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Merrigan JJ, Burke AA, Oladipo E, Kearney J, Marks D, Martin JR. Upper body push to pull ratios in law enforcement officer recruits. Work 2022; 73:1167-1174. [DOI: 10.3233/wor-210761] [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: 11/15/2022] Open
Abstract
BACKGROUND: Law enforcement recruits (LER) often encounter shoulder injuries, which may cause attrition from academies. Investigating required upper body muscular fitness may inform of muscular balance around shoulder joints through anterior and posterior ratios in LER. OBJECTIVE: To investigate push to pull ratios (P2P) and factors related with P2P in LER. METHODS: LER (95 males; 12 females) completed testing during a single session in the academy’s first week: body mass, one-repetition maximum (1RM) bench press, push-up repetitions (reps) to failure, and pull-up reps to failure. Calculations were: estimated pull-up 1-RM=body mass+0.033*(body mass x pull-ups); endurance P2P (eP2P)=push-ups / pull-ups; strength P2P (sP2P)=bench press 1RM / estimated pull-up 1-RM. Pearson correlation coefficients assessed relationships among tests and P2P (p < 0.05). RESULTS: The sP2P was positively correlated with bench press 1-RM and push-ups. The eP2P was negatively associated with pull-up reps and 1-RM. Females had similar eP2P, but lower sP2P than male recruits (p < 0.05). CONCLUSION: Practitioners may benefit from examining eP2P and sP2P as they should not be used interchangeably. Future research should examine whether the P2P ratios are associated with injury and subsequent inability to successfully complete law enforcement training academies.
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Affiliation(s)
- Justin J. Merrigan
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Adam A. Burke
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
| | - Eddo Oladipo
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
| | - James Kearney
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
| | - Daniel Marks
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
| | - Joel R. Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
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Marks D, Merrigan JJ, Martin J. Do baseline physical fitness measures predict law enforcement academy graduation? Work 2022; 72:263-269. [DOI: 10.3233/wor-205310] [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: 11/15/2022] Open
Abstract
BACKGROUND: Law enforcement officers experience high stress levels and perform various physical tasks. Thus, law enforcement academies emphasize physical fitness training and assessment. OBJECTIVE: To examine fitness test-performances and determine which entry-level fitness components best predict likelihood of successful law enforcement academy graduation. METHODS: Recruits (151 males, 42 females) completed initial academy fitness testing: one-repetition maximum bench press, push-ups, sit-ups, pull-ups, sit-and-reach, 1.5-mile run, and work performance test. Chi-square and t-tests were used to examine gender differences. Correlation coefficients assessed relationships, while logistical regression determined the best fitness components for predicting graduation (p < 0.05). RESULTS: Males had greater fitness performances except pull-ups, sit-ups and sit and reach (p < 0.05). Distributions of below average fitness performances were similar between genders with majority of recruits performing below average on all tests. Gender, age, push-ups, and pull-ups explained 18% of the variance in graduation rates (p < 0.05). Males were 4.68 (p < 0.05) times more likely to graduate, but other predictors were not significant. CONCLUSIONS: No single fitness test predicted the likelihood of graduation and majority of performances were below average, suggesting the importance for proficiency across multiple fitness components. Considering lower fitness performances and graduation rates, females may further benefit from training programs prior to academy entrance.
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Affiliation(s)
- Daniel Marks
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
| | - Justin J. Merrigan
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
- Human Performance Collaborative, Office of Research, The Ohio State University, Columbus, OH, USA
| | - Joel Martin
- Sports Medicine Assessment Research & Testing (SMART) Laboratory, George Mason University, Manassas, VA, USA
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Peigh G, Wasserlauf J, Vogel K, Kaplan RM, Pfenniger A, Marks D, Mehta A, Chicos AB, Arora R, Kim S, Lin A, Verma N, Patil KD, Knight BP, Passman RS. Impact of pre-ablation weight loss on the success of catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2021; 32:2097-2104. [PMID: 34191371 PMCID: PMC9305992 DOI: 10.1111/jce.15141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Obesity is an established risk factor for recurrent atrial fibrillation (AF) after ablation. The impact of pre-procedure weight changes on freedom from AF (FFAF) after ablation in obese and nonobese patients is unknown. METHODS A single-center retrospective cohort study of patients undergoing pulmonary vein isolation was performed. Before ablation, all candidates were encouraged to adopt healthy lifestyle habits according to American Heart Association guidelines, including weight loss, by their physician. The primary endpoint was FFAF through 1-year after completion of the 3-month blanking period. RESULTS Of the 601 patients (68% male; average age 62.1 ± 10.3 years) included in analysis, 234 patients (38.9%) were obese (body mass index ≥ 30) and 315 (52.4%) had paroxysmal AF. FFAF was observed in 420 patients (69.9%) at 15 months. Percent change in weight that occurred during the year before ablation independently predicted FFAF through 15-months in all patients (adjusted odds ratio = 1.17, 95% confidence interval: 1.11-1.23). Subgroup analyses based on paroxysmal vs persistent AF, presence of obesity, and history of prior ablation were performed. Percent change in weight over the year before ablation was independently associated with FFAF in all subgroups except nonobese patients with persistent AF. CONCLUSION Pre-ablation weight loss was associated with FFAF in both obese and nonobese patients. Further studies are needed to define the optimal approach to weight loss before AF ablation.
