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Stephenson A, Sykes D, Ward MD. Cu12 and Cd16 coordination cages and their Cu3 and Cd3 subcomponents, and the role of inter-ligand π-stacking in stabilising cage complexes. Dalton Trans 2013; 42:6756-67. [DOI: 10.1039/c3dt50161b] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Whitehead M, Turega S, Stephenson A, Hunter CA, Ward MD. Quantification of solvent effects on molecular recognition in polyhedral coordination cage hosts. Chem Sci 2013. [DOI: 10.1039/c3sc50546d] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Stephenson A. Three-axis static alternating field demagnetization of rocks and the identification of natural remanent magnetization, gyroremanent magnetization, and anisotropy. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/92jb01849] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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104
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Creer KM, Stephenson A. Some consequences of aluminum and magnesium impurities in naturally occurring titanomagnetites. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/jb077i020p03698] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Klink J, Mir M, Isariyawongse B, Kibel A, Klein E, Stephenson A. 172 PROSTATE CANCER SPECIFIC MORTALITY AND COMPETING CAUSES OF MORTALITY AMONG ELDERLY MEN AFTER LOCAL THERAPY FOR PROSTATE CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Isariyawongse B, Nguyen C, Gao T, Gilligan T, Klein E, Stephenson A. 667 TECHNICAL FACTORS CAN IMPACT NODE COUNTS FROM RETROPERITONEAL LYMPH NODE DISSECTION FOR TESTIS CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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107
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El-Shafei A, Moussa A, Miocinovic R, Li J, Fareed K, Berglund R, David L, Stephenson A, Jones J. 1455 EARLY REPEAT BIOPSY AS A PART OF AN ACTIVE SURVEILLANCE PROTOCOL. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tangpricha V, Kelly A, Stephenson A, Maguiness K, Enders J, Robinson KA, Marshall BC, Borowitz D. An update on the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis: evidence-based recommendations from the Cystic Fibrosis Foundation. J Clin Endocrinol Metab 2012; 97:1082-93. [PMID: 22399505 DOI: 10.1210/jc.2011-3050] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective was to develop evidence-based clinical care guidelines for the screening, diagnosis, management, and treatment of vitamin D deficiency in individuals with cystic fibrosis (CF). PARTICIPANTS The guidelines committee was comprised of physicians, registered dietitians, a pharmacist, a nurse, a parent of an individual with CF, and a health scientist, all with experience in CF. PROCESS Committee members developed questions specific to vitamin D health in individuals with CF. Systematic reviews were completed for each question. The committee reviewed and graded the available evidence and developed evidence-based recommendations and consensus recommendations when insufficient evidence was available. Each consensus recommendation was voted upon by an anonymous process. CONCLUSIONS Vitamin D deficiency is common in CF. Given the limited evidence specific to CF, the committee provided consensus recommendations for most of the recommendations. The committee recommends yearly screening for vitamin D status, preferably at the end of winter, using the serum 25-hydroxyvitamin D measurement, with a minimal 25-hydroxyvitamin D concentration of 30 ng/ml (75 nmol/liter) considered vitamin D sufficient in individuals with CF. Recommendations for age-specific vitamin D intake for all individuals with CF, form of vitamin D, and a stepwise approach to increase vitamin D intake when optimal vitamin D status is not achieved are delineated.
