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Higgins M, Healy A, Eakins S, Brennan A, Cregg K. 161 CLEAR DISCHARGE PRESCRIBING IN STROKE PATIENTS: A RETROSPECTIVE AUDIT OF DUAL ANTIPLATELET DURATION AT FIRST FOLLOW-UP APPOINTMENT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The risk of further ischaemic events post stroke and TIA is high in the following weeks. Short term treatment with Dual Anti-Platelet Therapy (DAPT) in appropriate patients has been shown to decrease the incidence of recurrent ischaemic events. However continuing DAPT longer than six weeks increases the risk of haemorrhagic complications.
Methods
Retrospective analysis of patients admitted to the Acute Stroke Unit over 4 months in a tertiary referral centre, reviewing discharge summaries and follow-up Outpatient Department (OPD) clinic letters on the online hospital computer system.
Results
We analysed data from 205 patients. 57 patients were discharged on DAPT. Of those, 18(31.6%) did not have a recommended duration of DAPT documented in their discharge summary. 40 patients returned to OPD for review, 16 patients had no documented follow-up, 11 were repatriated to a referring hospital for follow-up locally. The average time of OPD review was 4 months post discharge. Of those 40 patients who attended OPD follow up appointment, 33(82.5%) had documented evidence of a medication review in clinic. 9 of those patients (27.3%) were still inappropriately on DAPT, 5 of whom (55.6%) had no DAPT duration instructions documented in the discharge summary.
Conclusion
Treatment with DAPT puts patients at risk of haemorrhagic complications with longer term use. Clear documentation of treatment duration and communication with the patient and the patient’s GP is vital to ensure medication errors and unnecessary complications for the patient are avoided. Intervention: Following these results, we organised an education session for the Stroke Department staff and re-designed the stroke discharge summary template to highlight instructions on DAPT duration. We also emphasised the importance of communication with the patient’s GP and medication counselling with patients.
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Affiliation(s)
| | - A Healy
- Beaumont Hospital , Dublin, Ireland
| | - S Eakins
- Beaumont Hospital , Dublin, Ireland
| | | | - K Cregg
- Beaumont Hospital , Dublin, Ireland
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2
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Allan D, Chatzistergos PE, Mahadevan S, Healy A, Sundar L, Ramachandran A, Kumar S, Punnoose A, Chockalingam N, Naemi R. Increased exposure to loading is associated with decreased plantar soft tissue hardness in people with diabetes and neuropathy. Diabetes Res Clin Pract 2022; 187:109865. [PMID: 35398144 DOI: 10.1016/j.diabres.2022.109865] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 11/03/2022]
Abstract
AIMS Literature indicates that altered plantar loading in people with diabetes could trigger changes in plantar soft tissue biomechanics which, in turn, could affect the risk for ulceration. To stimulate more research in this area, this study uses in vivo testing to investigate the link between plantar loading and tissue hardness. METHODS Tissue hardness and plantar pressure distribution were measured for six plantar areas in 39 people with diabetes and peripheral neuropathy. RESULTS Spearman correlation analysis revealed that increased pressure time integral at the 1st metatarsal-head region (r = -0.354, n = 39, P = 0.027) or at the heel (r = -0.378, n = 39, P = 0.018) was associated with reduced hardness in the same regions. After accounting for confounding parameters, generalised estimating equations analysis also showed that 10% increase in pressure time integral at the heel was associated with ≈ 1 unit reduction in hardness in the same region. CONCLUSIONS For the first time, this study reveals that people with diabetes and neuropathy who tend to load their feet more heavily also tend to have plantar soft tissues with lower hardness. The observed difference in tissue hardness is likely to affect the tissue's vulnerability to overload injury. More research will be needed to explore the implications of the observed association for the risk of ulceration.
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Affiliation(s)
- D Allan
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - P E Chatzistergos
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom.
| | | | - A Healy
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - L Sundar
- India Diabetes Research Foundation, Chennai, India
| | | | - S Kumar
- Sri Ramachandra University, Chennai, India
| | - A Punnoose
- Sri Ramachandra University, Chennai, India
| | - N Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, School of Health, Science and Wellbeing, Staffordshire University, Stoke-On-Trent, United Kingdom
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3
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Joyce O, Black C, Armitage D, McDermott J, Healy A, O'Hara C, Flynn B, Costello M, McDonald M. 151 THERAPY OUTCOME MEASURES IN AN OLDER PERSONS REHABILITATION UNIT. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
The mission of an older person’s sub-acute rehabilitation unit is to improve the individual’s function and quality of life. This is achieved through patient and multidisciplinary team (MDT) collaboration. The MDT collect Therapy Outcome Measure (TOM) (Enderby and John 2015) data to measure the effectiveness of rehabilitation and facilitate analysis of patient and service outcomes. This abstract will present 6 months of data collection with the aim of evaluating the impact of MDT intervention from January 2021.
Methods
The MDT meet weekly to jointly record patient TOM scores on admission and discharge. The TOM scales used are; multifactorial conditions, stroke and neurological disorder. The patient is scored from 0–5 in four domains; impairment, activity, participation and well-being. There are 11 parts to the scale with 0.5 scores permitted (Enderby and John 2015).
Results
Data was analysed on 62 patients. Across an episode of rehabilitation an increase of 0.5 or more on the TOM is a clinically significant (positive) change. 84% of patients had an overall improvement in the total TOM score. There was an average overall increase of 2.6 points on the scale which equates to a 25% overall change. 63% improved in the domain of impairment, 77% in activity, 73% in participation and 66% in wellbeing. 100% of patients post-stroke, 81% with multifactorial conditions and 75% with neurological conditions experienced an overall improvement.
Conclusion
The data objectively shows positive patient outcomes in older persons rehabilitation. Individuals experienced the most positive change in their activity and participation function and high levels of change are also evident in impairment levels and well-being. Overall, TOM is a very useful MDT outcome measure tool. It has been successfully implemented and maintained in the service and facilitates the ongoing analysis of individual and service outcomes to understand the impact of intervention.
