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Barber J, Vial P. SU-F-T-296: Modulated Therapy Down Under: A Survey of IMRT & VMAT Physics Practice in Australia and New Zealand. Med Phys 2016. [DOI: 10.1118/1.4956481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tanguay JS, Catlow C, Smith C, Barber J, Staffurth J, Kumar S, Palaniappan N, Button M, Mason MD. High Risk of Neutropenia for Hormone-naive Prostate Cancer Patients Receiving STAMPEDE-style Upfront Docetaxel Chemotherapy in Usual Clinical Practice. Clin Oncol (R Coll Radiol) 2016; 28:611. [PMID: 27131755 DOI: 10.1016/j.clon.2016.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 03/11/2016] [Accepted: 03/31/2016] [Indexed: 10/21/2022]
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Elmorsi Y, Barber J, Rostami-Hodjegan A. Ontogeny of Hepatic Drug Transporters and Relevance to Drugs Used in Pediatrics. Drug Metab Dispos 2015; 44:992-8. [DOI: 10.1124/dmd.115.067801] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/23/2015] [Indexed: 12/13/2022] Open
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Winkler EA, Yue JK, McAllister TW, Temkin NR, Oh SS, Burchard EG, Hu D, Ferguson AR, Lingsma HF, Burke JF, Sorani MD, Rosand J, Yuh EL, Barber J, Tarapore PE, Gardner RC, Sharma S, Satris GG, Eng C, Puccio AM, Wang KKW, Mukherjee P, Valadka AB, Okonkwo DO, Diaz-Arrastia R, Manley GT. COMT Val 158 Met polymorphism is associated with nonverbal cognition following mild traumatic brain injury. Neurogenetics 2015; 17:31-41. [PMID: 26576546 DOI: 10.1007/s10048-015-0467-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 10/22/2015] [Indexed: 11/28/2022]
Abstract
Mild traumatic brain injury (mTBI) results in variable clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism in catechol-o-methyltransferase (COMT), an enzyme which degrades catecholamine neurotransmitters, may influence cognitive deficits following moderate and/or severe head trauma. However, this has been disputed, and its role in mTBI has not been studied. Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether the COMT Val (158) Met polymorphism influences outcome on a cognitive battery 6 months following mTBI--Wechsler Adult Intelligence Test Processing Speed Index Composite Score (WAIS-PSI), Trail Making Test (TMT) Trail B minus Trail A time, and California Verbal Learning Test, Second Edition Trial 1-5 Standard Score (CVLT-II). All patients had an emergency department Glasgow Coma Scale (GCS) of 13-15, no acute intracranial pathology on head CT, and no polytrauma as defined by an Abbreviated Injury Scale (AIS) score of ≥3 in any extracranial region. Results in 100 subjects aged 40.9 (SD 15.2) years (COMT Met (158) /Met (158) 29 %, Met (158) /Val (158) 47 %, Val (158) /Val (158) 24 %) show that the COMT Met (158) allele (mean 101.6 ± SE 2.1) associates with higher nonverbal processing speed on the WAIS-PSI when compared to Val (158) /Val (158) homozygotes (93.8 ± SE 3.0) after controlling for demographics and injury severity (mean increase 7.9 points, 95 % CI [1.4 to 14.3], p = 0.017). The COMT Val (158) Met polymorphism did not associate with mental flexibility on the TMT or with verbal learning on the CVLT-II. Hence, COMT Val (158) Met may preferentially modulate nonverbal cognition following uncomplicated mTBI.Registry: ClinicalTrials.gov Identifier NCT01565551.
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Nerva JD, Kim LJ, Barber J, Rockhill JK, Hallam DK, Ghodke BV, Sekhar LN. Outcomes of Multimodality Therapy in Pediatric Patients With Ruptured and Unruptured Brain Arteriovenous Malformations. Neurosurgery 2015; 78:695-707. [DOI: 10.1227/neu.0000000000001076] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Brain arteriovenous malformations (BAVMs) are a frequent cause of pediatric hemorrhagic stroke, which frequently results in significant morbidity and mortality.
OBJECTIVE:
To analyze the results of multimodality treatment for a consecutive series of pediatric patients with ruptured and unruptured BAVMs at a single institution.
METHODS:
Forty patients <18 years of age were retrospectively reviewed. Results were divided by hemorrhage status, ie, ruptured or unruptured, and the intended curative treatment modality, ie, surgical resection or stereotactic radiosurgery.
RESULTS:
Twenty-seven patients (68%) presented with hemorrhage, and 13 patients (32%) presented without hemorrhage. Among ruptured patients, 19 (70%) underwent surgery and 8 (30%) underwent stereotactic radiosurgery. In surviving patients who presented with hemorrhage, 23 of 26 (88%) had a modified Rankin Scale (mRS) score of 0 to 2 at the last follow-up, and 24 of 26 (92%) obtained radiographic cure. For unruptured BAVMs, all 6 patients with grade I to III BAVM obtained radiographic cure and had an mRS score of 0 to 1 at the last follow-up, whereas 1 of 5 patients (20%) with grade IV and V BAVM had BAVM obliteration and a mean mRS score of 1.8 at the last follow-up. In a total of 93.6 years of follow-up from date of presentation to last clinical follow-up, there was 1 hemorrhage (1.1%/y). Of 30 patients with radiographic obliteration, 2 patients had radiographic recurrence (7% incidence).
CONCLUSION:
The majority of ruptured patients had an mRS score of 0 to 2 at the last follow-up and obtained radiographic cure. Unruptured patients with grade I to III BAVMs had superior outcomes compared with those with grade IV and V AVMs. Treatment of grade I to III BAVMs appears safe, and additional study is needed to determine optimal strategies for the management of unruptured grade IV and V BAVMs.