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Isariyawongse B, Stephenson A, Kattan M, Gao T, Haslag-Minoff J, Nepple K, Piccirillo J, Ciezki J, Klein E, Kibel A. 161 PREDICTING ALL-CAUSE AND PROSTATE CANCER SPECIFIC MORTALITY FOLLOWING DEFINITIVE THERAPY FOR LOCALIZED PROSTATE CANCER. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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110
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Chang P, Regan M, Stephenson A, Ferrer M, Wei J, Hembroff L, Suárez JF, Michalski J, Saigal C, Litwin M, Hamstra D, Kaplan I, Aronovitz J, Ciezki J, Klein E, Kibel A, Pisters L, Kuban D, Wood D, Sandler H, Dunn R, Sanda M. 694 ALLEVIATION VERSUS INDUCTION OF URINARY OBSTRUCTION OR INCONTINENCE BY PROSTATE CANCER TREATMENT THE PIVOTAL ROLE OF PRETREATMENT URINARY SYMPTOMS. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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El-Shafei A, Abd El Latif A, Hatem A, Li J, luay S, David L, Stephenson A, Jones J. 1816 RECURRENCE DESCRIPTIVE PATTERN ON POST CRYOABLATION PROSTATE BIOPSY. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rini BI, Garcia J, Elson P, Wood L, Shah S, Stephenson A, Salem M, Gong M, Fergany A, Rabets J, Kaouk J, Krishnamurthi V, Klein E, Dreicer R, Campbell S. The effect of sunitinib on primary renal cell carcinoma and facilitation of subsequent surgery. J Urol 2012; 187:1548-54. [PMID: 22425095 DOI: 10.1016/j.juro.2011.12.075] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE We investigated the effect of sunitinib on locally advanced primary renal carcinoma tumors and the ability to facilitate subsequent surgery. MATERIALS AND METHODS Patients with an unresectable primary renal tumor, with or without distant metastases, received 50 mg sunitinib with continuous daily dosing in a phase II trial. Computerized tomography was performed every 12 weeks to determine surgical resectability. The primary end point of the trial was the percentage of patients with renal cell carcinoma and initially unresectable primary tumors who could undergo nephrectomy after sunitinib therapy. RESULTS Of 30 patients enrolled in the study (19 with distant metastases) 28 (35 total renal tumors) were evaluable for response. The median change in primary renal cell carcinoma tumors was a 22% decrease, corresponding to a median absolute reduction of 1.2 cm. The median reduction in primary renal cell carcinoma tumors of clear cell histology was -28% (absolute reduction 1.7 cm) compared to a 1.4% increase (0.1 cm absolute increase) in nonclear cell tumors. Of these patients 13 (45%) met the primary end point of being able to undergo nephrectomy after preoperative sunitinib. All patients had viable renal cell carcinoma in the surgical specimen and surgical morbidity was consistent with prior experience of nephrectomy in patients without preoperative therapy. CONCLUSIONS Sunitinib as initial therapy in patients with locally advanced features of the primary tumor was feasible and resulted in an antitumor effect that enabled subsequent surgery in a subset of patients. Further prospective study is required to refine the most suitable application of this approach.
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Matteo M, Greco P, Levi Setti P, Stracci F, De Rosario F, Massenzio F, Albani E, Falagario T, Liso A, Chavarro JE, Colaci DS, Afeiche M, Gaskins AJ, Wright D, Toth TL, Hauser R, Schram C, Tullis E, Stephenson A, Hannam T, Kesmodel US, Cristensen MW, Degn B, Ingerslev HJ. SESSION 53: CONFOUNDING FACTORS IN ART. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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114
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Stephenson A, Ward MD. A triple helix of double helicates: three hierarchical levels of self-assembly in a single structure. Chem Commun (Camb) 2012; 48:3605-7. [DOI: 10.1039/c2cc30197k] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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115
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Stephenson A, Ward MD. Coordination chemistry of Ag(i) with bridging ligands based on pyrazolyl–pyridine termini: polymers, helicates and a bow-tie. RSC Adv 2012. [DOI: 10.1039/c2ra21757k] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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116
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Shelton AH, Stephenson A, Ward MD, Kassim MB. 1-Benzoyl-3-(pyridin-2-yl)-1 H-pyrazole. Acta Crystallogr Sect E Struct Rep Online 2011; 67:o2445. [PMID: 22059016 PMCID: PMC3200672 DOI: 10.1107/s1600536811033368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 08/16/2011] [Indexed: 11/26/2022]
Abstract
In the title compound, C15H11N3O, the dihedral angle betwen the heterocyclic rings is 9.23 (5)° and the dihedral angle between the benzoyl and pyrazole rings is 58.64 (5)°. In the crystal, inversion dimers linked by pairs of C—H⋯O hydrogen bonds generate R22(10) loops. The dimers stack into a column running parallel to the b-axis direction.