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Affiliation(s)
- O Joyce
- Beaumont Hospital , Dublin, Ireland
| | - C Black
- Beaumont Hospital , Dublin, Ireland
| | | | | | - A Healy
- Beaumont Hospital , Dublin, Ireland
| | - C O'Hara
- Beaumont Hospital , Dublin, Ireland
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4
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O'Donnell K, Healy A, Staines A, Corrigan C, Burke T, McGettrick G, Waldron B. Pathways through rehabilitation for traumatic brain injury: preliminary results from an Irish study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In Ireland, little data exists on the number of TBI survivors or the availability of brain injury rehabilitation services. To address this, we examined nationally representative data to estimate the number of moderate to severe TBI survivors and to learn of their rehabilitation experiences.
Methods
A two-year mixed-methods, observational, cohort study was used to investigate the rehabilitation pathways of moderate to severe TBI survivors (N = 120). Participants were surveyed on two occasions six months apart using a range of standardised instruments (EQ-5D-3L, WHOQOL BREF and EBIQ). Preliminary findings from first surveys are reported.
Results
Fifty percent of participants reported having received some rehabilitation during their initial hospitalization. Following discharge, inpatient rehabilitation was recommended in 55.8% of cases (N = 67); 62.5% (N = 75) in an outpatient setting and 52.1% (N = 62) in a specialised brain injury community-based setting. Rehabilitation was not recommended in 9.2% (N = 11) of cases. Univariant analyses showed statistically significant differences between the experiences of males (N = 87) and females (N = 33) in three main elements; Isolation: males (M), mean 1.88, SD .488, females (F) mean 1.64, SD .476, (p = .015); Communication: M mean 1.85, SD .565, F mean 1.57, SD .469 (p = .012); Cognitive difficulties: M mean 1.81, SD .456, F mean 1.59, SD .426 (p = .020).
Discussion
Referrals to rehabilitation services varied substantially in this cohort of TBI survivors with evidence to suggest that, overall, males experience greater impacts on quality of life than do females. These findings support the need to, a) increase political priority and resource allocation for rehabilitation services for TBI survivors in Ireland and b) further study gender differences in TBI survivor outcome.
Key messages
Survivors of moderate to severe brain injury in Ireland have very divergent, and often inadequate experiences of rehabilitation. There is some evidence that male survivors of moderate to severe traumatic brain injury face more challenges than do female survivors.
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Affiliation(s)
- K O'Donnell
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - A Healy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - A Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - C Corrigan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - T Burke
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - B Waldron
- Acquired Brain Injury Ireland, Dublin, Ireland
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5
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Staines A, O'Farrell A, Healy A, O'Donnell K, McGettrick G, Bourke T, Johnson H, Corrigan C. Accuracy of identifcation of traumatic brain injuries in routine hospital data. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Much work on the epidemiology of TBI uses routinely collected health care data. There is no separate code for TBI in ICD-10, a common coding system for acute care. One reason for reported variations in TBI prevalence between countries is differences in the identification of TBI from routine data. This study assessed the performance of an Australian classification system (Pozzatto et al 2019), using a standardised approach to ICD-10 codes to identify cases of likely TBI in routine hospital discharge data.
Methods
The original study was done on hospital data from New South Wales. We replicated their approach using Irish hospital data, held by Health Intelligence, from 2013 to 2020. Cases not classified as TBI by this system, but with codes, such as loss-of-consciousness, skull fracture or intra-cranial injury were manually reviewed.
Results
All 98,419 discharges with any code in S00 to S99 were reviewed. 27,851 (28.3%) had a skull fracture or intracranial injury. 12,106 (12.3%) had loss-of-consciousness and/or post-traumatic amnesia. 11,976 (98.9%) of these (12.2% of the total) had either a skull fracture or an intra-cranial injury reported. 26,085 (26.5%) of the original 98,419 cases were classified as TBI using the NSW classification. Manual review of 1.3% (1,356) cases added a maximum of 0.32% (321) further possible cases of TBI, suggesting a sensitivity of the classification of 98.8% (95% CI 98.6% - 98.9%).
Discussion
The main limitation is that it is not possible to identify false positive cases - those coded as TBI, but where no TBI was present. This approach to identifying TBI works well, and is feasible for wider implementation. It provides comparability between different studies.
Pozzato I et al. (2019), Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population-based study. Australian and New Zealand Journal of Public Health. 2019
Key messages
There are problems comparing data on TBI between different countries because no single code for TBI exists in ICD-10, and this is a real challenge for epidemiologists and health services researchers. The use of an agreed system, developed in Australia, for recoding injury data to identify TBI has promise, and shows excellent sensitivity in two countries.
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Affiliation(s)
- A Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - A O'Farrell
- Health Intelligence, Health Services Executive, Dublin, Ireland
| | - A Healy
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - K O'Donnell
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | | | - T Bourke
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - H Johnson
- Health Intelligence, Health Services Executive, Dublin, Ireland
| | - C Corrigan
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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6
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Eddison N, Healy A, Chockalingam N. Does user perception affect adherence when wearing biomechanically optimised ankle foot orthosis - footwear combinations: A pilot study. Foot (Edinb) 2020; 43:101655. [PMID: 32086139 DOI: 10.1016/j.foot.2019.101655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/14/2019] [Accepted: 11/26/2019] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Pilot study. BACKGROUND Ankle foot orthoses (AFOs) and footwear combination (FC) is a commonly prescribed medical device given to children with cerebral palsy (CP) in an attempt to improve their gait. Biomechanically optimising the AFO-FC often requires large adaptations to the sole of the user's footwear. There is currently a dearth of literature regarding the user's perception of wearing biomechanically optimised AFOs and adapted footwear and whether their perception affects their adherence to orthotic treatment. OBJECTIVE This study aimed to investigate perception and adherence to wearing an AFO and FC the participants were asked to wear as part of their orthotic prescription. In particular, whether the visibly modified footwear affected the user's adherence to the orthotic treatment. METHODS Questionnaire devised for the purpose of this study. RESULTS All five participants responded to the questionnaire; reporting a high number of positive responses in relation to function, including; an improvement in the way they walked, improved balance and fewer falls. Conversely, there was a high level of negative responses regarding aesthetics, with all participants reporting they did not like the cosmesis of their AFO-FCs. They were conscious that the modification to their footwear was noticeable and therefore different from their peers, yet they adhered to the treatment and in some cases increased the wearing time. CONCLUSIONS This pilot set of questions indicated that cosmesis is an important factor for children who wear AFOs and adapted footwear. It can be concluded that the impact of the adapted AFO-FC on the participants' function outweighed their opinion on the cosmesis of the device. CLINICAL RELEVANCE It is vital to understand how orthotic prescriptions affect user adherence. Orthotic prescriptions which are not utilised by the user result in a failed treatment intervention, regardless of the scientific application underpinning them.