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Fann JR, Bombardier CH, Vannoy S, Dyer J, Ludman E, Dikmen S, Marshall K, Barber J, Temkin N. Telephone and in-person cognitive behavioral therapy for major depression after traumatic brain injury: a randomized controlled trial. J Neurotrauma 2015; 32:45-57. [PMID: 25072405 DOI: 10.1089/neu.2014.3423] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) is prevalent after traumatic brain injury (TBI); however, there is a lack of evidence regarding effective treatment approaches. We conducted a choice-stratified randomized controlled trial in 100 adults with MDD within 10 years of complicated mild to severe TBI to test the effectiveness of brief cognitive behavioral therapy administered over the telephone (CBT-T) (n = 40) or in-person (CBT-IP) (n = 18), compared with usual care (UC) (n = 42). Participants were recruited from clinical and community settings throughout the United States. The main outcomes were change in depression severity on the clinician-rated 17 item Hamilton Depression Rating Scale (HAMD-17) and the patient-reported Symptom Checklist-20 (SCL-20) over 16 weeks. There was no significant difference between the combined CBT and UC groups over 16 weeks on the HAMD-17 (treatment effect = 1.2, 95% CI: -1.5-4.0; p = 0.37) and a nonsignificant trend favoring CBT on the SCL-20 (treatment effect = 0.28, 95% CI: -0.03-0.59; p = 0.074). In follow-up comparisons, the CBT-T group had significantly more improvement on the SCL-20 than the UC group (treatment effect = 0.36, 95% CI: 0.01-0.70; p = 0.043) and completers of eight or more CBT sessions had significantly improved SCL-20 scores compared with the UC group (treatment effect = 0.43, 95% CI: 0.10-0.76; p = 0.011). CBT participants reported significantly more symptom improvement (p = 0.010) and greater satisfaction with depression care (p < 0.001), than did the UC group. In-person and telephone-administered CBT are acceptable and feasible in persons with TBI. Although further research is warranted, telephone CBT holds particular promise for enhancing access and adherence to effective depression treatment.
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Chesnut RM, Temkin N, Dikmen S, Rondina C, Videtta W, Lujan S, Petroni G, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T. Ethical and methodological considerations on conducting clinical research in poor and low-income countries: Viewpoint of the authors of the BEST TRIP ICP randomized trial in Latin America. Surg Neurol Int 2015; 6:116. [PMID: 26229731 PMCID: PMC4513298 DOI: 10.4103/2152-7806.159841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/08/2014] [Indexed: 11/04/2022] Open
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108
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Fraser RT, Johnson EK, Lashley S, Barber J, Chaytor N, Miller JW, Ciechanowski P, Temkin N, Caylor L. PACES in epilepsy: Results of a self-management randomized controlled trial. Epilepsia 2015; 56:1264-74. [DOI: 10.1111/epi.13052] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 11/26/2022]
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109
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Barber J, Sykes J, Holloway L, Thwaites D. SU-E-J-29: Automatic Image Registration Performance of Three IGRT Systems for Prostate Radiotherapy. Med Phys 2015. [DOI: 10.1118/1.4924116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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110
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Ramakrishna R, Hebb A, Barber J, Rostomily R, Silbergeld D. Outcomes in Reoperated Low-Grade Gliomas. Neurosurgery 2015; 77:175-84; discussion 184. [DOI: 10.1227/neu.0000000000000753] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Low-grade gliomas (LGGs) comprise a diverse set of intrinsic brain tumors that correlate strongly with survival. Data on the effect of reoperation are sparse.
OBJECTIVE:
To evaluate the effect of reoperation on patients with LGG.
METHODS:
Fifty-two consecutive patients with reoperated LGGs treated at the University of Washington between 1986 and 2004 were identified and evaluated in a retrospective analysis.
RESULTS:
The average overall survival (OS) for this cohort was 12.95 ± 0.96 years. The overall 10-year survival rate was 57%. The absence of any residual tumor at either the first or second operation was associated with significantly increased OS. Negative prognostic variables for OS included the use of upfront radiation and pathology at recurrence. The average overall progression-free survival to the first recurrence (PFS1) was 6.23 ± 0.51 years. Positive prognostic factors for improved PFS1 included the use of upfront radiation therapy. Variables not associated with differences in PFS1 included the use of upfront chemotherapy, enhancement, pathology, extent of resection, the presence of residual tumor, and Karnofsky Performance Scale score <80. The average overall progression-free survival to the second recurrence was 2.73 ± 0.39 years. Pathology at recurrence was associated with significant differences in progression-free survival to the second recurrence, as was extent of resection at time of first recurrence, and Karnofsky Performance Scale score <80.
CONCLUSION:
This is among the largest studies to assess variables associated with outcome in patients with reoperated LGG. Reresection appears to provide significant benefit, and extent of resection remains the strongest predictor of OS.
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Barber J, Pallister C, Avery A, Lavin J. Investigating motivations for weight loss and benefits of attending a commercial weight management organisation post-natally. Appetite 2015. [DOI: 10.1016/j.appet.2014.12.141] [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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112
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Jensen H, Bertelsen A, Brink C, Barber J, Thwaites D, Hansen C. PO-0862: Flattening filter free beam used for normal fractionated treatments. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40854-0] [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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113
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Alali AS, Vavrek D, Barber J, Dikmen S, Nathens AB, Temkin NR. Comparative study of outcome measures and analysis methods for traumatic brain injury trials. J Neurotrauma 2015; 32:581-9. [PMID: 25317951 DOI: 10.1089/neu.2014.3495] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a "super" dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data.
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114
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Yue JK, Pronger AM, Ferguson AR, Temkin NR, Sharma S, Rosand J, Sorani MD, McAllister TW, Barber J, Winkler EA, Burchard EG, Hu D, Lingsma HF, Cooper SR, Puccio AM, Okonkwo DO, Diaz-Arrastia R, Manley GT. Association of a common genetic variant within ANKK1 with six-month cognitive performance after traumatic brain injury. Neurogenetics 2015; 16:169-80. [PMID: 25633559 DOI: 10.1007/s10048-015-0437-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 01/02/2015] [Indexed: 01/18/2023]
Abstract
Genetic association analyses suggest that certain common single nucleotide polymorphisms (SNPs) may adversely impact recovery from traumatic brain injury (TBI). Delineating their causal relationship may aid in development of novel interventions and in identifying patients likely to respond to targeted therapies. We examined the influence of the (C/T) SNP rs1800497 of ANKK1 on post-TBI outcome using data from two prospective multicenter studies: the Citicoline Brain Injury Treatment (COBRIT) trial and Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot). We included patients with ANKK1 genotyping results and cognitive outcomes at six months post-TBI (n = 492: COBRIT n = 272, TRACK-TBI Pilot n = 220). Using the California Verbal Learning Test Second Edition (CVLT-II) Trial 1-5 Standard Score, we found a dose-dependent effect for the T allele, with T/T homozygotes scoring lowest on the CVLT-II Trial 1-5 Standard Score (T/T 45.1, C/T 51.1, C/C 52.1, ANOVA, p = 0.008). Post hoc testing with multiple comparison-correction indicated that T/T patients performed significantly worse than C/T and C/C patients. Similar effects were observed in a test of non-verbal processing (Wechsler Adult Intelligence Scale, Processing Speed Index). Our findings extend those of previous studies reporting a negative relationship of the ANKK1 T allele with cognitive performance after TBI. In this study, we demonstrate the value of pooling shared clinical, biomarker, and outcome variables from two large datasets applying the NIH TBI Common Data Elements. The results have implications for future multicenter investigations to further elucidate the role of ANKK1 in post-TBI outcome.