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Krishnamurthi V, Subramanian V, Berglund R, Navia J, Nowicki E, Miocinovic R, Stephenson A, Goldfarb D, Klein E, Novick A. MP-06.11 Contemporary Vascular Bypass Approach for Treatment of Retroperitoneal Tumors with Inferior Vena Cava and Atrial Extension: A 20-Year Single Institution Experience. Urology 2011. [DOI: 10.1016/j.urology.2011.07.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Lee B, Stephenson A, Ciezki J, Klein E, Reddy C, Yu C, Kattan M, Kibel A. 476 COMPARISON OF OBSERVED PROSTATE CANCER-SPECIFIC MORTALITY (PCSM) BY TREATMENT-SPECIFIC, NOMOGRAM-PREDICTED RISKS OF BIOCHEMICAL RECURRENCE (BCR) IN MEN WITH LOCALIZED PROSTATE CANCER TREATED BY RADICAL PROSTATECTOMY (RP), EXTERNAL BEAM RADIOTHERAPY (EBRT), OR BRACHYTHERAPY (PI). J Urol 2011. [DOI: 10.1016/j.juro.2011.02.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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119
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Feifer A, Taylor J, Shouery M, Savage C, Steinberg G, Stadler WM, DeCastro J, Lerner S, Godoy G, Lotan Y, Feldman AS, Psutka S, Kassouf W, Yafi F, Zlotta A, Black P, Schoenberg M, Grubb R, O'Donnell M, Rosevear H, Stephenson A, Patel A, Lee C, Weizer A, Bajorin D, Milowsky M, Dalbagni G, Basch E, Bochner B. 485 MULTI-INSTITUTIONAL QUALITY OF CARE INITIATIVE FOR NON-METASTATIC MUSCLE-INVASIVE TRANSITIONAL CELL CARCINOMA OF THE BLADDER: PHASE 1. J Urol 2011. [DOI: 10.1016/j.juro.2011.02.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Li W, Sun L, Corey M, Zou F, Lee S, Cojocaru AL, Taylor C, Blackman SM, Stephenson A, Sandford AJ, Dorfman R, Drumm ML, Cutting GR, Knowles MR, Durie P, Wright FA, Strug LJ. Understanding the population structure of North American patients with cystic fibrosis. Clin Genet 2011; 79:136-46. [PMID: 20681990 DOI: 10.1111/j.1399-0004.2010.01502.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
It is generally presumed that the cystic fibrosis (CF) population is relatively homogeneous, and predominantly of European origin. The complex ethnic make-up observed in the CF patients collected by the North American CF Modifier Gene Consortium has brought this assumption into question, and suggested the potential for population substructure in the three CF study samples collected from North America. It is well appreciated that population substructure can result in spurious genetic associations. To understand the ethnic composition of the North American CF population, and to assess the need for population structure adjustment in genetic association studies with North American CF patients, genome-wide single-nucleotide polymorphisms on 3076 unrelated North American CF patients were used to perform population structure analyses. We compared self-reported ethnicity to genotype-inferred ancestry, and also examined whether geographic distribution and cystic fibrosis transmembrane regulator (CFTR) mutation type could explain the population structure observed. Although largely Caucasian, our analyses identified a considerable number of CF patients with admixed African-Caucasian, Mexican-Caucasian and Indian-Caucasian ancestries. Population substructure was present and comparable across the three studies of the consortium. Neither geographic distribution nor CFTR mutation type explained the population structure. Given the ethnic diversity of the North American CF population, it is essential to carefully detect, estimate and adjust for population substructure to guard against potential spurious findings in CF genetic association studies. Other Mendelian diseases that are presumed to predominantly affect single ethnic groups may also benefit from careful analysis of population structure.