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Affiliation(s)
- N Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke, United Kingdom; Royal Wolverhampton NHS trust, United Kingdom.
| | - A Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke, United Kingdom
| | - N Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke, United Kingdom
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7
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Eddison N, Healy A, Needham R, Chockalingam N. The effect of tuning ankle foot orthoses-footwear combinations on gait kinematics of children with cerebral palsy: A case series. Foot (Edinb) 2020; 43:101660. [PMID: 32179372 DOI: 10.1016/j.foot.2019.101660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 02/04/2023]
Abstract
STUDY DESIGN Case series. BACKGROUND AFOs are a commonly prescribed medical device given to children with cerebral palsy (CP) in an attempt to improve their gait. The current literature is equivocal on the effects AFOs have on the gait of children with CP. The vast majority of AFOs issued are not subject to AFO-FC tuning. There are emerging studies investigating the effects tuning AFO-FCs has on the gait of children with CP. However, the research is limited, and there is a lack of quantitative data. OBJECTIVE To compare the kinematics of tuned versus non-tuned gait in children with CP. METHODS Gait analysis assessment of five children aged between 7-11 years with a diagnosis of CP (one hemiplegic and four diplegic participants, two female, three male, with a Gross Motor Functional Classification System (GMFCS) of 2) at a Gait Analysis Laboratory. RESULTS In comparison to barefoot and non-tuned gait, walking with a tuned AFO-FC produced improvements in several key gait parameters. Including hip flexion and extension, posterior pelvic tilt and knee extension. Results also indicated that the type of gait pattern demonstrated by the participant affected the outcomes of tuning. CONCLUSIONS Tuning the AFO-FC of children with CP has the potential to improve hip function, pelvic function, knee extension in stance phase and knee flexion during swing phase and that a non-tuned AFO-FC can potentially decrease hip function, posterior pelvic tilt and increase knee extension. CLINICAL RELEVANCE Whilst AFO-FC tuning has been recommended for routine clinical practice, there still remains a paucity of research on the kinematic effects of using a tuned AFO-FC compared to a non-tuned. This paper provides a comparison of kinematics on children with CP, during barefoot, non-tuned and tuned AFO-FC walking with a view to inform clinical practice.
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Affiliation(s)
- N Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, United Kingdom; Royal Wolverhampton NHS Trust, Wolverhampton.
| | - A Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, United Kingdom
| | - R Needham
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, United Kingdom
| | - N Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke on Trent, United Kingdom
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8
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Andrews GP, Li S, Almajaan A, Yu T, Martini L, Healy A, Jones DS. Fixed Dose Combination Formulations: Multilayered Platforms Designed for the Management of Cardiovascular Disease. Mol Pharm 2019; 16:1827-1838. [DOI: 10.1021/acs.molpharmaceut.8b01068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G. P. Andrews
- Pharmaceutical Engineering Group, School of Pharmacy, Queen’s University, Belfast BT9, U.K
| | - S. Li
- Pharmaceutical Engineering Group, School of Pharmacy, Queen’s University, Belfast BT9, U.K
| | - A. Almajaan
- Pharmaceutical Engineering Group, School of Pharmacy, Queen’s University, Belfast BT9, U.K
| | - T. Yu
- Pharmaceutical Engineering Group, School of Pharmacy, Queen’s University, Belfast BT9, U.K
| | - L. Martini
- Royal Pharmaceutical Society, East Smithfield, London E1W 1AW, U.K
| | - A. Healy
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin 2, Ireland
| | - D. S. Jones
- Pharmaceutical Engineering Group, School of Pharmacy, Queen’s University, Belfast BT9, U.K
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9
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Chetcuti Zammit S, Ching HL, McAlindon ME, Sanders DS, Healy A, Thurston V, Sidhu R. The Changing Platform of Small Bowel Endoscopy: a 15-Year Experience of Demand and Outcomes. J Gastrointest Surg 2018; 22:1305-1306. [PMID: 29679344 DOI: 10.1007/s11605-018-3772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 01/31/2023]
Affiliation(s)
- S Chetcuti Zammit
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK.