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115
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Nerva JD, Mantovani A, Barber J, Kim LJ, Rockhill JK, Hallam DK, Ghodke BV, Sekhar LN. Treatment Outcomes of Unruptured Arteriovenous Malformations With a Subgroup Analysis of ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-Eligible Patients. Neurosurgery 2015; 76:563-70; discussion570; quiz 570. [DOI: 10.1227/neu.0000000000000663] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
The design and conclusions of A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA) trial are controversial, and its structure limits analysis of patients who could potentially benefit from treatment.
OBJECTIVE:
To analyze the results of a consecutive series of patients with unruptured brain arteriovenous malformations (BAVMs), including a subgroup analysis of ARUBA-eligible patients.
METHODS:
One hundred five patients with unruptured BAVMs were treated over an 8-year period. From this series, 90 adult patients and a subgroup of 61 patients determined to be ARUBA eligible were retrospectively reviewed. A subgroup analysis for Spetzler-Martin grades I/II, III, and IV/V was performed. The modified Rankin Scale was used to assess functional outcome.
RESULTS:
Persistent deficits, modified Rankin Scale score deterioration, and impaired functional outcome occurred less frequently in ARUBA-eligible grade I/II patients compared with grade III to V patients combined (P = .04, P = .04, P = .03, respectively). Twenty-two of 39 patients (56%) unruptured grade I and II BAVMs were treated with surgery without and with preoperative embolization, and all had a modified Rankin Scale score of 0 to 1 at the last follow-up. All patients treated with surgery without and with preoperative embolization had radiographic cure at the last follow-up.
CONCLUSION:
The results of ARUBA-eligible and unruptured grade I/II patients overall show that excellent outcomes can be obtained in this subgroup of patients, especially with surgical management. Functional outcomes for ARUBA-eligible patients were similar to those of patients who were randomized to medical management in ARUBA. On the basis of these data, in appropriately selected patients, we recommend treatment for low-grade BAVMs.
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116
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McCullumsmith CB, Kalpakjian CZ, Richards JS, Forchheimer M, Heinemann AW, Richardson EJ, Wilson CS, Barber J, Temkin N, Bombardier CH, Fann JR. Novel risk factors associated with current suicidal ideation and lifetime suicide attempts in individuals with spinal cord injury. Arch Phys Med Rehabil 2015; 96:799-808. [PMID: 25613597 DOI: 10.1016/j.apmr.2014.12.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 11/12/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine unique associations of suicidal ideation (SI) and lifetime suicide attempts (SAs) in individuals with spinal cord injury (SCI). DESIGN Cross-sectional analysis. SETTING Outpatient. PARTICIPANTS Individuals with SCI (N=2533) who were 18 years or older with a history of traumatic SCI. INTERVENTIONS None. MAIN OUTCOME MEASURES Any SI in the past 2 weeks (9-item Patient Health Questionnaire) and any lifetime SA. RESULTS Three hundred twenty-three individuals (13.3%) reported SI in the past 2 weeks and 179 (7.4%) reported lifetime SA. After controlling for other factors, both lifetime SA and current SI were associated with study site and current level of depression. In addition, SA was associated with less education, younger age at injury, having current or past treatment of depression, and having bipolar disorder or schizophrenia. SI was associated with more years since injury and lifetime SA. Several psychological factors were associated with current SI and lifetime SAs, including lower environmental reward and less positive affect. In addition, control of one's community activities and spiritual well-being were associated with current SI. In bivariate comparisons, severity of SCI was also associated with the 47% of the SAs that occurred after injury. CONCLUSIONS Several unique associations of SI and lifetime SA in individuals with SCI were identified, including level of environmental reward and control, spiritual well-being, and severity of SCI. These factors bear further investigation as prospective risk factors for suicidal behavior after SCI.
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Hansen CR, Sykes JR, Barber J, West K, Bromley R, Szymura K, Fisher S, Sim J, Bailey M, Chrystal D, Deshpande S, Franji I, Nielsen TB, Brink C, Thwaites DI. Multicentre knowledge sharing and planning/dose audit on flattening filter free beams for SBRT lung. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1742-6596/573/1/012018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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118
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Kim LJ, Tariq F, Levitt M, Barber J, Ghodke B, Hallam DK, Sekhar LN. Multimodality treatment of complex unruptured cavernous and paraclinoid aneurysms. Neurosurgery 2014; 74:51-61; discussion 61; quiz 61. [PMID: 24089048 DOI: 10.1227/neu.0000000000000192] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Unruptured aneurysms of the cavernous and paraclinoid internal carotid artery can be approached via microsurgical and endovascular approaches. Trends in treatment reflect a steady shift toward endovascular techniques. OBJECTIVE To analyze our results with multimodal treatment. METHODS We reviewed patients with unruptured cavernous and paraclinoid internal carotid artery aneurysms proximal to the posterior communicating artery treated at a single center from 2007 to 2012. Treatment included 4 groups: (1) stent-assisted coiling, (2) pipeline endovascular device (PED) flow diverter, (3) clipping, and (4) trapping/bypass. Follow-up was 2 to 60 months. RESULTS The 109 aneurysms in 102 patients were studied with the following treatment groupings: 41 were done with stent-assisted coiling, 24 with Pipeline endovascular device, 24 by microsurgical clipping, and 20 by trap/bypass. Group: (1) two percent had delayed significant intraparenchymal hemorrhage; (2) thirteen percent had central nerve palsies, 8% had small asymptomatic infarcts, and 4% had small, asymptomatic remote-site hemorrhages; (3) twenty-nine percent of patients suffered from transient central nerve palsies, 4% experienced major stroke, and 8% had small intracerebral hemorrhages; (4) thirty-five percent had transient central nerve palsies, 10% had strokes, and 10% had intracerebral hemorrhages. In terms of follow-up obliteration, 83% had complete/nearly complete obliteration at last follow-up, 17% had residual aneurysms, and 10% required retreatment. Ninety-six percent of group 1 (35/38), 100% of group 2 (23/23), 100% of group 3 (21/21), and 95% of group 4 had modified Rankin Scale scores of 0 to 1. CONCLUSION Treatment of these aneurysms can be carried out with acceptable rates of morbidity. Careful patient selection is crucial for optimal outcome. Endovascular treatment volumes likely will continue to predominate over microsurgical techniques as changing skill sets evolve in neurosurgery, but individualized application of all available treatment options will continue.
