-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Labiche M, Orr NA, Marqués FM, Angélique JC, Axelsson L, Benoit B, Bergmann UC, Borge MJ, Catford WN, Chappell SP, Clarke NM, Costa G, Curtis N, D'Arrigo A, de Góes Brennand E, Dorvaux O, Fazio G, Freer M, Fulton BR, Giardina G, Grévy S, Guillemaud-Mueller D, Hanappe F, Heusch B, Jones KL, Jonson B, Le Brun C, Leenhardt S, Lewitowicz M, Lopez MJ, Markenroth K, Mueller AC, Nilsson T, Ninane A, Nyman G, de Oliveira F, Piqueras I, Riisager K, Saint Laurent MG, Sarazin F, Singer SM, Sorlin O, Stuttgé L. Halo structure of (14)Be. PHYSICAL REVIEW LETTERS 2001; 86:600-603. [PMID: 11177891 DOI: 10.1103/physrevlett.86.600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2000] [Indexed: 05/23/2023]
Abstract
The two-neutron halo nucleus (14)Be has been investigated in a kinematically complete measurement of the fragments ((12)Be and neutrons) produced in dissociation at 35 MeV/nucleon on C and Pb targets. Two-neutron removal cross sections, neutron angular distributions, and invariant mass spectra were measured, and the contributions from electromagnetic dissociation (EMD) were deduced. Comparison with three-body model calculations suggests that the halo wave function contains a large nu(2s(1/2))(2) admixture. The EMD invariant mass spectrum exhibited enhanced strength near threshold consistent with a nonresonant soft-dipole excitation.
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