| | - H-L Ching
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - M E McAlindon
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - D S Sanders
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - A Healy
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - V Thurston
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
| | - R Sidhu
- Gastroenterology Department, Sheffield Teaching Hospitals, Sheffield, UK
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Healy A, Fredriksson J, Goodenough D, Mallozzi R, Olafsdottir H, Kristbjornsson A. SU-D-303-04: A Survey of MRI Distortion Measurements. Med Phys 2016. [DOI: 10.1118/1.4923891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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11
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Nativi-Nicolau J, Healy A, Abdelrahman S, Jaramillo J, Elmer A, Tagge S, McKellar S, Stehlik J, Drakos S, Fang J, Gilbert E, Wever-Pinzon O, Kawamoto K, Selzman C. Readmission Rates in Patients with Left Ventricular Assist Devices. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Goodenough D, Olafsdottir H, Olafsson I, Fredriksson J, Mallozzi R, Kristinsson S, Healy A, Oskarsdottir G, Kristbjornsson A, Levy J. SU-E-P-31: Quantifying the Amount of Missing Tissue in a Digital Breast Tomosynthesis. Med Phys 2015. [DOI: 10.1118/1.4923965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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13
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Olafsdottir H, Goodenough D, Oskarsdottir G, Olafsson I, Fredriksson J, Mallozzi R, Healy A, Kristbjornsson A, Kristinsson S, Levy J. SU-E-P-50: Automated Uniformity Measurements Using a Comprehensive Tomosynthesis QA Phantom. Med Phys 2015. [DOI: 10.1118/1.4923984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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15
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Fredriksson J, Olafsdottir H, Levy J, Kristinsson S, Healy A, Dalbow G, Goodenough D, Pawlicki T. SU-C-134-01: CT Performance Assessment Using Statistical Processing Control Cloud-Based Image Processing. Med Phys 2013. [DOI: 10.1118/1.4813976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Healy A, Levy J, Fredriksson J, Olafsdottir H, Kristinsson S, Dalbow G, Pawlicki T, Goodenough D. SU-E-J-114: Automated Processing of Sensitometry Data for Radiation Therapy Treatment Planner and Quality Assurance. Med Phys 2013. [DOI: 10.1118/1.4814326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Goodenough D, Levy J, Kristinsson S, Fredriksson J, Olafsdottir H, Healy A. WE-G-217BCD-11: A New Phantom to Study Combined Effects of In-Plane (x,y) and Z Axis Resolution for 3-D Imaging. Med Phys 2012; 39:3974-3975. [PMID: 28519626 DOI: 10.1118/1.4736219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The aim of this work is to develop phantoms that can be used to sample the radial and 3D properties of a CT image, including in-plane (x,y) and z-axis information. The Phantom is amenable to mathematical analysis of the x, y, and z axis resolution properties separately and combined. METHODS A periodic pattern of a pair of opposed (30°) angled ramps is configured to produce a waveform profile across the CT image. A perfect CT image (with no loss of resolution) of the test object would produce a consistent geometric pattern of the intersection of a line with the pair of angled ramps. However, due to the finite resolution (x, y and z), the CT waveform profile will not yield the perfect profile; rather it will be influenced by slice thickness, and in-plane resolution (PSF, MTF), as well as noise limitations, and other sources of non-uniformity such as beam hardening etc. Various characteristics of the waveform profile including, amplitude, frequency, and slope (rate of climb) of the peaks, can be studied using mathematical analysis such as the Fourier transform. It will be shown how these performance characteristics are encoded in the wave pattern. RESULTS The waveform profiles are visually examined and mathematically analyzed, to demonstrate the effect of Slice Thickness (z axis) and changes of In-Plane (x,y) Resolution and non-uniformity across the image field; moreover, the harmonic analysis of the waveform is used to predict, either the in-plane resolution (MTF), or the z-axis MTF when one of the two is already known. CONCLUSIONS The Wave pattern phantom offers a way to consider 3-D imaging characteristics of a CT scanner by scanning a single repetitive test object that encodes both in-plane resolution and z-axis resolution and also offers a way to study non-uniformity effects throughout the CT plane (volume). DJG is a consultant to The Phantom Laboratory and Image OWL, Salem, NY. Funding of other authors is supplied by Image OWL Salem, NY.
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Affiliation(s)
- D Goodenough
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
| | - J Levy
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
| | - S Kristinsson
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
| | - J Fredriksson
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
| | - H Olafsdottir
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
| | - A Healy
- The George Washington University.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY.,Image Owl, Salem, NY
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Marteinsdóttir M, Olafsdottir H, Fredriksson J, Andresson A, Healy A, Kristbjornsson A, Kristinsson S, Levy J, Goodenough D. SU-E-I-38: Optimizing CT Slice Width Measurements. Med Phys 2012; 39:3633. [PMID: 28519500 DOI: 10.1118/1.4734753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE For almost four decades bead and wire ramps have been used in the evaluation of slice width as part of QA testing for CT scanners. While each of these approaches have been recognized and accepted as reliable, in this paper we investigate the differences, advantages and limitations of these tools. Moreover, we study the effect of varying the field of view (FOV) and focal spot size. METHODS The Catphan® 700 phantom includes two pairs of bead ramps (coarse and fine) and a pair of wire ramps in the same module providing an ideal setting for comparing bead ramps and wire ramps. The phantom was scanned using three devices from two different manufacturers. The data set consisted of 428 slices of 0.5,1,2,4,8 and 10 mm thickness. For the study of FOV and focal spot, 512 slices from the Catphan® 600 were acquired. All images were analyzed using Image Owl Catphan® QA software. RESULTS For 0.5mm slices, bead ramps gave more accurate and precise (lower variance) estimation of the thickness than wire ramps. For 2-4 mm slices, the two approaches performed on equal terms while for the thickest slices (8 and 10mm), the wires gave more precise results. For thin slices, a small FOV (100mm) gave better results and lower spread than a large FOV (240mm). Finally, a small focal spot gave significantly better results than a large one using wire ramps for 0.5 and 1mm slices. CONCLUSIONS For measuring thin slices, the use of bead ramps, with adequately small FOV and a small focal spot should be advised. For measuring thick slices, wire ramps will give less variability although bead ramps give equally accurate results on average. Funding provided by The Phantom Laboratory, Incorporated and Image Owl, Incorporated.