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Hegi-Johnson F, Kipritidis J, Barber J, West K, Unicomb K, Bui C, Yegiaian-Alvandi R, Keall P. Can 4D-CT Ventilation Imaging Replace Technegas V-SPECT for Functionally Adaptive Radiation Therapy? First Results. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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120
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Hall K, Kusunoki Y, Gatny H, Barber J. Social discrimination, mental health and unintended pregnancy among young women. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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121
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Kusunoki Y, Barber J, Gatny H, Melendez R. Intimate partner violence and contraceptive behaviors among young women. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.214] [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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122
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Lee A, Yarbrough CK, Greenberg JK, Barber J, Limbrick DD, Smyth MD. Comparison of posterior fossa decompression with or without duraplasty in children with Type I Chiari malformation. Childs Nerv Syst 2014; 30:1419-24. [PMID: 24777296 PMCID: PMC4104143 DOI: 10.1007/s00381-014-2424-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/10/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE Chiari malformation type I (CM1) is a common and often debilitating neurosurgical disease. Whether to treat CM1 patients with a traditional posterior fossa decompression with duraplasty (PFDD) or a less invasive extradural decompression (PFDO) is controversial. The purpose of this study was to compare clinical outcome and syrinx resolution between the two procedures. METHODS We retrospectively reviewed the records of 36 patients treated with PFDD and 29 patients with PFDO between 2003 and 2011. We compared baseline demographic, clinical, and radiographic characteristics. The primary clinical outcome was the Chicago Chiari Outcome Scale (CCOS). The primary radiographic outcome was qualitative syrinx improvement or resolution. RESULTS At baseline, age and sex distributions, radiographic characteristics, and presenting symptoms were similar in patients undergoing PFDD and PFDO. Patients undergoing PFDO had shorter surgical time (1.5 vs. 2.8 h; p < 0.001) and length of hospital stay (2.1 days compared to 3.3 days; p < 0.001). Cerebrospinal fluid-related complications were more common in patients receiving PFDD (7/36) than PFDO (0/29) (p = 0.014). Clinical improvement, defined by the mean CCOS score, was comparable in patients receiving PFDO (14.7) and PFDD (14.6) (p = 0.70). Among patients with postoperative syrinx imaging, 10/13 in the PFDD group improved or resolved, compared to 8/8 in the PFDO group (p = 0.26). CONCLUSIONS Extradural decompression for CM1 produces comparable rates of clinical and radiographic improvement as the more invasive decompression with duraplasty. Given the increased morbidity and resource utilization associated with PFDD, PFDO should be considered an attractive first-line option for most CM1 patients.
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Giardi MT, Barber J, Giardina MC, Bassi R. Studies on the Herbicide Binding Site in Isolated Photosystem II Core Complexes from a Flat-Bed Isoelectrofocusing Method. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znc-1990-0510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Isoelectrofocusing has been used to separate various chlorophyll-protein complexes of photosystem two (PS II). Light-harvesting complexes containing chlorophyll a and chlorophyll b (LHC II) were located in bands having p/s in the region of 4.5. At slightly higher pH other light-harvesting complexes containing little or no chlorophyll b were found. In the most basic region of the isoelectrofocusing gel, were located PS II core complexes characterized by containing the proteins of CP47, CP43, D 1, D 2 and α-subunit of cytochrome b559. The number of PS II core bands depended on the particular conditions employed for the separation procedure and in some cases were contaminated by CP 29. It is suggested that this heterogeneity resulting from different protonation states of the PS II.
The least-acidic PS II core complex (pI 5.5) was found to bind the herbicides atrazine, diuron and dinoseb. In contrast, a PS II core complex with a p / of 4.9 bound only diuron. Its inability to bind atrazine was shown to be due to the low pH but no such explanation could be found for dinoseb.
When atrazine-resistant mutant Senecio vulgaris was used, no binding of radioactive atra zine was observed with the PS II cores having a p i of 5.5. It is therefore suggested that the normal atrazine binding observed with PS II cores involves the high affinity site detected with intact membranes. With the PS II cores, however, this site has a reduced affinity probably due to structural modification in the D 1-polypeptide resulting from the isolation procedures.
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Brody SS, Barber J, Tredwell C, Beddard G. Effects of Linolenic Acid on the Spectral Properties and Picosecond Fluorescence of Pea Chloroplasts. Z NATURFORSCH C 2014. [DOI: 10.1515/znc-1981-11-1219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Linolenic acid induces changes in the absorption spectrum and in the picosecond fluorescence of pea chloroplasts. The effects of linolenic acid are dependent on concentration and time.
Linolenic acid increases the fluorescence life time of chloroplasts at room temperature. The contribution of the slow fluorescence component relative to the fast component is increased almost 10 fold in the presence of 0.5 mᴍ linolenic acid. The synergistic action of digitonin and linolenic acid increases the ratio of “closed” to “open” traps in the photosynthetic units.
Upon addition of 0.5 mᴍ linolenic acid there are increases in absorbance at 676 and 436 nm, and decreases in absorbance at 705 and 496 nm. Some of the spectral changes have a biphasic character, they reach a maxi um um after about 30 min then start to reverse. Based on the spectral changes at 496 and 705 nm it appears that linolenic acid has at least two effects, i.e. it modifies the thylakoid membrane and secondarily decreases the concentration of P700, respectively.