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Stephenson A, Ward MD. An octanuclear coordination cage with a ‘cuneane’ core—a topological isomer of a cubic cage. Dalton Trans 2011; 40:7824-6. [DOI: 10.1039/c0dt01767a] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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122
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Hall BR, Manck LE, Tidmarsh IS, Stephenson A, Taylor BF, Blaikie EJ, Griend DAV, Ward MD. Structures, host–guest chemistry and mechanism of stepwise self-assembly of M4L6 tetrahedral cage complexes. Dalton Trans 2011; 40:12132-45. [DOI: 10.1039/c1dt10781j] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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123
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Stephenson A, Ward MD. Molecular squares, cubes and chains from self-assembly of bis-bidentate bridging ligands with transition metal dications. Dalton Trans 2011; 40:10360-9. [DOI: 10.1039/c1dt10263j] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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124
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Stephenson A, Argent SP, Riis-Johannessen T, Tidmarsh IS, Ward MD. Structures and Dynamic Behavior of Large Polyhedral Coordination Cages: An Unusual Cage-to-Cage Interconversion. J Am Chem Soc 2010; 133:858-70. [DOI: 10.1021/ja107403p] [Citation(s) in RCA: 160] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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125
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Lerner SP, Grossman HB, Messing EM, Kibel AS, Stephenson A, Gee JR, O'Donnell MA, Reid RD, Kamat AM, Parnes HL, House MG. BCAN Think Tank session 3: Prevention of bladder cancer. Urol Oncol 2010; 28:338-42. [PMID: 20439034 DOI: 10.1016/j.urolonc.2009.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 06/23/2009] [Accepted: 06/24/2009] [Indexed: 11/17/2022]
Abstract
The Bladder Cancer Think Tank III brought together a multidisciplinary group of clinician scientists, patient advocates, representatives from the National Cancer Institute, and Industry leaders to discuss the current state of the field in urothelial cancer and to develop strategies to move forward. This paper summarizes the session devoted to prevention. Experts sought to define primary, secondary, and tertiary prevention and discussed clinical trials performed to date testing retinoids, difluoromethylornithine, celecoxib, and other oral agents in a tertiary prevention setting following transurethral resection with or without intravesical therapy. Urologists practice tertiary prevention in the form of intravesical therapy, and strategies were discussed to identify biomarkers, including urinary cytokines and pathway single nucleotide polymorphism analysis associated with response to treatment. Optimizing delivery of intravesical chemotherapy to the target tissue with simple pharmacologic manipulations or packaging drugs in nanoparticles may improve treatment outcome. Defining a premalignant lesion should be a focus of future research as a strategy for early detection and secondary prevention. Cigarette smoking is the most prevalent risk factor for urothelial cancer, and emphasis was placed on smoking cessation as a powerful tool to reduce the burden of urothelial cancer, and the central role physicians must play in educating patients and providing resources. There is a strong need for research to develop markers of disease initiation and progression. These markers, combined with histories of environmental exposure to bladder carcinogens, may provide a tool to identify patients who will benefit from primary prevention.
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Ghoneim I, Gong M, Hansel D, Lane B, Fergany A, Stephenson A. 1644 LYMPH NODE INVOLVEMENT OF BLADDER CANCER OUTSIDE THE BOUNDARIES OF A STANDARD TEMPLATE DISSECTION: RESULTS OF A PROSPECTIVE MAPPING STUDY. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grubb RL, Black A, Shaul S, Mabie J, Riley T, Kattan M, Izmirlian G, Vickers AJ, Bochner BH, Kibel AS, Prorok PC, Berg CD, Stephenson A, Andriole GL. 1159 PREDICTING THE RISK OF BLADDER CANCER AND HIGH-GRADE BLADDER CANCER USING PATIENT CLINICAL AND DEMOGRAPHIC INFORMATION FROM PLCO PARTICIPANTS. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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128