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Affiliation(s)
- M Marteinsdóttir
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - H Olafsdottir
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - J Fredriksson
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - A Andresson
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - A Healy
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - A Kristbjornsson
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - S Kristinsson
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - J Levy
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
| | - D Goodenough
- Stockholm University, Stockholm, Sweden.,Image Owl, Salem, NY.,Raforninn, Reykjavik, Iceland.,The Phantom Laboratory, Salem, NY.,George Washington University, Washington DC
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19
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Fredriksson J, Goodenough D, Healy A, Kristbjornsson A, Kristinsson S, Levy J, Olafsdottir H. SU-E-I-37: A Renewed Look at CT Numbers as Encountered in the Diagnostic and Therapeutic Range. Med Phys 2012; 39:3633. [DOI: 10.1118/1.4734752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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20
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Fredriksson J, Olafsdottir H, Kristbjornsson A, Healy A, Levy J, Goodenough D, Kristinsson S. SU-C-217BCD-04: Application of Statistical Process Control to Long Term CT Constancy Testing. Med Phys 2012. [DOI: 10.1118/1.4734639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Macklin K, Healy A, Chockalingam N. The effect of calf muscle stretching exercises on ankle joint dorsiflexion and dynamic foot pressures, force and related temporal parameters. Foot (Edinb) 2012; 22:10-7. [PMID: 21944945 DOI: 10.1016/j.foot.2011.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 08/31/2011] [Accepted: 09/02/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous research has found that ankle joint equinus can lead to foot pathologies. Calf stretching exercises are a common treatment prescription; however, no dynamic quantitative data on its effectiveness is available. OBJECTIVE To investigate the effect of calf muscle stretching on ankle joint dorsiflexion and subsequent changes within dynamic forefoot peak plantar pressures (PPP), force and temporal parameters. METHOD Thirteen runners with ankle joint equinus were required to perform calf muscle stretching twice a day (morning and evening) on a Flexeramp. Measurements were collected on day 1, week 4 and week 8. A repeated measures ANOVA with Bonferroni-adjusted post hoc comparisons was used to assess differences across the three data collection sessions. RESULTS Findings indicated that the calf stretching program increased ankle joint dorsiflexion significantly (from 5° to 16°, p≤0.05). The adaptive kinetics brought about by the increased ankle joint range of motion included significantly increased forefoot PPP and maximum force during stance phase but decreased time between heel contact and heel lift and total stance phase time. CONCLUSION The calf stretching programme used in this study was found to increase ankle joint dorsiflexion and hence can be used for first line conservative management of ankle equinus.
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Affiliation(s)
- K Macklin
- Centre for Sport, Health and Exercise Research, Staffordshire University, ST4 2DF, UK
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22
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Needham R, Chockalingam N, Naemi R, Shannon T, Healy A. Validation of a multi-segment spinal model for kinematic analysis and a comparison of different data processing techniques. Stud Health Technol Inform 2012; 176:151-154. [PMID: 22744479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Optoelectronic motion capture technology is a useful tool in the quantitative dynamic assessment of the spine. In a clinical setting this may help gain a further understanding of underlining musculoskeletal pathology. It is therefore important that accurate measurements are made to allow data to be comparable across various investigations. This report outlines a new multi-segment spinal model and its validation. A mechanical model consisting of an upper thoracic (UT), lower thoracic and lumbar segment was developed allowing for range of motion assessment. An electrogoniometer and torsiometer were attached to the model to provide a control measurement. The UT segment was chosen for analysis and static trials were collected at angles ranging from 2-45°. Kinematic data was captured using an optoelectronic motion capture system. Software computed angles corresponded well with the control measure. While highlighting the differences in the estimation of angles between software platforms, this study emphasizes the need for the clear description and understanding of the kinematic model used.
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Affiliation(s)
- R Needham
- Staffordshire University, Stoke on Trent, UK.
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23
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Needham R, Chockalingam N, Dunning D, Healy A, Ahmed EB, Ward A. The effect of leg length discrepancy on pelvis and spine kinematics during gait. Stud Health Technol Inform 2012; 176:104-107. [PMID: 22744469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There are assumptions that leg length discrepancy (LLD) may cause low back pain by creating pelvis obliquity and lumbar scoliosis. Although individuals with LLD develop compensatory movements in the lower limbs and pelvis during walking, few investigations have attempted to identify kinematic variables of the upper body. This study aims to gain an understanding of how simulated LLD influences three-dimensional motion of the pelvis and spine. Seven male participants were required to walk barefoot at a preferred speed. Three LLD conditions (1, 2, and 3cm) were simulated using modified pieces of high density EVA attached to the right foot. An optoelectronic motion analysis system was used to record kinematic data of the pelvis and spine (lumbar, lower and upper thoracic segments) for each condition. Differences in range of motion and patterns of movement for the pelvis and lumbar spine were minimal between barefoot and LLD conditions. These observations could be attributed to various kinematic compensatory strategies within the lower limbs which require further in-depth investigation.
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Affiliation(s)
- R Needham
- Staffordshire University, Stoke on Trent, UK.
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24
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Healy A, Baird B, Weng C, Stehlik J, Selzman C. 361 VAD-Related Complications Do Not Influence Long-Term Post-Transplant Survival – An Analysis of the UNOS Database. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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25
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Chukudebelu O, Leonard DS, Healy A, McCoy D, Charles D, Hone S, Rafferty M. The effect of gastric decompression on postoperative nausea and emesis in pediatric, tonsillectomy patients. Int J Pediatr Otorhinolaryngol 2010; 74:674-6. [PMID: 20381174 DOI: 10.1016/j.ijporl.2010.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 03/04/2010] [Accepted: 03/08/2010] [Indexed: 10/19/2022]
Affiliation(s)
- O Chukudebelu
- Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland.
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26
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Heuer C, Healy A, Zerbini C. Economic Effects of Exposure to Bovine Viral Diarrhea Virus on Dairy Herds in New Zealand. J Dairy Sci 2007; 90:5428-38. [DOI: 10.3168/jds.2007-0258] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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27
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Gilmore BF, Lynas JF, Harriott P, Healy A, Walker B. Peptides containing acylated C-terminal gem diamines: novel irreversible inactivators of the cysteine and serine proteinases. Chem Biol Drug Des 2006; 67:364-9. [PMID: 16784461 DOI: 10.1111/j.1747-0285.2006.00390.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study reports on the synthesis of peptides containing C-terminal acylated gem-diamines and their utilization for the preparation of irreversible inactivators of the serine and cysteine proteinases. We have succeeded in obtaining an inhibitor Acetyl-Val-Pro-g-Val-CO-O-C(6)H(4)-NO(2) of neutrophil and pancreatic elastases that functions in a time-dependent manner, indicative of the action of an irreversible inactivator, functioning, most probably, through the formation of a long-lived acyl enzyme intermediate. In addition, we have demonstrated the irreversible inhibition of the cysteine proteinase bovine cathepsin B, by chloroacetyl and bromoacetyl derivatives of a dipeptide gem-diamine, Cbz-Phe-g-Ala-CO-CH(2)Hal (Hal = Br, Cl).