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Critoph C, Lam K, Baumwol J, Dembo L, Shah A, Hayes H, Barber J, Larbalestier R, Chih S. Pulmonary Vasodilators Early and in High Dose Improve Outcomes and Reduce Right Ventricular Failure After Left Ventricular Device Implantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hansen C, Sykes J, Barber J, Bromley R, Fisher S, Bailey M, Brink C, Thwaites D. PD-0410: Multi centre planning study on flattening filter free beams for SBRT lung cancer treatment. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30515-6] [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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Buckley RT, Morgan T, Saneto RP, Barber J, Ellenbogen RG, Ojemann JG. Dysphagia after pediatric functional hemispherectomy. J Neurosurg Pediatr 2014; 13:95-100. [PMID: 24206342 DOI: 10.3171/2013.10.peds13182] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Functional hemispherectomy is a well-recognized surgical option for the treatment of unihemispheric medically intractable epilepsy. While the resultant motor deficits are a well-known and expected consequence of the procedure, the impact on other cortical functions has been less well defined. As the cortical control of swallowing would appear to be threatened after hemispherectomy, the authors retrospectively studied a pediatric population that underwent functional hemispherectomy for medically intractable epilepsy to characterize the incidence and severity of dysphagia after surgery. METHODS A retrospective cohort (n = 39) of pediatric patients who underwent hemispherectomy at a single institution was identified, and available clinical records were reviewed. Additionally, the authors examined available MR images for integrity of the thalamus and basal ganglia before and after hemispherectomy. Clinical and video fluoroscopic assessments of speech pathology were reviewed, and the presence, type, and duration of pre- and postoperative dysphagia were recorded. RESULTS New-onset, transient dysphagia occurred in 26% of patients after hemispherectomy along with worsening of preexisting dysphagia noted in an additional 15%. Clinical symptoms lasted a median of 19 days. Increased duration of symptoms was seen with late (> 14 days postoperative) pharyngeal swallow dysfunction when compared with oral dysphagia alone. Neonatal stroke as a cause for seizures decreased the likelihood of postoperative dysphagia. There was no association with seizure freedom or postoperative hydrocephalus. CONCLUSIONS New-onset dysphagia is a frequent and clinically significant consequence of hemispherectomy for intractable epilepsy in pediatric patients. This dysphagia was always self-limited except in those patients in whom preexisting dysphagia was noted.
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Thwaites D, Hansen C, Kafrouni M, Caloz M, Leturgie Q, Corde S, Downes S, Barber J, Sykes J, Juneja P, Lehmann J. Pilot dose intercomparisons of 3D and 4D advanced lung radiotherapy. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Barber J, Nakatani HY, Mansfield R. Photosynthetic Oxygen Evolution and the Water Splitting Enzyme. Isr J Chem 2013. [DOI: 10.1002/ijch.198100046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nicholson S, Hall E, Harland SJ, Chester JD, Pickering L, Barber J, Elliott T, Thomson A, Burnett S, Cruickshank C, Carrington B, Waters R, Bahl A. Phase II trial of docetaxel, cisplatin and 5FU chemotherapy in locally advanced and metastatic penis cancer (CRUK/09/001). Br J Cancer 2013; 109:2554-9. [PMID: 24169355 PMCID: PMC3833214 DOI: 10.1038/bjc.2013.620] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/11/2013] [Accepted: 09/15/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Penis cancer is rare and clinical trial evidence on which to base treatment decisions is limited. Case reports suggest that the combination of docetaxel, cisplatin and 5-flurouracil (TPF) is highly active in this disease. METHODS Twenty-nine patients with locally advanced or metastatic squamous carcinoma of the penis were recruited into a single-arm phase II trial from nine UK centres. Up to three cycles of chemotherapy were received (docetaxel 75 mg m(-2) day 1, cisplatin 60 mg m(-2) day 1, 5-flurouracil 750 mg m(-2) per day days 1-5, repeated every 3 weeks). Primary outcome was objective response (assessed by RECIST). Fourteen or more responses in 26 evaluable patients were required to confirm a response rate of 60% or higher (Fleming-A'Hern design), warranting further evaluation. Secondary endpoints included toxicity and survival. RESULTS 10/26 evaluable patients (38.5%, 95% CI: 20.2-59.4) achieved an objective response. Two patients with locally advanced disease achieved radiological complete remission. 65.5% of patients experienced at least one grade 3/4 adverse event. CONCLUSION Docetaxel, cisplatin and 5FU did not reach the pre-determined threshold for further research and caused significant toxicity. Our results do not support the routine use of TPF. The observed complete responses support further investigation of combination chemotherapy in the neoadjuvant setting.
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Morton RP, Moore AE, Barber J, Tariq F, Hare K, Ghodke B, Kim LJ, Sekhar LN. Monitoring Flow in Extracranial-Intracranial Bypass Grafts Using Duplex Ultrasonography: A Single-Center Experience in 80 Grafts Over 8 Years. Neurosurgery 2013; 74:62-70. [DOI: 10.1227/neu.0000000000000198] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
High-flow extracranial-intracranial (EC-IC) bypass is performed by using radial artery graphs (RAGs) or saphenous vein grafts (SVGs) for various pathologies such as aneurysms, ischemia, and skull-base tumors. Quantifying the acceptable amount of blood flow to maintain proper cerebral perfusion has not been well established, nor have the variables that influence flow been determined.
OBJECTIVE:
To identify the normative range of blood flow through extracranial-intracranial RAGs and SVGs as measured by duplex ultrasonography. Multiple variables were evaluated to better understand their influence of graft flow.
METHODS:
All EC-IC grafts performed at Harborview Medical Center from 2005 to 2012 were retrospectively reviewed for this cohort study. Daily extracranial graft duplex ultrasonography with flow volumes and transcranial graft Doppler were examined, as were short- and long-term outcomes. Both ischemic and hyperemic events were evaluated in further detail.