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Wood L, Garcia JA, Elson P, Salas RN, Lane BR, Klein E, Stephenson A, Dreicer R, Campbell SC, Rini BI. Sunitinib in patients (pts) with unresectable primary renal cell carcinoma (RCC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5096] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5096 Background: Sunitinib inhibits VEGF and related receptors, with high tumor shrinkage rates in metastatic (met) RCC. Shrinkage of primary tumors has been observed, although prospective investigation is lacking. The ability of sunitinib to convert primary RCC tumors from unresectable to resectable is of high clinical interest. Methods: Pts with histologically-confirmed RCC with an unresectable primary tumor with or without met disease were enrolled on a single-arm phase II trial. Primary tumors were unresectable due to ≥ 1 of the following: large tumor size, bulky lymphadenopathy, encasement of renal vessels, IVC thrombosis or proximity to vital structures. Pts received 50 mg sunitinib continuous dosing in repeated 6-week cycles. Staging by CT scans or MRI was done at baseline and every 2 cycles. A Simon 2-stage design was employed to test the alternative hypothesis of a conversion to resectability rate of 20% versus the null hypothesis of 5%; β = 0.8, α = 0.05 (n = 31). Results: 18 pts have been enrolled; 1 excluded due to a non-RCC diagnosis. Pts were unresectable due to bulky lymphadenopathy (6), IVC thrombosis (4), proximity to vital structures (4) or tumor size (3), although most pts had multiple factors. Median age among 14 evaluable pts was 61 years (range, 37–80), 59% male, 76% ECOG PS 0; 79% had distant met disease. The 14 evaluable pts have received a median of 3 cycles of therapy (range, 1–10+). Three pts (21%) have undergone primary tumor resection; viable RCC was identified in all specimens with no unexpected surgical morbidity. Nine pts (53%) had primary tumor reduction (median 19%; range, -64% to -1%). Overall, median best % change in tumor burden was 4.9% reduction for primary tumors (range, -43.1% to +8.5%) and 10.7% reduction for met sites (range, -89.5% to +28.6%). Median PFS is 4.9 months. Eleven pts (79%) discontinued therapy; 8 for PD, 1 for adverse events and 2 following surgery which removed all visible disease. Eight pts (57%) experienced grade 3 toxicity including thrombocytopenia, fatigue, hypertension, anemia, hemoptysis, and hand-foot syndrome; 1 pt had grade 4 neutropenia. Conclusions: Sunitinib has activity in unresectable primary RCC tumors, permitting resection in some pts. Continued prospective investigation is required to optimize patient selection and timing of surgery. [Table: see text]
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Ghoneim I, Stephenson A, Gong M, Campbell S, Fergany A. Micropapillary urothelial carcinoma of the urinary bladder: Early surgery or neoadjuvant chemotherapy? J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16007 Background: Micropapillary bladder carcinoma is a rare variant of urothelial carcinoma (UC) of the urinary bladder. As a particularly aggressive variant, patients are often urged to undergo up-front radical cystectomy. Though data is scarce on the treatment outcomes of patients with this entity, we present the case for neoadjuvant chemotherapy as opposed to early cystectomy in the setting of clinically localized micropapillary UC. Methods: A review of records of all patients evaluated at our institution for UC was conducted to identify micropapillary UC of the bladder over the period from 2000–2007. A total of 24 cases were found, and were evaluated for preoperative pathology and clinical stage, treatment course, pathological stage and cancer specific survival. Results: Mean patient age was 67.9 years with 19 males and 5 females. Twenty-one (87.5%) patients had clinically organ confined micropapillary UC at the time of diagnosis, three had minimally enlarged lymph nodes on pelvic CAT scans. Half of our patients had BCG refractory high grade non-muscle invasive UC. Twenty-two patients (91.67%) were offered radical cystectomy as first line management. Extended lymph node dissection was performed in eleven patients (45.83%). Final pathologic examination diagnosed metastatic lymph node involvement in 20 patients (83.33%), with 4 patients (20%) having positive LN outside the standard (pelvic) template of dissection. A stage upgrade was noticed in 95.23% of cases. Median cancer specific survival was 13 months. Survival at one year was 44% and 50% at 2years, with only one patient alive at 5 years. Conclusions: Our results suggest that clinically localized micropapillary UC is often metastatic to LN at the time of presentation. This setting of frequent systemic disease should encourage standard neoadjuvant chemotherapy rather than early surgical management for these patients. Extended LN dissection is warranted in these cases due to the high incidence of nodal involvement outside the standard template. No significant financial relationships to disclose.