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Affiliation(s)
- Graham Peigh
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Kelly Vogel
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel M Kaplan
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anna Pfenniger
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniel Marks
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Arjun Mehta
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexandru B Chicos
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rishi Arora
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Susan Kim
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Albert Lin
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nishant Verma
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kaustubha D Patil
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bradley P Knight
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rod S Passman
- Division of Cardiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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Wu CY, Tibbitts D, Beattie Z, Dodge HH, Beer TM, Marks D, Shannon J, Kaye J, Winters-Stone KM. Continuous unobtrusive assessment of meaningful change in older adults with cancer: The Pacific Aging & Cancer Study Collaborative—PACS collaborative. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.1569] [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: 11/20/2022] Open
Abstract
1569 Background: Knowledge of changes in health that precede a cancer diagnosis is challenging because of a lack of longitudinal, objective measurement techniques. Current approaches rely on periodic assessment via self-report which may miss when and how health changes, particularly when changes may appear subtly over time. Remote-monitoring technologies provide a mechanism to continuously, passively, and unobtrusively monitor changes in health so that trajectories of change in relation to a life event (i.e., cancer diagnosis, treatment) can be detected and described. We examined the changes in digital indicators of health and life events 1 year before and after a self-reported cancer diagnosis in community-dwelling adults aged 65 and older. Methods: This is a secondary, retrospective data analysis of older adults who self-reported a new cancer diagnosis in the Oregon Center for Aging & Technology (ORCATECH) cohort. Ten older adults (age = 71.8±4.9 years, 30% women) were included with various cancer types (esophageal, prostate, uterine, pancreatic, b-cell follicular lymphoma, multiple myeloma, basal cell melanoma, basal and/or squamous cell carcinoma). Daily physical activity was measured using step counts derived from an actigraph watch. Weekly health and life events (pain severity, loneliness, hospitalization/emergency room (ER) visits, days away from home overnight) were self-reported from weekly online surveys. Results: A total of 3,624 days of actigraphy data (210 ± 88 days pre-cancer; 153 ± 81 days post-cancer) and 750 weeks of self-reported online survey data (36 ± 12 weeks pre-cancer; 39 ± 14 weeks post-cancer) were collected. Longitudinal linear mixed-effects models revealed that the trajectory of step counts was different pre- and post-cancer (β = -1.52, p <.001), with a gradual decrease in step counts before a cancer diagnosis. The trajectory of pain severity was different pre- and post-cancer (β = 0.01, p <.001), with a gradual increase in pain severity before a cancer diagnosis. There was a gradual increase in the occurrence of hospitalization/ER visits (OR = 1.07, p = 0.02) and days away from home overnight (OR = 1.04, p = 0.01) before a cancer diagnosis. Feelings of loneliness increased over time, regardless of pre- or post-cancer (OR = 1.04, p <.001). Conclusions: Changes in health and life events 1-year before a cancer diagnosis in older adults with varying cancer types and severity were unobtrusively observed. This study suggests that a remote-monitoring technology platform deployed in homes can detect meaningful intra-individual changes before and after a cancer diagnosis. Future studies can employ this technology as a pathway for improving the timeliness of detection and more effective therapeutic follow-up for older adults.
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Affiliation(s)
- Chao-Yi Wu
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR
| | | | - Zachary Beattie
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR
| | - Hiroko H. Dodge
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR
| | - Tomasz M. Beer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Daniel Marks
- Oregon Health & Science University, Portland, OR
| | | | - Jeffrey Kaye
- Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, OR
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Nathan K, Kamel O, Marks D, Russo AM. Treatment of symptomatic bradycardia due to T-wave oversensing with implantation of a new generator incorporating delayed decay and threshold start sensitization algorithms. HeartRhythm Case Rep 2020; 6:891-895. [PMID: 33365232 PMCID: PMC7749220 DOI: 10.1016/j.hrcr.2020.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Marks D, Knight BP. Delayed occurrence of atypical fast-slow atrioventricular nodal reentry years after successful slow pathway ablation for typical atrioventricular nodal reentry. HeartRhythm Case Rep 2020; 6:960-962. [PMID: 33365249 PMCID: PMC7749200 DOI: 10.1016/j.hrcr.2020.10.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Daniel Marks
- Address reprint requests and correspondence: Dr Daniel Marks, 251 East Huron Street, Feinberg 8-503, Chicago, IL 60611.
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Marks D, Ho R, Then R, Weinstock JL, Teklemariam E, Kakadia B, Collins J, Andriulli J, Hunter K, Ortman M, Russo AM. Real-world experience with implantable loop recorder monitoring to detect subclinical atrial fibrillation in patients with cryptogenic stroke: The value of p wave dispersion in predicting arrhythmia occurrence. Int J Cardiol 2020; 327:86-92. [PMID: 33186666 DOI: 10.1016/j.ijcard.2020.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/20/2020] [Revised: 10/27/2020] [Accepted: 11/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE We hypothesized patients implanted with ILRs for cryptogenic stroke in "real life" clinical practice will show an AF detection rate comparable to prior clinical studies, and that clinical or imaging features may help to identify those at higher risk of AF detection. METHODS A retrospective chart review was conducted of all patients who presented with cryptogenic stroke and received an ILR at an academic medical center from 2015 to 2017 with an active inpatient stroke service. The electronic health record and remote monitoring were used to identify occurrence of AF. RESULTS A total of 178 patients who received ILRs for cryptogenic stroke were included. Overall, after a thorough evaluation for other etiologies of stroke, 35 (19.6%) were found to have AF detected. Mean follow-up was 365 days with a median time to detection of 131 days. Advanced age (p = 0.001), diastolic dysfunction on echo (p = 0.03), as well as ECG findings of premature atrial contractions (PACs) and p wave dispersion (PWD) > 40 ms were found to be predictive of AF detection (p = 0.04, p < 0.001, respectively). On multiple regression analysis, the only independent predictor of AF detection was PWD > 40 ms. CONCLUSION After a thorough evaluation to exclude other etiologies for stroke, approximately 20% of patients of our cryptogenic stroke population were found to have AF with ILR surveillance. Advanced age, diastolic dysfunction, as well as ECG findings of PACs and increased PWD may help to predict those at higher risk of AF detection, while PWD was the only independent predictor. This has important clinical implications, as better prediction of AF may help identify those at highest risk and might subsequently aid in guiding therapy.
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Affiliation(s)
- Daniel Marks
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Rady Ho
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Ryna Then
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Joshua L Weinstock
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Ephrem Teklemariam
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Bhavika Kakadia
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Jared Collins
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - John Andriulli
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Krystal Hunter
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Matthew Ortman
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
| | - Andrea M Russo
- Division of Cardiology, Cooper Medical School of Rowan University, Camden, NJ, United States of America.
