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Wiesen B, Atwell M, Leavitt C, Clark N, Kessler E, Lam E, Flaig T, Kukreja J, Kim S, Maroni P, Cost NG. Use of Peripheral Intravenous Access in Patients Undergoing Chemotherapy for Testicular Cancer. JCO Oncol Pract 2024; 20:361-369. [PMID: 38127812 DOI: 10.1200/op.23.00580] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/27/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Systemic chemotherapy, depending on the regimen, can be administered through peripheral intravenous (pIV) access or through central venous access devices (CVADs). There is no current best practice regarding optimal access for chemotherapy for patients with testicular cancer (TC). We retrospectively evaluated patients undergoing systemic chemotherapy for TC and compared baseline characteristics and complications of patients using pIV versus CVADs. METHODS We included patients with TC who underwent first-line systemic chemotherapy at the University of Colorado Hospitals from 2005 to 2020. Data were collected on demographics, cancer characteristics, type, duration of chemotherapy, pIV or CVAD use, and associated complication rates. We then performed univariate and multivariate regression analyses to compare complication rates and risk factors for each group. RESULTS One hundred fifty-four patients met inclusion criteria. Ninety-two (60%) patients used CVADs, and 62 patients (40%) used pIV for their initial treatment. Only six (9.7%) of 62 patients transitioned from pIV to CVADs during therapy. Similarly, 10 of 92 (10.9%) patients with initial CVAD needed to transition to a different type of CVAD or to pIV (P = .81). There were a greater number of venous access-related complications (48 of 92 patients, 52.2%) and overall thrombotic events (33 of 92 patients, 35.9%) for the CVAD group (P > .001) when compared with the pIV group. We observed an association between the following factors and venous access-related complications during chemotherapy: higher stage TC, increased total chemotherapy cycles, and delayed therapy. CONCLUSION Peripheral IV use for first-line nonvesicant chemotherapy in patients with TC appears to be well tolerated with high rates of therapy completion and lower rates of complications when compared with CVADs. These data support our preferred treatment approach and provide evidence that pIV access is a safe and effective way to deliver chemotherapy for patients with TC.
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Affiliation(s)
- Brett Wiesen
- The University of Colorado, Division of Urology, Aurora, CO
| | - Michael Atwell
- The University of Colorado, Division of Urology, Aurora, CO
| | - Colton Leavitt
- The University of Utah, Department of Urology, Salt Lake City, UT
| | - Nathan Clark
- The University of Colorado, Division of Urology, Aurora, CO
| | - Elizabeth Kessler
- The University of Colorado, Division of Medical Oncology, Aurora, CO
| | - Elaine Lam
- The University of Colorado, Division of Medical Oncology, Aurora, CO
| | - Thomas Flaig
- The University of Colorado, Division of Medical Oncology, Aurora, CO
| | - Janet Kukreja
- The University of Colorado, Division of Urology, Aurora, CO
| | - Simon Kim
- The University of Colorado, Division of Urology, Aurora, CO
| | - Paul Maroni
- The University of Colorado, Division of Urology, Aurora, CO
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Barnard LM, Spark TL, Leavitt C, Leary J, Lehmkuhl LJ, Johnston N, Wallace EA. Leveraging Community Context, Data, and Resources to Inform Suicide Prevention Strategies. J Law Med Ethics 2023; 51:83-92. [PMID: 37226747 DOI: 10.1017/jme.2023.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Colorado has consistently had one of the highest rates of suicide in the United States, and El Paso County has the highest number of suicide and firearm-related suicide deaths within the state. Community-based solutions like those of the Suicide Prevention Collaborative of El Paso County may be more effective in preventing suicide as they are specific to local issues, sensitive to local culture, and informed by local data, community members, and stakeholders.