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Stephenson A. V. On the forcing of oscillations by disturbances of different frequencies. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14786440709463663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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133
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Ciezki JP, Reddy CA, Angermeier K, Ulchaker J, Stephenson A, Campbell S, Altman A, Chehade N, Klein EA. PSA kinetics >5 years after treatment with brachytherapy or external beam radiotherapy: Defining the long-term PSA profile for biochemical control. Brachytherapy 2009. [DOI: 10.1016/j.brachy.2009.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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134
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Eastham J, Bianco F, Cronin A, Stephenson A, Scardino P. 195. Outcomes After Salvage Radical Prostatectomy. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.235] [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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135
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Stephenson A. On the telepathophone. New Sci 2008. [DOI: 10.1016/s0262-4079(08)60844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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136
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Klein EA, Kattan M, Stephenson A, Vickers A. How Many Lymphadenectomies Does It Take to Cure One Patient? Eur Urol 2008; 53:13-5; discussion 18-20. [PMID: 17900798 DOI: 10.1016/j.eururo.2007.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 09/10/2007] [Indexed: 11/24/2022]
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137
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Horwitz E, Hanlon A, Pisansky T, Sandler H, Kuban D, Catton C, Michalski J, Stephenson A, Pollack A. The Phoenix Definition of Biochemical Failure Correlates With Clinical Failure for Men Treated With Adjuvant and Salvage Post-Prostatectomy Radiation: Results of the Multi-institutional Pooled Analysis. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.313] [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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138
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Stephenson A. Gyromagnetic remanence and anisotropy in single-domain particles, rocks, and magnetic recording tape. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/01418638108223770] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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139
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Shcönberg A, Stephenson A, Kaltschmitt H, Petersen E, Schulten H. Über die Einwirkung von alkali-metallorganischen Verbindungen auf Disulfide, Diselenide, Schwefelkohlenstoff, Thionylamin-Derivate, und über eine neue Synthese des dimeren Diphenyl-thioketens (2. Mitteil. über metallorganische Verbindungen). ACTA ACUST UNITED AC 2006. [DOI: 10.1002/cber.19330660228] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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140
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Schumacher R, Stephenson A, Gaddy C, Bojko A, Khoo B, Moore C. Eye tracking to improve electronic communications with oncology practitioners. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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141
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Ehrhardt GCMA, Stephenson A, Reis PM. Segregation mechanisms in a numerical model of a binary granular mixture. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2005; 71:041301. [PMID: 15903662 DOI: 10.1103/physreve.71.041301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2004] [Indexed: 05/02/2023]
Abstract
A simple phenomenological numerical model of a binary granular mixture is developed and investigated numerically. We attempt to model a recently reported experimental system where a horizontally vibrated binary monolayer was found to exhibit a transition from a mixed to a segregated state as the filling fraction of the mixture was increased. This numerical model is found to reproduce much of the experimentally observed behavior, most importantly the transition from the mixed to the segregated state. We use the numerical model to investigate granular segregation mechanisms and explain the experimentally observed behavior.
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142
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Wichtel MEG, Fenwick SG, Hunter J, Stephenson A, Martin D, Wichtel JJ. Septicaemia and septic arthritis in a neonatal calf caused by Lactococcus lactis. Vet Rec 2003; 153:22-3. [PMID: 12877215 DOI: 10.1136/vr.153.1.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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143
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Hauptman Z, Stephenson A. A technique for growing ulv$ouml$spinel single crystals from the melt. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0022-3735/1/12/427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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144
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Stephenson A, Sa AD. A simple method for the measurement of the temperature variation of initial magnetic susceptibility between 77 and 1000 K. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0022-3735/3/1/313] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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145
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Wylie A, Robinson R, Stephenson A. Student learning centres in the community: a review of an organisation model. MEDICAL EDUCATION 2001; 35:1078-1079. [PMID: 11715965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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146
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Schuster DP, Kozlowski JK, McCarthy T, Morrow J, Stephenson A. Effect of endotoxin on oleic acid lung injury does not depend on priming. J Appl Physiol (1985) 2001; 91:2047-54. [PMID: 11641343 DOI: 10.1152/jappl.2001.91.5.2047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Recent studies have demonstrated significant synergistic physiological and biochemical effects between low-dose endotoxin (Etx) administration and oleic acid (OA)-induced canine lung injury. To evaluate whether this interaction depends on Etx priming of some key cell population, we compared the effects of giving low-dose Etx both after as well as before inducing lung injury with OA. In addition to hemodynamic and blood-gas measurements, positron emission tomographic imaging was used to measure edema accumulation and intrapulmonary blood flow distribution. Biochemical measurements of the stable metabolites of prostacyclin and thromboxane were obtained as well as measurements of isoprostanes and reactive sulfhydryls as evidence for possible concomitant oxidant production. We found that the physiological and biochemical effects of low-dose Etx developed 30-45 min after its administration, regardless of whether Etx was administered before or after OA. No increase in either isoprostane or reactive sulfhydryl production after Etx and/or OA was detected. These data suggest that the synergistic effect of low-dose Etx and OA-induced lung injury is not due to a priming effect of Etx.
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147
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Mason CF, Stephenson A. Metals in tissues of European otters (Lutra lutra) from Denmark, Great Britain and Ireland. CHEMOSPHERE 2001; 44:351-353. [PMID: 11459138 DOI: 10.1016/s0045-6535(00)00352-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Samples of livers of European otters from Denmark, Great Britain and Ireland were analyzed for manganese, chromium, zinc, copper, nickel and cobalt. Concentrations were generally significantly higher in samples from Great Britain. It was considered that this reflected the catchment geology from where the specimens originated.