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Marks D, De La Paz A, Walston BJ. Acyclovir-induced neurotoxicity in an immunocompromised patient. SAGE Open Med Case Rep 2020; 8:2050313X20946518. [PMID: 32850129 PMCID: PMC7425261 DOI: 10.1177/2050313x20946518] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/13/2020] [Indexed: 11/25/2022] Open
Abstract
This is a case report of a 75-year-old immunocompromised male who developed encephalopathy while undergoing treatment for disseminated herpes zoster with peripheral nerve involvement. While his initial presentation involved primarily profound lower extremity weakness, he developed progressive confusion to the point of obtundation only after initiation of standard therapy with intravenous acyclovir. The evaluation of his altered mental status was largely unremarkable. It was only after his acyclovir was discontinued that his symptoms resolved and he returned to his baseline mental status. His presentation was most consistent with acyclovir-induced neurotoxicity, which can present in patients with renal impairment and those who are immunocompromised.
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Affiliation(s)
- Daniel Marks
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew De La Paz
- Internal Medicine Residency Program, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bobbi Jo Walston
- Infectious Diseases, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Marks D, Chicos AB. Implantable defibrillators and cardiac amyloidosis: Infiltrating the knowledge gap. J Cardiovasc Electrophysiol 2020; 31:1759-1761. [DOI: 10.1111/jce.14605] [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: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Marks
- Northwestern Memorial Hospital Chicago Illinois
- Division of Cardiology, Center for Heart Rhythm Disorders at the Bluhm Cardiovascular Institute Northwestern University Feinberg School of Medicine Chicago Illinois
| | - Alexandru B. Chicos
- Division of Cardiology, Center for Heart Rhythm Disorders at the Bluhm Cardiovascular Institute Northwestern University Feinberg School of Medicine Chicago Illinois
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Stone L, Olson B, Mowery A, Krasnow S, Jiang A, Li R, Schindler J, Wax MK, Andersen P, Marks D, Achim V, Clayburgh D. Association Between Sarcopenia and Mortality in Patients Undergoing Surgical Excision of Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2020; 145:647-654. [PMID: 31169874 DOI: 10.1001/jamaoto.2019.1185] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Importance Sarcopenia, or the loss of muscle mass, is associated with poor treatment outcomes in a variety of surgical fields. However, the association between sarcopenia and long-term survival in a broad cohort of patients with head and neck cancer (HNC) is unknown. Objective To determine whether sarcopenia is associated with long-term survival in patients undergoing major head and neck surgery for HNC. Design, Setting, and Participants A retrospective medical records review was conducted at a tertiary care academic hospital. Two hundred sixty patients undergoing major head and neck ablative procedures with cross-sectional abdominal imaging performed within 45 days prior to surgery were included in the analysis. The study was conducted from January 1, 2005, to December 31, 2016. Data analysis was performed from June 1, 2018, to February 28, 2019. Interventions Measurement of cross-sectional muscle area at the L3 vertebra level. Main Outcomes and Measures Two- and 5-year overall survival were the primary outcomes. Results Of the 260 patients included in the study, 193 were men (74.2%); mean (SD) age was 61.1 (11) years. Sarcopenia was present in 144 patients (55.4%). Two-year overall survival was 71.9% of the patients (n = 82) in the sarcopenia group compared with 88.5% of the patients (n = 85) in the nonsarcopenia group (odds ratio [OR], 0.33; 95% CI, 0.16-0.70). At 5 years, overall survival was 36.5% in patients (n = 23) with sarcopenia and 60.5% in patients (n = 26) without sarcopenia (OR, 0.38; 95% CI, 0.17-0.84). On multivariate analysis, sarcopenia was a significant negative predictor of both 2-year (OR, 0.33; 95% CI, 0.14-0.77) and 5-year (OR, 0.38; 95% CI, 0.17-0.84) overall survival. Conclusions and Relevance Sarcopenia appears to be a significant negative predictor of long-term overall survival in patients with HNC undergoing major head and neck surgery. Sarcopenia may be accurately assessed on cross-sectional imaging and may be useful clinically as a prognostic variable and as an area for intervention to improve treatment outcomes.
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Affiliation(s)
- Lucas Stone
- Medical student, School of Medicine, Oregon Health and Science University, Portland
| | - Brennan Olson
- Medical student, School of Medicine, Oregon Health and Science University, Portland
| | - Alia Mowery
- Medical student, School of Medicine, Oregon Health and Science University, Portland
| | - Stephanie Krasnow
- Department of Pediatrics, Oregon Health and Science University, Portland
| | - Angie Jiang
- School of Medicine, Oregon Health and Science University, Portland
| | - Ryan Li
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland
| | - Joshua Schindler
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland
| | - Mark K Wax
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland
| | - Peter Andersen
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland
| | - Daniel Marks
- Department of Pediatrics, Oregon Health and Science University, Portland
| | - Virginie Achim
- Department of Otolaryngology/Head and Neck Surgery, University of Illinois at Chicago
| | - Daniel Clayburgh
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland.,Operative Care Division, Portland Veterans' Affairs Health Care System, Portland, Oregon
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Marks D, Knight BP, Verma N. Difficult posteroseptal pathway ablation and recurrent PSVT. J Cardiovasc Electrophysiol 2020; 31:985-987. [PMID: 32141119 DOI: 10.1111/jce.14434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/12/2020] [Accepted: 02/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Marks
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bradley P Knight
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nishant Verma
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Chin C, Marks D, Hart T, Saenger Y, Hibshoosh H, Kalinsky K, Connolly E. Characterization of the Tumor Microenvironment (TME) with Quantitative Multiplex Immunofluorescence (qMIF) in a Cohort of Neoadjuvant Breast Cancer (BC) Patients: A Pilot Analysis. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1575] [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: 11/24/2022]
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McKay A, Hogan H, Humphries S, Marks D, Ray K, Miners A. Cost-effectiveness of universal screening for familial hypercholesterolaemia (fh) at age 1-2 years. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.07.026] [Citation(s) in RCA: 1] [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: 11/24/2022]
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Powell S, Tam H, Gold A, Marks D, Montalto D. B - 19Septo-Optic Dysplasia (de Morsier syndrome): Neuropsychological Sequelae in a Four-Year-Old. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.95] [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: 11/14/2022] Open
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Chacko A, Bedard ACV, Marks D, Gopalan G, Feirsen N, Uderman J, Chimiklis A, Heber E, Cornwell M, Anderson L, Zwilling A, Ramon M. Sequenced neurocognitive and behavioral parent training for the treatment of ADHD in school-age children. Child Neuropsychol 2018; 24:427-450. [PMID: 28277151 PMCID: PMC6224162 DOI: 10.1080/09297049.2017.1282450] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The present study examines the potential of sequencing a neurocognitive intervention with behavioral parent training (BPT) to improve executive functions (EFs), psychiatric symptoms, and multiple indices of functional impairment in school-age children aged 7 to 11 years who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Specifically, in a randomized controlled trial design, 85 children were assigned to either Cogmed Working Memory Training (CWMT) followed by an empirically supported, manualized BPT intervention, or to a placebo version of CWMT followed by the same BPT intervention. Working memory maintenance (i.e., attention control/short-term memory), working memory processing and manipulation, ADHD and oppositional defiant disorder (ODD) symptoms, impairment in parent-child dynamics, familial impairment, and overall functional compromise were evaluated as outcomes. The results suggest specific effects of the combined CWMT and BPT program on verbal and nonverbal working memory storage and nonverbal working memory processing and manipulation but no incremental benefits in regard to ADHD symptoms, ODD symptoms, and functional outcomes. The present findings do not support the hypothesis regarding the complementary and augmentative benefits of sequenced neurocognitive and BPT interventions for the treatment of ADHD. These results, the study's limitations, and future directions for research are further discussed.