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Affiliation(s)
- B F Gilmore
- The School of Pharmacy, McClay Research Centre, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK.
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28
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Rasmusson K, Long J, Nelson K, Healy A, Blank D, Renlund D, Rasmusson B, Smith H, Clayson S, Kfoury A. 296. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Rasmusson K, Long J, Child J, Rasmusson B, Renlund D, Healy A, Brush S, Kerwin B, Kfoury A. 308. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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30
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Healy JA, Cross TF, Healy A. The alpha-Gpdh polymorphism in the tick Ixodes ricinus: similar diurnal trends in genotypic composition in Irish and Swedish population samples. Exp Appl Acarol 2004; 32:111-118. [PMID: 15139277 DOI: 10.1023/b:appa.0000018198.83551.72] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Analysis of the alpha-Gpdh locus, coding for the enzyme alpha-glycerophosphate dehydrogenase (glycerol-3-phosphate dehydrogenase), was conducted using starch-gel electrophoresis on samples from one Irish and one Swedish population of the tick Ixodes ricinus. Morning ('AM') and late afternoon ('PM') samples of unfed adults were collected in each case. The results show a higher frequency of homozygotes in females in the AM than in the PM sub-samples in both populations. No such diurnal differentiation was found in the case of male ticks. The results are discussed in relation to previous studies on the polymorphism in Ireland and in the context of the known metabolic role of alpha-glycerophosphate dehydrogenase in insect muscle. The possible selective influence of climatological factors is considered.
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Affiliation(s)
- J A Healy
- Department of Zoology, Ecology and Plant Science, University College, Cork, Ireland.
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31
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O'Doherty E, Healy A, Aherne M, Hanrahan JP, Weavers E, Doherty M, Roche JF, Gunn M, Sweeney T. Prion protein (PrP) gene polymorphisms associated with natural scrapie cases and their flock-mates in Ireland. Res Vet Sci 2002; 73:243-50. [PMID: 12443681 DOI: 10.1016/s0034-5288(02)00073-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The PrP genotypes associated with natural scrapie in Ireland were determined and a comparison was made between genotypes found in scrapie-infected sheep and those found in healthy animals from scrapie-infected flocks. Seven PrP genotypes were identified in scrapie-infected animals: VV(136)RR(154)QQ(171),VA(136)RR(154)QQ(171),VA(136)RR(154)QR(171),VA(136)RR(154)QH(171),AA(136)RR(154)QQ(171),AA(136)RR(154)QH(171) and AA(136)RR(154)HH(171). Of 11 scrapie-infected flocks, 15 genotypes were identified in the healthy flock-mates. The genotypes identified in scrapie-affected animals were also all identified in healthy flock-mates. In 9 of the 11 flocks studied, the genotype frequencies among scrapie-infected animals were significantly different from those among healthy flock-mates. The results show that there is a significant risk of developing the clinical signs of scrapie associated with particular PrP genotypes in the Irish sheep population. The association between the V(136)R(154)Q(171) allele and scrapie was evident, as was the association between A(136)R(154)R(171) and resistance to developing the clinical signs of scrapie. The presence of the A(136)H(154)Q(171) allele in the flocks examined resulted in a decreased risk of developing scrapie compared to the presence of the A(136)R(154)Q(171).
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Affiliation(s)
- E O'Doherty
- Department of Animal Husbandry and Production, Faculty of Veterinary Medicine, U.C.D., Ballsbridge, Dublin, Ireland
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33
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Burke FJ, Crisp RJ, Bell TJ, Healy A, Mark B, McBirnie R, Osborne-Smith KL. One-year retrospective clinical evaluation of hybrid composite restorations placed in United Kingdom general practices. Quintessence Int 2001; 32:293-8. [PMID: 12066649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE The purpose of this study was to assess Pertac II restorations placed in general dental practice. METHOD AND MATERIALS A total of 86 restorations (14 Class I, 10 Class II, 17 Class III, 5 Class IV, and 40 Class V) using a hybrid composite material (Pertac II) placed in 56 patients (mean age, 39 years) in 5 dental practices in the United Kingdom were assessed after 1 year by a trained evaluator and the dental practitioner who had placed the restoration. All the restorations were assessed for anatomic form, marginal adaptation, surface roughness, sensitivity or discomfort, gingival condition, and the presence or absence of secondary caries. RESULTS Thirty-five (43%) restorations were placed in load-bearing situations, 9% of which were assessed as being in "heavy" occlusion. Five (6%) of the restorations were lost (all Class V restorations), 4 from premolars and 1 from a molar. Four were in wedge-shaped cavities and 1 small restoration was actually dislodged during examination. The remaining 81 (94%) restorations were found to be intact, with no secondary caries detected. A high percentage of optimal scores were recorded for both anatomic form and surface roughness. CONCLUSION It is concluded that the evaluation demonstrated satisfactory clinical performance of Pertac II restorations after 1 year of clinical service in the wide variety of clinical situations seen in general dental practice. However, the potential for failure of hybrid composite materials in Class V situations appears high. It may be argued that clinicians who wish to use a resin-based material in a Class V situation should use a compomer or microfilled composite.
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Affiliation(s)
- F J Burke
- University of Birmingham School of Dentistry, Primary Dental Care Research Group, St. Chad's Queensway, Birmingham B4 6NN, United Kingdom.