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148
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Abstract
Doctors must increasingly be aware of what they should be, as well as what they should know. Professionalism, including a value system that supports the compassionate care of patients, is a means of encapsulating and prioritising these competing responsibilities. Accordingly, in this article, we assume that professionalism is an essential aspect of medical practice that needs to be taught to those entering medicine. We first describe critiques of professionalism and current challenges to it, in practice and in medical education. We then assess the current efforts of curriculum reform to incorporate professionalism and the methods used to teach it. Adopting and assessing such approaches to ensure that they are effective is of central importance in the education of future clinicians.
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149
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Holden BA, Stephenson A, Stretton S, Sankaridurg PR, O'Hare N, Jalbert I, Sweeney DF. Superior epithelial arcuate lesions with soft contact lens wear. Optom Vis Sci 2001; 78:9-12. [PMID: 11233339 DOI: 10.1097/00006324-200101010-00008] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Superior epithelial arcuate lesions (SEALs) are an infrequent and often asymptomatic complication of conventional soft contact lens wear. The characteristic arcuate pattern of the full-thickness corneal epithelial lesion usually occurs in the area covered by the upper eyelid, within 2 to 3 mm of the superior limbus in the 10- and 2-o'clock region. METHODS Literature on SEALs and recent clinical records from clinical trials using two types of prototype high Dk soft contact lenses were reviewed to gain greater insights into the etiology of SEALs. RESULTS AND CONCLUSIONS The reported low incidence of SEALs is partly because SEALs are not usually symptomatic. The etiology of SEALs is multifactorial. Our current hypothesis is that SEALs are produced by mechanical chaffing at the peripheral cornea. This chaffing occurs as a result of inward pressure of the upper lid, in an area where the peripheral corneal topography and lens design, rigidity, and surface characteristics combine to create excessive "frictional" pressure and abrasive shear force on the epithelial surface. Patient characteristics such as gender, age, and specific corneal and lid topographies also appear to influence the occurrence of SEALs. Prototype silicone hydrogel lenses are made from higher modulus materials with surfaces that seem to differ subtly in wettability in some patients. The prevalence of SEALs may well increase with the first generations of these lenses.
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150
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Shield JP, Wadsworth EJ, MacDonald A, Stephenson A, Tyfield L, Holton JB, Marlow N. The relationship of genotype to cognitive outcome in galactosaemia. Arch Dis Child 2000; 83:248-50. [PMID: 10952646 PMCID: PMC1718484 DOI: 10.1136/adc.83.3.248] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate the cognitive outcome of a cohort of children with galactosaemia in relation to genotype. METHODS The cohort was drawn from children notified to the British Paediatric Surveillance Unit galactosaemia study which ran from 1988 to 1990. Cognitive outcome was assessed using the Wechsler Intelligence Scale for Children or the Wechsler Preschool and Primary Scale of Intelligence. Parents completed a questionnaire detailing educational status, and the attending paediatrician returned a questionnaire regarding age at diagnosis and biochemical outcome over the previous two years. RESULTS A total of 45 children were genotyped: 30 were homoallelic for the Q188R mutation, the remainder being heteroallelic for Q188R with K285N (n = 4), L195P (n = 4), or other mutations (n = 7). Psychometric evaluation was available in 34 cases: mean full scale IQ was 79, verbal quotient 79, and performance quotient 82. Genotype was not related to galactose-1-phosphate (Gal-1-P) concentrations. However, children homoallelic for the Q188R mutation had significantly lower IQ scores than those who were heteroallelic (73. 6 v 94.8). This difference was independent of social and demographic influences and Gal-1-P concentrations over the previous two years. CONCLUSIONS In children with galactosaemia, cognitive outcome appears to relate to genotype rather than metabolic control, as reflected by Gal-1-P concentrations. The value of measuring Gal-1-P concentrations routinely once successfully established on a galactosaemia diet is questionable as concentrations do not appear to affect outcome. In the UK population, homozygosity for the Q188R mutation is invariably associated with a poor outcome, and there is evidence that variability in neurocognitive outcome is at least part dependent on allelic heterogeneity.
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