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Affiliation(s)
- A Chacko
- a Department of Applied Psychology , New York University , NY , USA
| | - A-C V Bedard
- b Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education , University of Toronto , Canada
| | - D Marks
- c Department of Child and Adolescent Psychiatry , New York University School of Medicine , NY , USA
| | - G Gopalan
- d Department of Social Work , University of Maryland at Baltimore , MD , USA
| | - N Feirsen
- e Department of Psychology , City University of New York , NY , USA
| | - J Uderman
- e Department of Psychology , City University of New York , NY , USA
| | - A Chimiklis
- e Department of Psychology , City University of New York , NY , USA
| | - E Heber
- e Department of Psychology , City University of New York , NY , USA
| | - M Cornwell
- e Department of Psychology , City University of New York , NY , USA
| | - L Anderson
- e Department of Psychology , City University of New York , NY , USA
| | - A Zwilling
- e Department of Psychology , City University of New York , NY , USA
| | - M Ramon
- e Department of Psychology , City University of New York , NY , USA
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Mehling W, Marks D, Woodstock R, Ventura M, Flatt J, Chesney M, Barnes D. PAIRED INTEGRATIVE EXERCISE FOR PEOPLE WITH DEMENTIA AND CAREGIVIERS (PAIRED PLIÉ STUDY). Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1723] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W. Mehling
- University of California San Francisco, San Francisco, California
| | - D. Marks
- University of California San Francisco, San Francisco, California
| | - R. Woodstock
- University of California San Francisco, San Francisco, California
| | - M. Ventura
- University of California San Francisco, San Francisco, California
| | - J.D. Flatt
- University of California San Francisco, San Francisco, California
| | - M.A. Chesney
- University of California San Francisco, San Francisco, California
| | - D.E. Barnes
- University of California San Francisco, San Francisco, California
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Marks D, Rashid A, Warriner D. Book Reviews. Br J Hosp Med (Lond) 2017. [DOI: 10.12968/hmed.2017.78.3.177] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - David Warriner
- NHS England and the Academy of Medical Royal Colleges, London
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McGill ET, Sumpter C, Marks D, Egan M. PP43 Reducing ‘problem drinking’ by removing a ‘problem drink’: a qualitative study of a local alcohol availability intervention. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.140] [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: 11/03/2022]
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Motwani M, De Maeyer R, Fullerton J, Marks D, Smith A, GIlroy D. Exudate suction blister: a novel in vivo model of acute infllammation and resolution in humans. (CAM1P.145). The Journal of Immunology 2015. [DOI: 10.4049/jimmunol.194.supp.48.2] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Resolution of acute inflammation is an active process and its dysregulation may contribute to chronic inflammatory disorders. While animal models have been used to study resolution their appropriateness has been questioned. We describe a novel model of resolving inflammation in humans triggered by intradermal injection of UV killed E. coli into the forearm of healthy volunteers (n=30). Inflammatory exudate was drawn into a skin blister induced by negative pressure applied over the injection site. Blister cells were analyzed by flow cytometry while the cell free exudates were assayed for cytokines. To study the different phases of inflammation, blisters were raised at multiple time points up to day 14 post-injection. Vascular response was monitored by laser doppler. Onset (8hr) was characterised by peak erythema and neutrophilia (HLA-DR-/CD16++). By 24hr, neutrophil numbers had fallen by 80% while CD14+ monocytes and CD1c+ dendritic cell numbers increased, indicating resolution. At 48hr blood flow declined along with mononuclear cell numbers. Lymphocytes (CD4+, CD8+ and CD56+ cells) dominated the site at day 3 and persisted up to day 14. Levels of TNF-α, IL-8 and IL-1β were maximal at 8hr, IFN-γ at 24hr. This safe and reproducible model allows, for the first time, exploration of cells and soluble mediators in parallel with the clinical signs of resolution in humans. Potential applications include testing the efficacy of novel anti-inflammatory and pro-resolving drugs.
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Affiliation(s)
- Madhur Motwani
- 1Centre for Clinical Pharmacology, Division of Medicine, University Col. London, London, United Kingdom
| | - Roel De Maeyer
- 1Centre for Clinical Pharmacology, Division of Medicine, University Col. London, London, United Kingdom
| | - James Fullerton
- 1Centre for Clinical Pharmacology, Division of Medicine, University Col. London, London, United Kingdom
| | - Daniel Marks
- 2Centre for Molecular Medicine, Division of Medicine, University Col. London, London, United Kingdom
| | - Andrew Smith
- 2Centre for Molecular Medicine, Division of Medicine, University Col. London, London, United Kingdom
| | - Derek GIlroy
- 1Centre for Clinical Pharmacology, Division of Medicine, University Col. London, London, United Kingdom
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Affiliation(s)
| | - D. Marks
- Physiotherapie, Rehaklinik Zihlschlacht, Schweiz
| | - C. Grüneberg
- Leiter des Studienbereichs Physiotherapie, Hochschule für Gesundheit, Bochum
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Braithwaite J, Marks D, Taylor N. Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature. Int J Qual Health Care 2014; 26:321-9. [DOI: 10.1093/intqhc/mzu047] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Affiliation(s)
- Richard Rees
- Department of Clinical Pharmacology, University College London Hospital, London, UK.