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Affiliation(s)
| | | | | | | | - Lee J Lehmkuhl
- FIRST CONGREGATIONAL UNITED CHURCH OF CHRIST, COLORADO SPRINGS, CO, USA
| | - Nicole Johnston
- SUICIDE PREVENTION COLLABORATIVE OF EL PASO COUNTY, COLORADO SPRINGS, CO, USA
| | - Erik A Wallace
- UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, AURORA, CO, USA
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Ogundipe EA, Behrendt N, Leavitt C, Reynolds R, Vemulakonda VM. Prenatal and Early Postnatal Outcomes for Fetuses with Anatomic or Functional Renal Agenesis. Fetal Diagn Ther 2022; 49:411-418. [PMID: 36198283 DOI: 10.1159/000526820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The advent of novel fetal interventions has increased interest in interventions for previously "lethal" anomalies such as bilateral renal agenesis or other congenital anomalies of the kidney and urinary tract (CAKUT) associated with in utero renal failure. While there have been rare reports of successful births following intervention in these cases, there is a paucity of data regarding the risks, benefits, and outcomes of intervention. To address this gap, this study presents our experience with fetal intervention for anatomic or functional renal agenesis. CASE PRESENTATION A retrospective review was conducted for patients referred to the Colorado Fetal Care Center (CFCC) between 2013 and 2019 for evaluation of CAKUT anomalies. Eligibility was determined by a multidisciplinary team. Amnioinfusion was scheduled prior to 24 weeks gestation, with normal saline or lactated ringers infused as needed to obtain a "normal" amniotic fluid volume. During this time period, a total of 5 cases received fetal amnioinfusion for treatment of bilateral renal agenesis or bladder outlet obstruction. All 5 cases reached birth. 3/5 cases expired on day one of life. 1/2 of the remaining infants expired at 3 months secondary to peritoneal dialysis failure. The remaining infant is 4 years. Developmentally, she is on track with cognitive and language skills but is behind with general motor skills. We observed a 30-day mortality of 60% and 1-year mortality of 80%. CONCLUSIONS Individuals carrying a pregnancy complicated by CAKUT anomalies face a difficult choice when considering intervention. Morbidity and mortality remain high at this stage of this evolving therapy, including difficulty with retaining infused intra-amniotic fluid >72 h and complications with peritoneal dialysis after birth. The surviving infant in this case series is 4 years. She currently awaits renal transplantation. These findings reinforce that treatment of these cases should remain experimental and large-scale multicenter trials are needed to determine the optimal indications for prenatal intervention.
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Affiliation(s)
- Eniola A Ogundipe
- Division of Urology, Department of Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
| | | | - Colton Leavitt
- Division of Urology, Department of Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Regina Reynolds
- Department of Neonatal/Perinatal Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Vijaya M Vemulakonda
- Division of Urology, Department of Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
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Heinzelmann K, Hu Q, Hu Y, Dobrinskikh E, Ansari M, Melo-Narváez MC, Ulke HM, Leavitt C, Mirita C, Trudeau T, Saal ML, Rice P, Gao B, Janssen WJ, Yang IV, Schiller HB, Vladar EK, Lehmann M, Königshoff M. Single-cell RNA sequencing identifies G-protein coupled receptor 87 as a basal cell marker expressed in distal honeycomb cysts in idiopathic pulmonary fibrosis. Eur Respir J 2022; 59:2102373. [PMID: 35604813 PMCID: PMC9203838 DOI: 10.1183/13993003.02373-2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/02/2022] [Indexed: 11/15/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a devastating and life-threatening lung disease characterised by epithelial reprogramming and increased extracellular matrix deposition leading to loss of lung function. Prominent histopathological structures in the distal IPF lung include honeycomb cysts in the alveolar space [1]. These are heterogeneous bronchiolised areas that feature clusters of simple epithelium with keratin (KRT)5+ basal-like cells interspersed with pseudostratified epithelium containing differentiated, hyperplastic epithelial cells, as well as aberrant ciliated cells [2–5]. Recent single-cell RNA sequencing studies of whole lungs from IPF and donor tissue revealed cellular subtypes unique to IPF, including basaloid KRT5−/KRT17+ cells present in the distal lung [6–10]. Bronchiolisation and honeycombing are features of IPF. ScRNA sequencing identified GPR87 as a novel marker of basal cells in IPF, enriched in honeycomb cysts. GPR87 overexpression resulted in aberrant airway cell differentiation. https://bit.ly/3i4dXeT