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Walker B, Wharry S, Hamilton RJ, Martin SL, Healy A, Walker BJ. Asymmetric preference of serine proteases toward phosphonate and phosphinate esters. Biochem Biophys Res Commun 2000; 276:1235-9. [PMID: 11027616 DOI: 10.1006/bbrc.2000.3597] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have previously reported the asymmetric synthesis of (alpha-aminoalkyl) diphenylphosphonate and phosphinate derivatives designed as inhibitors of chymotrypsin- and elastase-like proteases. This paper reports the first kinetic evaluation of individual epimers of the (alpha-aminoalkyl) diphenylphosphonates as inactivators of chymotrypsin, cathepsin G and neutrophil elastase (HNE). Results show that the (R)-epimers consistently function as more potent irreversible inactivators of their respective target proteases than the corresponding (S)-epimers. Additionally, phosphinate analogues were found to be consistently superior to their diphenylphosphonate counterparts. For example, Cbz. Phe(P)(OPh)-(CH(2))(2)-CO(2)Et inactivates cathepsin G approximately 45-fold more rapidly (k(i)/K(i) = 1.2 x 10(5) M(-1). min(-1)) than the analogous Cbz.Phe(P)(OPh)(2) (2.6 x 10(3) M(-1). min(-1)). Similarly, Cbz.Val(P)(OPh)-(CH(2))(2)-CO(2)Et was found to inactivate HNE some 3-fold more efficiently than Cbz.Val(P)(OPh)(2) (6.5 x 10(3) and 2.0 x 10(3) M(-1). min(-1), respectively).
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Affiliation(s)
- B Walker
- Division of Biomedicinal Chemistry, School of Pharmacy, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, United Kingdom
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35
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Healy A. Training for transformation: reorientating primary health care nurses for the provision of mental health care in South Africa. Clin Excell Nurse Pract 2000; 4:256-8. [PMID: 11261091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Healy A, Elliott EP. Developing case management in a nursing home environment. Nurs Case Manag 1999; 4:112-21. [PMID: 10476181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Abstract
We trained parents to conduct functional analyses and functional communication treatment for 28 young children with developmental disabilities who displayed aberrant behavior. Of this sample, 22 parents conducted treatment for at least 3 months and 11 for 1 year. We conducted single-case analyses of the results of assessment and treatment. The functional analysis identified social functions (positive and negative reinforcement) for 86% (24 of 28) of the children. Treatment resulted in a pre/post decrease in aberrant behavior averaging 87% across the range of children, with the greatest decrease occurring at 3 months. Appropriate social responding increased, on average, by 69% across the range of children. Decreases in aberrant behavior were demonstrated in all children, and all except one child displayed increased social behavior during treatment. On a measure of parent-rated treatment acceptability, ranging from 1 (not at all acceptable) to 7 (very acceptable), the average overall acceptability was 6.35.
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Affiliation(s)
- D P Wacker
- Department of Pediatrics, University of Iowa, Iowa City
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40
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Lynas JF, Harriott P, Healy A, McKervey MA, Walker B. Inhibitors of the chymotrypsin-like activity of proteasome based on di- and tri-peptidyl alpha-keto aldehydes (glyoxals). Bioorg Med Chem Lett 1998; 8:373-8. [PMID: 9871688 DOI: 10.1016/s0960-894x(98)00030-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A series of peptidyl alpha-keto aldehydes (glyoxals) have been synthesised as putative inhibitors of the chymotryptic-like activity of proteasome. The most potent peptides, Cbz-Leu-Leu-Tyr-COCHO and Bz-Leu-Leu-Leu-COCHO, function as slow-binding reversible inhibitors, exhibiting final Ki values of approximately 3.0 nM. These are among the lowest values so far reported for (tri)peptide-based aldehyde-related inhibitors.
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Affiliation(s)
- J F Lynas
- Centre for Peptide and Protein Engineering, School of Biology and Biochemistry, Queen's University Belfast, Northern Ireland, U.K
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41
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Affiliation(s)
- A Healy
- Division of Developmental Disabilities, University of Iowa, University Hospital School, Iowa City 52242, USA
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Singh TK, Fox PF, Healy A. Isolation and identification of further peptides in the diafiltration retentate of the water-soluble fraction of Cheddar cheese. J DAIRY RES 1997; 64:433-43. [PMID: 9275258 DOI: 10.1017/s0022029997002227] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Several peptides were isolated from the diafiltration retentate, prepared using 10 kDa membranes, of the water-soluble extract from a commercial mature Cheddar cheese and identified by amino acid sequencing and mass spectrometry. Most of the peptides were from the N-terminal half of the beta-casein, but peptides from alpha s1- and alpha s2-caseins were also identified; the extract also contained alpha-lactalbumin. Identified peptides showed the important role played by lactococcal cell envelope proteinases in the degradation of primary proteolytic products from alpha s1- and beta-caseins, produced by chymosin and plasmin respectively. Plasmin seemed to be involved in the hydrolysation of alpha s2-casein. Several phosphopeptides were identified and the action of phosphatase on these peptides was evident.
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Affiliation(s)
- T K Singh
- Department of Food Chemistry, University College, Cork, Irish Republic
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Abstract
The specificity of the extracellular proteinase from Brevibacterium linens ATCC 9174 on bovine beta-casein was studied. Hydrolysis was monitored over time by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (PAGE) and urea-PAGE. The major pH 4.6-soluble peptides were isolated by high-performance liquid chromatography and identified by N-terminal amino acid sequencing and mass spectrometry. The major sites of hydrolysis were Ser-18-Ser-19, Glu-20-Glu-21, Gln-56-Ser-57, Gln-72-Asn-73, Leu-77-Thr-78, Ala-101-Met-102, Phe-119-Thr-120, Leu-139-Leu-140, Ser-142-Trp-143, His-145-Gln-146, Gln-167-Ser-168, Gln-175-Lys-176, Tyr-180-Pro-181, and Phe-190-Leu-191. The proteinase had a broad specificity for the amino acid residues present at the P1 and P'1 positions but showed a preference for hydrophobic residues at the P2, P3, P4, P'2, P'3, and P'4 positions.
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Affiliation(s)
- F P Rattray
- Department of Food Chemistry, University College, Cork, Ireland.