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Klatt M, Steinberg B, Marks D, Duchemin A. OA04.04. Changes in physiological and psychological markers of stress in hospital personnel after a low-dose mindfulness-based worksite intervention. Altern Ther Health Med 2012. [PMCID: PMC3373711 DOI: 10.1186/1472-6882-12-s1-o16] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Dermatomyositis is an idiopathic acute inflammatory disorder, characterized by inflammation of skeletal muscle, progressive symmetrical proximal myopathy and classical cutaneous manifestations. It affects both children and adults, and women more frequently than men. Dermatomyositis is the commonest inflammatory myopathy in all age groups, with an estimated prevalence of 0.6-1.0 per 100 000 (Dalakas and Hohlfeld, 2003). Its association with malignancy mandates a thorough search for underlying neoplasia in all cases.
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Abstract
AIMS To estimate the seroprevalence of antibodies to Erysipelothrix rhusiopathiae in chickens in New Zealand, and to estimate the effect of housing type, geographical location and age on seroprevalence. METHODS A cross-sectional serological survey of a convenience sample of 545 broiler, breeder, and layer chickens in 55 flocks was conducted in 2010-2011. Birds were aged 5-83 weeks; housing types were free-range, shed, caged, and unknown; and flocks were located in the Auckland, Manawatu, North Canterbury, Otago, Taranaki, Waikato, and Wairarapa regions of New Zealand. An ELISA was used to measure antibodies to E. rhusiopathiae. Samples with an optical density reading ≥ 1.50 were considered to be positive. Logistic regression analysis was used to model the effect of housing type, geographical location and flock age on the prevalence of samples positive for antibodies to E. rhusiopathiae. RESULTS The overall prevalence of samples with antibodies to E. rhusiopathiae was 39.8 (95% CI=35.68-44.06)% for the 545 samples, and 46/55 (84%) farms that were tested had at least one positive sample. Mean seroprevalence for types of housing was 44.2 (95% CI=37.79-50.70)% for free-range (n=240 birds), 23.7 (95% CI=17.83-30.38)% for shed (n=190), 73 (95% CI=56-86)% for caged (n=37) and 50 (95% CI=38-62)% for unknown (n=78). The disease was present in all seven geographical locations from which samples were obtained for this study. Seroprevalence increased with increasing age of birds (p<0.001); for birds ≤ 12 weeks of age it was 2 (95% CI=0.3-8)% (n=91), 13-24 weeks 29.1 (95% CI=23.34-35.46)% (n=230), 25-36 weeks 47 (95% CI=32-64)% (n=40), 37-48 weeks 75 (95% CI=51-91)% (n=20), >48 weeks 63.8 (95% CI=54.78-72.12)% (n=127). Neither housing type nor geographical location had a significant effect on the likelihood of samples being positive for antibodies to E. rhusiopathiae. CONCLUSIONS The results of this study suggest the prevalence of erysipelas under New Zealand field conditions may be higher than expected and that the disease is significantly associated with increasing age. Housing type and geographical location appear to be unrelated to seroprevalence. CLINICAL RELEVANCE Further study of the epidemiology of E. rhusiopathiae in chickens in New Zealand should be considered in order to minimise the extent of birds' exposure to the organism. These findings will assist in the design of further studies.
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Affiliation(s)
- A Kurian
- EpiCentre, Institute of Veterinary, Animal, and Veterinary Biosciences, Massey University, Palmerston North 4442, New Zealand
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Nherera L, Marks D, Minhas R, Thorogood M, Humphries SE. Probabilistic cost-effectiveness analysis of cascade screening for familial hypercholesterolaemia using alternative diagnostic and identification strategies. Heart 2011; 97:1175-81. [PMID: 21685482 DOI: 10.1136/hrt.2010.213975] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [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] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To estimate the probabilistic cost-effectiveness of cascade screening methods in familial hypercholesterolaemia (FH) from the UK NHS perspective. DESIGN Economic evaluation (cost utility analysis) comparing four cascade screening strategies for FH: Using low-density lipoprotein (LDL) cholesterol measurements to diagnose affected relatives (cholesterol method); cascading only in patients with a causative mutation identified and using DNA tests to diagnose relatives (DNA method); DNA testing combined with LDL-cholesterol testing in families with no mutation identified, only in patients with clinically defined 'definite' FH (DNA+DFH method); DNA testing combined with LDL-cholesterol testing in no-mutation families of both 'definite' and 'probable' FH patients (DNA+DFH+PFH). A probabilistic model was constructed to estimate the treatment benefit from statins, with all diagnosed individuals receiving high-intensity statin treatment. POPULATION A cohort of 1000 people suspected of having FH aged 50 years for index cases and 30 years for relatives, followed for a lifetime. MAIN OUTCOMES Costs, quality-adjusted life-years (QALY) and incremental cost-effectiveness ratios (ICER). RESULTS The DNA+DFH+PFH method was the most cost-effective cascade screening strategy. The ICER was estimated at £3666/QALY. Using this strategy, of the tested relatives 30.6% will be true positives, 6.3% false positives, 61.9% true negatives and 1.1% false negatives. Probabilistic sensitivity analysis showed that this approach is 100% cost-effective using the conventional benchmark for cost-effective treatments in the NHS of between £20,000 and £30,000 per QALY gained. CONCLUSION Cascade testing of relatives of patients with DFH and PFH is cost-effective when using a combination of DNA testing for known family mutations and LDL-cholesterol levels in the remaining families. The approach is more cost-effective than current primary prevention screening strategies.
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Affiliation(s)
- L Nherera
- Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Royal Free and University College London Medicine School, London WC1E 6JF, UK.