RESULTS:
Eighty monitorable high-flow EC-IC bypasses were performed over the 8-year period. Sixty-five bypasses were performed by using RAGs and 15 were performed with SVGs. The average flow was 133 mL/min for RAGs and 160 mL/min for SVGs (P = .25). For both RAG and SVG groups, the donor and recipient vessel selected significantly impacted flow. For the RAG group only, preoperative graft diameter, postoperative hematocrit, and postoperative date significantly influenced flow. A 1-week average of >200 mL/min was 100% sensitive to cerebral hyperemia syndrome.
CONCLUSION:
This study establishes the normative range of duplex ultrasonographic flow after high-flow EC-IC bypass, as well the usefulness and practicality of such monitoring as a surrogate to flow in the postoperative period.
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Childers M, Joubert R, Poulard K, Holder M, Grange R, Doering J, Lawlor M, Moal C, Jamet T, Danièle N, Martin C, Rivière C, Poppante K, Soker T, Hammer C, Van Wittenberghe L, Guan X, Goddard M, Mitchell E, Barber J, Furth M, Vignaud A, Masurier C, Moullier P, Beggs A, Buj-Bello A. P.4.3 Intravenous infusion of AAV8–MTM1 prolongs life and ameliorates severe muscle pathology in mouse and dog models of X-linked myotubular myopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Podurgiel S, Nunes E, Yohn S, Barber J, Thompson A, Milligan M, Lee C, López-Cruz L, Pardo M, Valverde O, Lendent C, Baqi Y, Müller C, Correa M, Salamone J. The vesicular monoamine transporter (VMAT-2) inhibitor tetrabenazine induces tremulous jaw movements in rodents: Implications for pharmacological models of parkinsonian tremor. Neuroscience 2013; 250:507-19. [DOI: 10.1016/j.neuroscience.2013.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/29/2013] [Accepted: 07/03/2013] [Indexed: 11/17/2022]
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Barber J, Rumsby E, Parker S, Mohebati L, Venables S, Lawson K, Scanlon T, Memon A. OP02 Women’s Views on Smoking Cessation Services and National Tobacco Control Measures. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barber J, Rumsby E, Parker S, Mohebati L, Venables S, Lawson K, Scanlon T, Memon A. PP75 What Factors are Important in Smoking Cessation and Relapse in Women from Deprived Communities? – A Qualitative Study. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Raine R, Xanthopoulou P, Wallace I, Nic a’ Bháird C, Barber J, Clarke A, Lanceley A, Ardron D, Harris M, Blazeby J, Ferlie E, Gibbs S, King M, Livingston G, Michie S, Prentice A. OP92 Improving the Effectiveness of Multidisciplinary Team Meetings for Patients with Chronic Diseases: Assessing the Predictors of Decision Implementation. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nic a’ Bháird C, Wallace I, Xanthopoulou P, Barber J, Clarke A, Lanceley A, Ardron D, Harris M, Blazeby J, Ferlie E, Gibbs S, King M, Livingston G, Michie S, Prentice A, Raine R. PP45 Developing Recommendations to Improve the Effectiveness of Multidisciplinary Team Meetings for Patients with Chronic Diseases. Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hall K, Kusunoki Y, Gatny H, Barber J. UNINTENDED PREGNANCY RISK AMONG YOUNG WOMEN WITH PSYCHOLOGICAL STRESS AND DEPRESSION SYMPTOMS. Contraception 2013. [DOI: 10.1016/j.contraception.2013.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brines Ferrando L, Del Canto I, Such-Miquel L, Parra G, Soler C, Barber J, Trapero I, Alberola A, Such L, Chorro FJ. Ranolazine induced modifications of ventricular fibrillation activation complexity under mechanical stretch. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kaucikas M, Barber J, Van Thor JJ. Polarization sensitive ultrafast mid-IR pump probe micro-spectrometer with diffraction limited spatial resolution. OPTICS EXPRESS 2013; 21:8357-8370. [PMID: 23571925 DOI: 10.1364/oe.21.008357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A setup of ultrafast transient infrared IR spectrometer is described in this paper that employed Schwarzschild objectives to focus the probe beam to a diffraction limited spot. Thus measurements were performed with very high spatial resolution in the mid-IR spectral region. Furthermore, modulating the polarization of the probe light enabled detecting transient dichroism of the sample. These capabilities of the setup were applied to study transient absorption of Photosystem II core complex and to image an organized film of methylene blue chloride dye. Moreover, a study of noise sources in a pump probe measurement is presented. The predicted noise level of the current setup was 8.25 μOD in 10(4) acquisitions and compared very well with the experimental observation of 9.6 μOD.
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Sweeney L, Sneller S, Button M, Barber J, Lester J, Staffurth J. The Use of Strontium-89 in Castration-resistant Metastatic Prostate Cancer at Velindre Hospital. Clin Oncol (R Coll Radiol) 2013. [DOI: 10.1016/j.clon.2012.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Caley A, Argyle G, Barber J, Button M, Lester J, Staffurth J. The Outcomes of Patients Treated with Abiraterone Acetate Outside of Clinical Trials at Velindre Hospital. Clin Oncol (R Coll Radiol) 2013. [DOI: 10.1016/j.clon.2012.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moreau C, Hall K, Trussell J, Barber J. Effect of prospectively measured pregnancy intentions on the consistency of contraceptive use among young women in Michigan. Hum Reprod 2013; 28:642-50. [PMID: 23241838 PMCID: PMC3619965 DOI: 10.1093/humrep/des421] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2004] [Revised: 10/15/2005] [Accepted: 11/07/2012] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the predictive value of pregnancy intentions on contraceptive behaviours among women aged 18-19? SUMMARY ANSWER Women aged 18-19 have high levels of inconsistent use of contraception, which mostly occur at times when women strongly wish to avoid a pregnancy. WHAT IS KNOWN ALREADY Pregnancy intentions provide an indication of how well individuals achieve their reproductive goals. However, retrospective accounts of pregnancy intentions using dichotomous indicators suffer temporal instability and fail to capture the wide range of attitudes towards pregnancy. STUDY DESIGN, SIZE, DURATION In this study, data are drawn from a population-based survey of 992 women of ages 18-19 years in Michigan, who completed weekly journals assessing contraceptive use, pregnancy intentions and reproductive outcomes during 2.5 years of follow-up. The response rate was 86% for the baseline interview and 65% after 2.5 years of follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS We examined 15 446 pairs of journal entries. We used logistic regression with random effects to assess the predictive effect of women's desire to become pregnant and to avoid a pregnancy, measured each week, on consistency of use of contraception the following week. MAIN RESULTS AND THE ROLE OF CHANCE Women reported inconsistent use of contraception in more than a quarter of weekly journals (28.3%). Consistent use of contraception increased from 22 to 78% as women s intentions to become pregnant decreased and increased from 23 to 78% as motivations to avoid pregnancy increased. The combination of scores of the pregnancy desire and avoidance scales shows indifferent or ambivalent pregnancy attitudes in 8.6% of weekly records. These women were more likely to report inconsistent contraceptive use compared with women who expressed anti-conception attitudes [OR = 2.8 (2.2-3.5)]. However, 23% of women who had unequivocal anti-conception feelings did not use contraception consistently, contributing to 72% of the weeks of inconsistent use in our population. LIMITATIONS, REASONS FOR CAUTION In this study, consistency of contraceptive use, based on the use of contraception at every act of intercourse, does not fully capture a women's risk of becoming pregnant. The 35% attrition after 2.5 years may have affected the internal validity of our results, although a reanalysis based on the first year of observation produced very similar results. WIDER IMPLICATIONS OF THE FINDINGS Because most instances of inconsistent use of contraception occur among women who are keen to avoid a pregnancy, our results suggest there is room for improving contraceptive behaviours by promoting use of methods which do not require user adherence. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Child Health and Human Development for grant #R01-HDHD050329 (P.I. Barber, University of Michigan) and grant #R24HD047879 (Center infrastructure of the Office of Population Research at Princeton University, JT and KSH). None of the authors have a competing interest.