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44
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Healy A. Is GA for orthodontic extractions in children necessary? Br Dent J 1996; 181:319. [PMID: 8972948 DOI: 10.1038/sj.bdj.4809247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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45
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Mannix ET, Healy A, Farber MO. Aerobic power and supramaximal endurance of competitive figure skaters. J Sports Med Phys Fitness 1996; 36:161-8. [PMID: 8979645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE HYPOTHESES 1) figure skaters possess average aerobic power; 2) on-ice training would not improve aerobic power of supramaximal endurance; 3) off-ice training plus on-ice training would improve aerobic power and supramaximal endurance. EXPERIMENTAL DESIGN This was a prospective, controlled study in which we monitored ice skaters before, during and after two different 10 week training programs. SETTING Athletes training for competition sanctioned by the United States Figure Skating Association. PARTICIPANTS 15 figure skaters (12 females) enrolled at an ice skating academy were randomly placed in two study groups. INTERVENTIONS Grp 1 maintained on-ice training and Grp 2 supplemented on-ice with cycle ergometer training. MEASURES Maximum O2 consumption (VO2peak) during cycle ergometer exercise, anaerobic threshold, HR, supramaximal exercise time and the lactate (LACT) response to exercise. RESULTS (*, p < 0.05), Grp 1: VO2peak, pre = 44.2 +/- 2.2 ml/[kg.min], post = 41.4 +/- 1.6 ml/[kg.min]; VO2peak% (% predicted), pre = 100 +/- 5%, post = 92 +/- 4%; anaerobic threshold as % VO2peak (AT%), pre = 74 +/- 3%, post = 73 +/- 3%; Supramaximal Time, pre = 0.87 +/- 0.12 min, post = 0.94 +/- 0.12 min; lower LACT occurred at VO2peak and supramaximal exercise following on-ice training. Grp 2: VO2peak, pre = 50.7 +/- 3.6 ml/[kg.min], post = 55.9 +/- 3.3 ml/[kg.min]*; VO2peak%, pre = 110 +/- 7%, post = 121 +/- 6%*; AT%, pre = 80 +/- 2%, post = 83 +/- 2%*; Supramaximal Time, pre = 1.31 +/- 0.18 min, post = 2.69 +/- 0.66 min*; lower LACT occurred at 50%, 75% and VO2peak following training. CONCLUSIONS 1) Grp 1 plus Grp 2 had average aerobic power (VO2peak = 105 +/- 3% of predicted) prior to the study; 2) on-ice training did not affect aerobic power or supramaximal endurance, while off-ice training improved these parameters; 3) the LACT response detected training adaptations.
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Affiliation(s)
- E T Mannix
- Indiana University Department of Medicine, Indianapolis 46202, USA
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Abstract
The specificity of the extracellular proteinase from Brevibacterium linens ATCC 9174 on bovine alpha s1-casein was studied. Hydrolysis was monitored over time by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (PAGE) and urea-PAGE. The major pH 4.6-soluble peptides were isolated by high-performance liquid chromatography and identified by N-terminal amino acid sequencing and mass spectrometry. The time course of peptide formation indicated that His-8-Gln-9, Ser-161-Gly-162, and either Gln-172-Tyr-173 or Phe-23-Phe-24 were the first, second, and third bonds cleaved, respectively. Other cleavage sites included Asn-19-Leu-20, Phe-32-Gly-33, Tyr-104-Lys-105, Leu-142-Ala-143, Phe-150-Arg-151, Gln-152-Phe-153, Leu-169-Gly-170, and Thr-171-Gln-172. The proteinase had a broad specificity for the amino acid residues at the P1 and P'1 positions but showed a preference for hydrophobic residues at the P2, P3, P4, P'2, P'3, and P'4 positions.
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Affiliation(s)
- F P Rattray
- Department of Food Chemistry, University College, Cork, Ireland.
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Singh TK, Fox PF, Healy A. Water-soluble peptides in Cheddar cheese: isolation and identification of peptides in the diafiltration retentate of the water-soluble fraction. J DAIRY RES 1995; 62:629-40. [PMID: 8568032 DOI: 10.1017/s0022029900031368] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The water-soluble extract of Cheddar cheese was fractionated by diafiltration using 10 kDa cut-off membranes. Peptides were isolated from the diafiltrate retentate by chromatography on DEAE-cellulose with a linear NaCl gradient in 50 mM-Tris-HCl. pH 8.6, and reversed-phase HPLC or electroblotting from urea-PAGE gels. Peptides were identified by determining N-terminal amino acid sequences and mass spectrometry. Most (45) of the total 51 peptides identified in the diafiltrate retentate originated from beta-casein, especially from a short region in the N-terminal half of the molecule. Only six peptides originated from alpha s1-casein; beta-lactoglobulin was also identified in the retentate. The origin of most of these peptides could be explained on the basis of known specificities of lactococcal cell envelope proteinases.
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Affiliation(s)
- T K Singh
- Department of Food Chemistry, University College, Cork, Irish Republic
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Abstract
Proteolysis of bovine alpha s2-casein by chymosin (E. C. 3.4.23.4) in solution in 100 mM Na phosphate buffer, pH 6.5, at 30 degrees C was studied by reversed-phase (RP)-HPLC and urea-polyacrylamide gel electrophoresis (PAGE). Chymosin hydrolyzed alpha s2-casein in solution to eight peptides detectable by urea-PAGE. Peptides soluble in acetate buffer, pH 4.6, were isolated by RP-HPLC on a C18 column using an acetonitrile/water gradient and identified from their N-terminal amino acid sequence. The chymosin cleavage sites were at the bonds Phe88-Tyr89, Tyr95-Leu96, Gln97-Tyr98, Tyr98-Leu99, Phe163-Leu164, Phe174-Ala175 and Tyr179-Leu180. Chymosin cleavage sites were restricted to the hydrophobic regions of the molecule. The bond-type in alpha s2-casein cleaved by chymosin was in agreement with that found to be susceptible to chymosin in other caseins. The primary site of chymosin action on alpha s2-casein appeared to be at Phe88-Tyr89.
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Affiliation(s)
- P L McSweeney
- Center for Dairy Research, University of Wisconsin, Madison 53706
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Affiliation(s)
- P L McSweeney
- Department of Food Chemistry, University College, Cork, Irish Republic
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50
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Greising T, Monaghan P, Healy A, Gordon A, Gallagher M, Wahid H, Gordon I. The influence of cytoplasmic composition and quantity of cytoplasm in recipient oocytes on the developmental capacity of bovine nuclear transfer embryos. Theriogenology 1994. [DOI: 10.1016/s0093-691x(05)80118-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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