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Anzueto A, Frutos-Vivar F, Esteban A, Bensalami N, Marks D, Raymondos K, Apezteguia C, Arabi Y, Hurtado J, Gonzalez M, Tomicic V, Abroug F, Elizalde J, Cakar N, Pelosi P, Ferguson ND. Influence of body mass index on outcome of the mechanically ventilated patients. Thorax 2010; 66:66-73. [DOI: 10.1136/thx.2010.145086] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sack S, Kahlert P, Bilodeau L, Pièrard L, Lancellotti P, Legrand V, Bartunek J, Vanderheyden M, Hoffmann R, Schauerte P, Shiota T, Marks D, Ellis S, Erbel R. Initial Experiences with a Non-Stented Coronary Sinus Device for the Treatment of Functional Mitral Regurgitation: Results of the PTOLEMY I Feasibility Trial. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.986] [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]
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Abstract
BACKGROUND Transient hyperglycemia (TH) is a recognized side effect of the corticosteroids and asparaginase given during induction chemotherapy for pediatric acute lymphoblastic leukemia (ALL). Information is needed about how TH has been impacted by changes in ALL therapy. This study examined the prevalence of TH in a cohort of pediatric ALL patients and the impact on TH of type of steroid or asparaginase used and of risk factors such as age, gender, and overweight. METHODS Retrospective record review of patients aged 2-18 years diagnosed with ALL in 1999-2006. TH was defined as >or=2 random glucose values >or=200 mg/dl. Overall prevalence of TH was calculated. Risk factors were evaluated using Chi-square analysis and logistic regression. RESULTS One hundred sixty-two subjects (70 female) were reviewed, 33 (20.4%) of whom had TH. 42.2% of subjects over age 10 years had TH, compared to 12.0% of younger children (P < 0.001). No gender difference was found. Overweight (BMI >or= 95th percentile) and at risk for overweight (BMI >or= 85th percentile) were significant risk factors for TH (P = 0.007 and P = 0.003, respectively). Native L-asparaginase was associated with increased TH compared to PEG-asparaginase (P = 0.047). There was a non-significant trend toward more TH in patients who received prednisone, but this disappeared in multivariate analysis. CONCLUSIONS The prevalence of TH in this study was higher than previously reported. Overweight, age >or=10 years, and use of native L-asparaginase were significant predictors of TH.
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Affiliation(s)
- Stefanie R Lowas
- Division of Pediatric Hematology-Oncology, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, USA.
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Abstract
BACKGROUND Pediatric acute lymphoblastic leukemia (ALL) therapies have been associated with many late effects, including obesity, hyperglycemia, and insulin resistance. Few data are available linking these abnormalities to specific risk factors present during ALL treatment. METHODS Retrospective cohort study with prospective follow-up. Subjects had been diagnosed with ALL at ages 1-18 years and had been off chemotherapy for >9 months. Oral glucose tolerance testing (OGTT) was performed and these results compared to demographic, treatment, and anthropomorphic data from medical records. RESULTS Twenty-seven subjects (11 female) were evaluated. Mean (+/-SD) diagnosis age 5.7 +/- 3.5 years, mean study age 11.3 +/- 3.7 years, mean time off therapy 2.8 +/- 1.5 years. Six subjects had transient hyperglycemia during ALL treatment. At study time, one subject had prediabetes; eight (29.6%) had insulin resistance. Insulin resistance was not predicted by glucose levels during treatment, cumulative steroid or asparaginase dose, or type of steroid received. Body mass index (BMI) for age correlated significantly with several measures of insulin resistance, including fasting insulin, HOMA index, Matsuda index and insulin AUC (P = 0.001-0.009). Waist/hip ratio and BMI at ALL diagnosis also correlated with insulin resistance, but these factors' effects could not be separated from BMI at study time. CONCLUSIONS Variations in ALL therapy and presence of transient hyperglycemia do not appear to increase risk of glucose intolerance or insulin resistance in the first few years after completion of therapy. Elevated BMI strongly predicted insulin resistance in this study, as it does in the general population.
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Affiliation(s)
- Stefanie Lowas
- Division of Pediatric Hematology-Oncology, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA.
| | - Suman Malempati
- Division of Pediatric Hematology-Oncology, Doernbecher Children’s Hospital, Oregon Health & Science University, Portland, OR
| | - Daniel Marks
- Division of Pediatric Endocrinology, Doernbecher Children’s Hospital, Oregon Health & Science University, Portland, OR
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Lim Z, Cook G, Johnson P, Parker A, Zuckerman M, Marks D, Wiltshire H, Mufti G, Pagliuca A. Results of a phase I/II British Society of Bone Marrow Transplantation study on PCR-based pre-emptive therapy with valganciclovir or ganciclovir for active CMV infection following alemtuzumab-based reduced intensity allogeneic stem cell transplantation. Leuk Res 2009; 33:244-9. [DOI: 10.1016/j.leukres.2008.07.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 07/07/2008] [Accepted: 07/17/2008] [Indexed: 10/21/2022]
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Hadfield SG, Horara S, Starr BJ, Yazdgerdi S, Marks D, Bhatnagar D, Cramb R, Egan S, Everdell R, Ferns G, Jones A, Marenah CB, Marples J, Prinsloo P, Sneyd A, Stewart MF, Sandle L, Wang T, Watson MS, Humphries SE. Family tracing to identify patients with familial hypercholesterolaemia: the second audit of the Department of Health Familial Hypercholesterolaemia Cascade Testing Project. Ann Clin Biochem 2008; 46:24-32. [PMID: 19028807 DOI: 10.1258/acb.2008.008094] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Family tracing is a method recognized to find new patients with familial hypercholesterolaemia (FH). We have implemented family tracing led by FH Nurses and have determined acceptability to patients, feasibility and costs. METHODS Nurses were located at five National Health Service (NHS) Trusts; they identified FH patients and offered them family tracing. Responses and test results were recorded on a database and summarized on a family pedigree. RESULTS The majority ( approximately 70%) of index cases participated; the proportion was lower when patients had been discharged from the clinics and in metropolitan areas. On average, 34% (range 13-50%) of relatives lived outside the catchment area of the clinics and could not attend the nurse-led FH clinics. Of the previously untested relatives, 76% who lived in the catchment area of the clinic came forward to be tested. One-third of the relatives who came forward for testing were children <or=16 y of age. The proportion of relatives diagnosed as likely to have FH was lower than would be predicted (30% vs. 50%). This was mainly due to the uncertainty of a diagnosis based on lipid measurements. The average cost to identify and test one relative was approximately pound 500 but was higher in the metropolitan areas. CONCLUSION Cascade testing for FH in the UK is feasible, acceptable and likely to be cost-effective if it is a routine aspect of clinical care. However, national implementation would require an integrated infrastructure, so that all individuals have access to testing, and specialist services for the management of young people.