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Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, Petroni G, Lujan S, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T. A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 2012; 367:2471-81. [PMID: 23234472 PMCID: PMC3565432 DOI: 10.1056/nejmoa1207363] [Citation(s) in RCA: 772] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Intracranial-pressure monitoring is considered the standard of care for severe traumatic brain injury and is used frequently, but the efficacy of treatment based on monitoring in improving the outcome has not been rigorously assessed. METHODS We conducted a multicenter, controlled trial in which 324 patients 13 years of age or older who had severe traumatic brain injury and were being treated in intensive care units (ICUs) in Bolivia or Ecuador were randomly assigned to one of two specific protocols: guidelines-based management in which a protocol for monitoring intraparenchymal intracranial pressure was used (pressure-monitoring group) or a protocol in which treatment was based on imaging and clinical examination (imaging-clinical examination group). The primary outcome was a composite of survival time, impaired consciousness, and functional status at 3 months and 6 months and neuropsychological status at 6 months; neuropsychological status was assessed by an examiner who was unaware of protocol assignment. This composite measure was based on performance across 21 measures of functional and cognitive status and calculated as a percentile (with 0 indicating the worst performance, and 100 the best performance). RESULTS There was no significant between-group difference in the primary outcome, a composite measure based on percentile performance across 21 measures of functional and cognitive status (score, 56 in the pressure-monitoring group vs. 53 in the imaging-clinical examination group; P=0.49). Six-month mortality was 39% in the pressure-monitoring group and 41% in the imaging-clinical examination group (P=0.60). The median length of stay in the ICU was similar in the two groups (12 days in the pressure-monitoring group and 9 days in the imaging-clinical examination group; P=0.25), although the number of days of brain-specific treatments (e.g., administration of hyperosmolar fluids and the use of hyperventilation) in the ICU was higher in the imaging-clinical examination group than in the pressure-monitoring group (4.8 vs. 3.4, P=0.002). The distribution of serious adverse events was similar in the two groups. CONCLUSIONS For patients with severe traumatic brain injury, care focused on maintaining monitored intracranial pressure at 20 mm Hg or less was not shown to be superior to care based on imaging and clinical examination. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT01068522.).
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Barber J. Photosystem II: the water-splitting enzyme of photosynthesis. COLD SPRING HARBOR SYMPOSIA ON QUANTITATIVE BIOLOGY 2012; 77:295-307. [PMID: 23234808 DOI: 10.1101/sqb.2012.77.014472] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The oxygen in our atmosphere is derived and maintained by the water-splitting process of photosynthesis. The enzyme that facilitates this reaction and therefore underpins virtually all life on our planet is known as photosystem II (PSII), a multisubunit enzyme embedded in the lipid environment of the thylakoid membranes of plants, algae, and cyanobacteria. During the past 10 years, crystal structures of a 700-kDa cyanobacterial dimeric PSII complex have been reported with ever-increasing improvement in resolution--the latest at 1.9 Å. Thus, the organizational and structural details of its many subunits and cofactors are now well understood. The water-splitting site was revealed as a cluster of four Mn ions and one Ca ion surrounded by amino-acid side chains, of which seven provide ligands to the metals. The metal cluster is organized as a cubane-like structure composed of three Mn ions and the one Ca2+ ion linked by oxo bonds. The fourth Mn is attached to the cubane via one of its bridging oxygens together with another oxo bridge to an Mn ion of the cubane. The overall structure of the catalytic site provides a framework to propose a mechanistic scheme for the water-splitting process and gives a blueprint for the development of catalysts that mimick the reaction in an artificial chemical system as a means to generate solar fuels.