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Affiliation(s)
- Katharina Heinzelmann
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- K. Heinzelmann and Q. Hu contributed equally
| | - Qianjiang Hu
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- K. Heinzelmann and Q. Hu contributed equally
| | - Yan Hu
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Evgenia Dobrinskikh
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Meshal Ansari
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - M Camila Melo-Narváez
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Henrik M Ulke
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Colton Leavitt
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Carol Mirita
- Eastern Colorado VA Healthcare System, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Tammy Trudeau
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Maxwell L Saal
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Pamela Rice
- Eastern Colorado VA Healthcare System, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Bifeng Gao
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - William J Janssen
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, National Jewish Health, Denver, CO, USA
| | - Ivana V Yang
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Herbert B Schiller
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Eszter K Vladar
- Dept of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Dept of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mareike Lehmann
- Institute of Lung Health and Immunity, Comprehensive Pneumology Center Munich, Helmholtz Zentrum München, Member of the German Center for Lung Research (DZL), Munich, Germany
- M. Lehmann and M. Königshoff contributed equally to this article as lead authors and supervised the work
| | - Melanie Königshoff
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- M. Lehmann and M. Königshoff contributed equally to this article as lead authors and supervised the work
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Stanislawski MA, Lange LA, Raffield LM, Zakai NA, Meyer M, Ferrier K, Szeto MD, Leavitt C, Shortt JA, Thornton TA, Tracy RP, Auer PL, Reiner AP, Lange EM, Olson NC. Soluble CD14 Levels in the Jackson Heart Study: Associations With Cardiovascular Disease Risk and Genetic Variants. Arterioscler Thromb Vasc Biol 2021; 41:e369-e378. [PMID: 33910371 DOI: 10.1161/atvbaha.121.316035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/20/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Maggie A Stanislawski
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | - Leslie A Lange
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.).,Department of Epidemiology (L.A.L.), University of Colorado School of Public Health, Aurora
| | - Laura M Raffield
- Department of Genetics, University of North Carolina, Chapel Hill (L.M.R.)
| | - Neil A Zakai
- Department of Pathology and Laboratory Medicine (N.A.Z., R.P.T., N.C.O.), Larner College of Medicine, University of Vermont, Burlington.,Department of Medicine (N.A.Z.), Larner College of Medicine, University of Vermont, Burlington
| | - Mariah Meyer
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | - Kendra Ferrier
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | - Mindy D Szeto
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | - Colton Leavitt
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | - Jonathan A Shortt
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.)
| | | | - Russell P Tracy
- Department of Pathology and Laboratory Medicine (N.A.Z., R.P.T., N.C.O.), Larner College of Medicine, University of Vermont, Burlington.,Department of Biochemistry (R.P.T.), Larner College of Medicine, University of Vermont, Burlington
| | - Paul L Auer
- Department of Biostatistics, School of Public Health, University of Wisconsin, Milwaukee (P.L.A.)