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Affiliation(s)
- S G Hadfield
- Institute of Child Health, London IDEAS Genetics Knowledge Park, UCL, 30 Guilford Street, London WC1N 1EH
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Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, Jatoi A, Kalantar-Zadeh K, Lochs H, Mantovani G, Marks D, Mitch WE, Muscaritoli M, Najand A, Ponikowski P, Rossi Fanelli F, Schambelan M, Schols A, Schuster M, Thomas D, Wolfe R, Anker SD. Cachexia: a new definition. Clin Nutr 2008. [PMID: 18718696 DOI: 10.1016/j.clnu.2008.06.013.] [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] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
On December 13th and 14th a group of scientists and clinicians met in Washington, DC, for the cachexia consensus conference. At the present time, there is no widely agreed upon operational definition of cachexia. The lack of a definition accepted by clinician and researchers has limited identification and treatment of cachectic patient as well as the development and approval of potential therapeutic agents. The definition that emerged is: "cachexia, is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults (corrected for fluid retention) or growth failure in children (excluding endocrine disorders). Anorexia, inflammation, insulin resistance and increased muscle protein breakdown are frequently associated with cachexia. Cachexia is distinct from starvation, age-related loss of muscle mass, primary depression, malabsorption and hyperthyroidism and is associated with increased morbidity. While this definition has not been tested in epidemiological or intervention studies, a consensus operational definition provides an opportunity for increased research.
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Affiliation(s)
- William J Evans
- Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, 4301 W. Markham, Slot 806, Little Rock, AR 72205, USA.
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Evans WJ, Morley JE, Argilés J, Bales C, Baracos V, Guttridge D, Jatoi A, Kalantar-Zadeh K, Lochs H, Mantovani G, Marks D, Mitch WE, Muscaritoli M, Najand A, Ponikowski P, Rossi Fanelli F, Schambelan M, Schols A, Schuster M, Thomas D, Wolfe R, Anker SD. Cachexia: a new definition. Clin Nutr 2008; 27:793-9. [PMID: 18718696 DOI: 10.1016/j.clnu.2008.06.013] [Citation(s) in RCA: 1519] [Impact Index Per Article: 94.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/02/2008] [Accepted: 06/05/2008] [Indexed: 12/23/2022]
Abstract
On December 13th and 14th a group of scientists and clinicians met in Washington, DC, for the cachexia consensus conference. At the present time, there is no widely agreed upon operational definition of cachexia. The lack of a definition accepted by clinician and researchers has limited identification and treatment of cachectic patient as well as the development and approval of potential therapeutic agents. The definition that emerged is: "cachexia, is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults (corrected for fluid retention) or growth failure in children (excluding endocrine disorders). Anorexia, inflammation, insulin resistance and increased muscle protein breakdown are frequently associated with cachexia. Cachexia is distinct from starvation, age-related loss of muscle mass, primary depression, malabsorption and hyperthyroidism and is associated with increased morbidity. While this definition has not been tested in epidemiological or intervention studies, a consensus operational definition provides an opportunity for increased research.
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Affiliation(s)
- William J Evans
- Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, 4301 W. Markham, Slot 806, Little Rock, AR 72205, USA.
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Craddock C, Bardy P, Kreiter S, Johnston R, Apperley J, Marks D, Huber C, Kolbe K, Goulding R, Lawler M, Goldman J, Hughes T, Derigs G. Engraftment of T-cell-depleted allogeneic haematopoietic stem cells using a reduced intensity conditioning regimen. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.2000.02454.x] [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: 11/26/2022]
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Chen C, Tucci FC, Jiang W, Tran JA, Fleck BA, Hoare SR, Wen J, Chen T, Johns M, Markison S, Foster AC, Marinkovic D, Chen CW, Arellano M, Harman J, Saunders J, Bozigian H, Marks D. Pharmacological and pharmacokinetic characterization of 2-piperazine-alpha-isopropyl benzylamine derivatives as melanocortin-4 receptor antagonists. Bioorg Med Chem 2008; 16:5606-18. [PMID: 18417348 DOI: 10.1016/j.bmc.2008.03.072] [Citation(s) in RCA: 18] [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] [Received: 03/06/2008] [Revised: 03/25/2008] [Accepted: 03/28/2008] [Indexed: 11/19/2022]
Abstract
A series of 2-piperazine-alpha-isopropylbenzylamine derivatives were synthesized and characterized as melanocortin-4 receptor (MC4R) antagonists. Attaching an amino acid to benzylamines 7 significantly increased their binding affinity, and the resulting compounds 8-12 bound selectively to MC4R over other melanocortin receptor subtypes and behaved as functional antagonists. These compounds were also studied for their permeability using Caco-2 cell monolayers and metabolic stability in human liver microsomes. Most compounds exhibited low permeability and high efflux ratio possibly due to their high molecular weights. They also showed moderate metabolic stability which might be associated with their moderate to high lipophilicity. Pharmacokinetic properties of these MC4R antagonists, including brain penetration, were studied in mice after oral and intravenous administrations. Two compounds identified to possess high binding affinity and selectivity, 10d and 11d, were studied in a murine cachexia model. After intraperitoneal (ip) administration of 1mg/kg dose, mice treated with 10d had significantly more food intake and weight gain than the control animals, demonstrating efficacy by blocking the MC4 receptor. Similar in vivo effects were also observed when 11d was dosed orally at 20mg/kg. These results provide further evidence that a potent and selective MC4R antagonist has potential in the treatment of cancer cachexia.