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Chesnut RM, Temkin N, Carney N, Dikmen S, Pridgeon J, Barber J, Celix JM, Chaddock K, Cherner M, Hendrix T, Lujan S, Machamer J, Petroni G, Rondina C, Videtta W. Traumatic brain injury in Latin America: lifespan analysis randomized control trial protocol*. Neurosurgery 2012; 71:1055-63. [PMID: 22986600 PMCID: PMC3549327 DOI: 10.1227/neu.0b013e31827276b7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although in the developed world the intracranial pressure (ICP) monitor is considered the standard of care for patients with severe traumatic brain injury (TBI), its usefulness to direct treatment decisions has never been tested rigorously. OBJECTIVE The primary focus was to conduct a high-quality, randomized, controlled trial to determine whether ICP monitoring used to direct TBI treatment improves patient outcomes. By providing education, equipment, and structure, the project will enhance the research capacity of the collaborating investigators and will foster the collaborations established during earlier studies. METHODS Study centers were selected that routinely treated ICP based on clinical examination and computed tomography imaging using internal protocols. We randomized patients to either an ICP monitor group or an imaging and clinical examination group. Treatment decisions for the ICP monitor group are guided by ICP monitoring based on established guidelines. Treatment decisions for the imaging and clinical examination group are made using a single protocol derived from those previously being used at those centers. EXPECTED OUTCOMES There are 2 study hypotheses: (1) patients with severe TBI whose acute care treatment is managed using ICP monitors will have improved outcomes and 2) incorporating ICP monitoring in the care of patients with severe TBI will minimize complications and decrease length of intensive care unit stay. DISCUSSION This clinical trial tests the effectiveness of a management protocol based on technology considered pivotal to brain trauma treatment in the developed world: the ICP monitor. A randomized, controlled trial of ICP monitoring has never been performed-a critical gap in the evidence base that supports the role of ICP monitoring in TBI care. As such, the results of this randomized, controlled trial will have global implications regardless of the level of development of the trauma system.
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Sekhar LN, Tariq F, Morton RP, Ghodke B, Hallam DK, Barber J, Kim LJ. Basilar Tip Aneurysms. Neurosurgery 2012; 72:284-98; discussion 298-9. [DOI: 10.1227/neu.0b013e3182797952] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Endovascular therapy has largely replaced microsurgical clipping for the treatment of basilar tip aneurysms.
OBJECTIVE:
We describe the variables our center evaluates when choosing to clip or coil basilar tip aneurysms and our outcomes. Four case illustrations are presented.
METHODS:
All patients with ruptured or unruptured basilar tip aneurysms from 2005 to April 2012 were examined. The patients were treated by 2 interventional neuroradiologists and 2 dually trained neurosurgeons.
RESULTS:
There were 63 ruptured (clipped 38%, coiled 62%) and 37 unruptured (clipped 35%, coiled 65%) aneurysms in this 100-patient study. Seventy percent of the patients with ruptured aneurysms and 92% of the patients with unruptured aneurysms had a good outcome (modified Rankin scale 0–2) at 3 months. For ruptured aneurysms, there was a statistically significant difference in clipping and coiling with respect to age and treatment modality (clip 48.8 years, coil 57.6 years). Patients in the coiled group had higher dome-to-neck (1.3 vs 1.1) (P = .01) and aspect ratios (1.6 vs 1.2) (P = .007). In the ruptured coiling group, 69.5% achieved a Raymond 1 radiographic outcome, 28% Raymond 2, and 2.5% Raymond 3. Eleven (17.4%) patients required re-treatment, and 3 (4.4%) patients were re-treated more than twice. Coiling of unruptured aneurysms resulted in 75% Raymond 1. There were no residual lesions for unruptured clipped aneurysms. There were no differences in outcome between clipping and coiling in the ruptured and unruptured group.
CONCLUSION:
In our current management of basilar tip aneurysms, the majority can be treated via endovascular means, albeit with the expectation of a higher percentage of residual lesions and recurrences. Microsurgery is still appropriate for aneurysms with complex neck morphologies and in young patients desiring a more durable treatment.
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Barber J, Critis-Christoph P. Development of a therapist adherence/competence rating scale for supportive-expressive dynamic psychotherapy: a preliminary report. Psychother Res 2012; 6:81-94. [PMID: 22242608 DOI: 10.1080/10503309612331331608] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This paper reports on the development of the Penn Adherence/Competence Scale for Supportive-Expressive (SE) Dynamic Psychotherapy. The rating scale includes 45 items which are rated separately for both frequency (adherence) and quality (competence) of therapists' application. Audiotaped from four SE therapists who saw a total of 33 depressed patients were rated by two independent judges. The same judges also rated four cognitive (CT) therapists who saw a total of seven patients. Interjudge reliability for the six subscales and the two total scale scores ranged from .35 to .79, and internal consistency coefficients ranged from .62 to .95. While SE therapists used more expressive and interpretative techniques than did CT therapists, the two groups did not differ in their use of supportive and general techniques. In addition, SE therapists were judged to be more competent in their use of SE specific techniques than were CT therapists. SE therapists' adherence and competence were not associated with patients' level of psychiatric severity as indicated by pretreatment and concurrent levels of depression, comorbid personality disorder, or level of psychological health. Therapists' adherence and competence were unrelated to a concurrent measure of the therapeutic alliance.
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Beggs A, Jamet T, Joubert R, Furth M, Holder M, Grange R, Lawlor M, Viola M, Poulard K, Masurier C, Martin S, Rivière C, Poppante K, Soker T, Hammer C, Vignaud A, Wittenberghe LV, Messaddeq N, Guan X, Goddard M, Mitchell E, Barber J, Danièle N, Widrick J, Pierson C, Moullier P, Armstrong D, Childers M, Buj-Bello A. T.O.4 Development of AAV-gene and protein-based therapies for X-linked myotubular myopathy. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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150
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Johnson EK, Fraser RT, Miller JW, Temkin N, Barber J, Caylor L, Ciechanowski P, Chaytor N. A comparison of epilepsy self-management needs: provider and patient perspectives. Epilepsy Behav 2012; 25:150-5. [PMID: 23032121 DOI: 10.1016/j.yebeh.2012.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 07/21/2012] [Accepted: 07/23/2012] [Indexed: 11/16/2022]
Abstract
A consistent and serious empirical issue in the epilepsy self-management literature involves dropout and attrition in intervention studies. One explanation for this issue revolves around "top-down" intervention designs (i.e., interventions generated by epilepsy clinicians and researchers) and the potential for disparity with patient interests, capabilities, and perceived needs. The purpose of this study was to extend the work of Fraser et al. (2011) [19] by comparing perceptions regarding self-management problems, topics, and program design, between two subgroups of adult patients with epilepsy (n=165) and epilepsy clinicians (n=20). Results indicate differences in problem severity ratings, program emphasis (i.e., goal-setting, coping, education), and program leadership between clinicians and each patient subgroup to varying degrees. These findings highlight some of the differences in opinion between patients and clinicians and emphasize the need for patient-involved planning with regard to self-management programs. Implications and explanations are offered as points for consideration in self-management program development.
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