| | - Alex P Reiner
- Department of Epidemiology (A.P.R.), University of Washington, Seattle
| | - Ethan M Lange
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora (M.A.S., L.A.L., M.M., K.K., M.D.S., C.L., J.A.S., E.M.L.).,Department of Biostatistics and Informatics (E.M.L.), University of Colorado School of Public Health, Aurora
| | - Nels C Olson
- Department of Pathology and Laboratory Medicine (N.A.Z., R.P.T., N.C.O.), Larner College of Medicine, University of Vermont, Burlington
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Marie Willard T, Khan A, Eugene Reckard P, Day G, Leavitt C, Roberts S, Schroeppel TJ. Pediatric Trauma Outreach and Prevention: Early Data Suggesting We Are Making an Impact. J Am Coll Surg 2020. [DOI: 10.1016/j.jamcollsurg.2020.08.655] [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: 10/23/2022]
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7
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Leavitt C, Zakai NA, Auer P, Cushman M, Lange EM, Levitan EB, Olson N, Thornton TA, Tracy RP, Wilson JG, Lange LA, Reiner AP, Raffield LM. Interferon gamma-induced protein 10 (IP-10) and cardiovascular disease in African Americans. PLoS One 2020; 15:e0231013. [PMID: 32240245 PMCID: PMC7117698 DOI: 10.1371/journal.pone.0231013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/15/2020] [Indexed: 12/25/2022] Open
Abstract
Biomarkers of chronic inflammation (such as C-reactive protein) have long been associated with cardiovascular disease and mortality; however, biomarkers involved in antiviral cytokine induction and adaptive immune system activation remain largely unexamined. We hypothesized the cytokine interferon gamma inducible protein 10 (IP-10) would be associated with clinical and subclinical cardiovascular disease and all-cause mortality in African Americans. We assessed these associations in the Jackson Heart Study (JHS) cohort and the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. There was a modest association of IP-10 with higher odds of left ventricular hypertrophy (OR = 1.20 (95% confidence interval (CI) 1.03, 1.41) per standard deviation (SD) higher natural log-transformed IP-10 in JHS). We did not observe associations with ankle brachial index, intima-media thickness, or arterial calcification. Each SD higher increment of ln-transformed IP-10 concentration was associated with incident heart failure (hazard ratio (HR) 1.26; 95% CI 1.11, 1.42, p = 4x10-4) in JHS, and with overall mortality in both JHS (HR 1.12 per SD, 95% CI 1.03, 1.21, p = 7.5x10-3) and REGARDS (HR 1.31 per SD, 95% CI 1.10, 1.55, p = 2.0 x 10-3), adjusting for cardiovascular risk factors and C-reactive protein. However, we found no association between IP-10 and stroke or coronary heart disease. These results suggest a role of IP-10 in heart failure and mortality risk independent of C-reactive protein. Further research is needed to investigate how the body's response to chronic viral infection may mediate heart failure and overall mortality risk in African Americans.
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Affiliation(s)
- Colton Leavitt
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Neil A. Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Paul Auer
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Ethan M. Lange
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Emily B. Levitan
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, United States of America
| | - Nels Olson
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - Timothy A. Thornton
- Department of Biostatistics, University of Washington, Seattle, WA, United States of America
| | - Russell P. Tracy
- Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
- Department of Biochemistry, Larner College of Medicine at the University of Vermont, Burlington, VT, United States of America
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, United States of America
| | - Leslie A. Lange
- Division of Biomedical Informatics and Personalized Medicine, School of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, United States of America
| | - Alex P. Reiner
- Department of Epidemiology, University of Washington, Seattle, WA, United States of America
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States of America
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Koetke DD, Fisk R, Koetke DS, Manweiler R, Bowles TJ, Brown A, Brown RE, Burman RL, Clark DA, Clearwater S, Dombeck T, Kruse H, Lee D, Aas B, Igo G, Newsom C, Beavis D, Fung SY, Gorn W, Poe RT, VanDalen GJ, Bassalleck B, Dieterle B, Gregory C, Hill RE, Kang JH, Leavitt C, Auerbach L, Datta S, Huang Y. Muon-neutrino carbon charged-current interaction near the muon threshold. Phys Rev C Nucl Phys 1992; 46:2554-2566. [PMID: 9968386 DOI: 10.1103/physrevc.46.2554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Alston-Garnjost M, Dougherty B, Kenney R, Krivicich J, Tripp R, Nicholson H, Sutton S, Dieterle B, Kang J, Leavitt C. Limit on majoron emission in beta beta decay of 100Mo. Phys Rev Lett 1988; 60:1928-1931. [PMID: 10038179 DOI: 10.1103/physrevlett.60.1928] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Leavitt C. A continuing care nurse's role on the statewide advisory. Disch Plann Update 1981; 2:11-3. [PMID: 10268526] [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: 04/13/2023]
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