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Affiliation(s)
- Chen Chen
- Department of Medicinal Chemistry, Neurocrine Biosciences, Inc., 12790 El Camino Real, San Diego, CA 92130, USA.
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Damergis J, Napoli A, Marks D, Regan J, Milzman D. 215: Physiologic Parameter Changes of High Altitude and Their Correlation With Acute Mountain Sickness. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.185] [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: 11/25/2022]
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Tran JA, Jiang W, Tucci FC, Fleck BA, Wen J, Sai Y, Madan A, Chen TK, Markison S, Foster AC, Hoare SR, Marks D, Harman J, Chen CW, Arellano M, Marinkovic D, Bozigian H, Saunders J, Chen C. Design, synthesis, in vitro, and in vivo characterization of phenylpiperazines and pyridinylpiperazines as potent and selective antagonists of the melanocortin-4 receptor. J Med Chem 2007; 50:6356-66. [PMID: 17994683 DOI: 10.1021/jm701137s] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Benzylamine and pyridinemethylamine derivatives were synthesized and characterized as potent and selective antagonists of the melanocortin-4 receptor (MC4R). These compounds were also profiled in rodents for their pharmacokinetic properties. Two compounds with diversified profiles in chemical structure, pharmacological activities, and pharmacokinetics, 10 and 12b, showed efficacy in an established murine cachexia model. For example, 12b had a K(i) value of 3.4 nM at MC4R, was more than 200-fold selective over MC3R, and had a good pharmacokinetic profile in mice, including high brain penetration. Moreover, 12b was able to stimulate food intake in the tumor-bearing mice and reverse their lean body mass loss. Our results provided further evidence that a potent and selective MC4R antagonist with appropriate pharmacokinetic properties might potentially be useful for the treatment of cancer cachexia.
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Affiliation(s)
- Joe A Tran
- Department of Medicinal Chemistry, Neurocrine Biosciences, Inc., 12790 El Camino Real, San Diego, California 92130, USA
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Tran JA, Tucci FC, Jiang W, Marinkovic D, Chen CW, Arellano M, Markison S, Fleck BA, Wen J, White NS, Pontillo J, Saunders J, Marks D, Hoare SR, Madan A, Foster AC, Chen C. Pyrrolidinones as orally bioavailable antagonists of the human melanocortin-4 receptor with anti-cachectic activity. Bioorg Med Chem 2007; 15:5166-76. [PMID: 17544282 DOI: 10.1016/j.bmc.2007.05.026] [Citation(s) in RCA: 10] [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] [Received: 11/07/2006] [Revised: 05/03/2007] [Accepted: 05/10/2007] [Indexed: 11/24/2022]
Abstract
A series of pyrrolidinones derived from phenylalanines were synthesized as potent antagonists of the human melanocortin-4 receptor. These compounds showed high potencies and selectivities, and several of them had good oral bioavailabilities. In addition, 12e demonstrated in vivo efficacy in a murine cachexia model.
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Affiliation(s)
- Joe A Tran
- Department of Medicinal Chemistry, Neurocrine Biosciences Inc, San Diego, CA 92130, USA
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Le D, Marks D, Lyle E, Corless CL, Diggs BS, Jobe BA, Kay T, Deveney CW, Wolfe BM, Roberts CT, O'Rourke RW. Serum leptin levels, hepatic leptin receptor transcription, and clinical predictors of non-alcoholic steatohepatitis in obese bariatric surgery patients. Surg Endosc 2007; 21:1593-9. [PMID: 17294310 DOI: 10.1007/s00464-006-9185-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 12/04/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) is a major cause of liver disease in morbidly obese patients. Clinical predictors of NASH remain elusive, as do molecular mechanisms of pathogenesis. METHODS A series of 35 morbidly obese patients undergoing bariatric surgery had a liver biopsy performed for standard histologic analysis. In addition, RNA was obtained from liver tissue and analyzed for leptin receptor gene expression. Regression analysis was used to correlate clinical variables, including serum leptin levels and hepatic leptin receptor gene expression, with the presence of histologically confirmed NASH. RESULTS Of the 35 subjects enrolled, 29% had steatosis only, 60% had NASH, and 11% had normal liver histology. Among the clinical variables studied, only diabetes mellitus was an independent predictor of NASH. There was a trend toward lower levels of mRNA encoding the long form of the leptin receptor in hepatic tissue from patients with NASH compared to those with steatosis only. CONCLUSIONS Diabetes mellitus is associated with an increased risk of NASH in obese patients. Downregulation of hepatic leptin receptor may play a role in the pathogenesis of NASH.
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Affiliation(s)
- D Le
- Department of Surgery-L223A, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon 97239, USA
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Marks D, Thorogood M, Neil SM, Humphries SE, Neil HAW. Cascade screening for familial hypercholesterolaemia: implications of a pilot study for national screening programmes. J Med Screen 2006; 13:156-9. [PMID: 17007658 DOI: 10.1258/096914106778440617] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [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: 11/18/2022]
Abstract
OBJECTIVES To determine what proportion of cases of heterozygous familial hypercholesterolaemia would be identified by cascade screening conducted by a specialist hospital clinic, and by how much this would increase the prevalence of diagnosed cases. SETTING Hospital clinic serving a population of 605,900 in Oxfordshire, UK. METHODS A specialist nurse obtained details of living first-degree relatives from 227 adult patients with heterozygous familial hypercholesterolaemia currently or previously attending Oxford lipid clinic after excluding 79 adults without relatives living in Oxfordshire and 48 children. Index cases were asked to invite relatives resident in Oxfordshire for testing. RESULTS A total of 227 index cases had 1075 first-degree relatives, including 442 adults and 117 children aged < 18 years resident in Oxfordshire. We excluded 171 previously screened adults and 46 for other reasons. Among 225 eligible adult relatives, 28 responders (12%) planned to consult their general practitioner and 52 (23%) attended the clinic for testing. Parents of 113 children (97%) wanted them tested. The positive diagnostic rate was 29% (15/52) in adults and 32% (36/113) in children. Screening increased prevalence by 14.4%, from 0.58/1000 (95% confidence intervals [CI] 0.52-0.65) to 0.67/1000 (95% CI 0.60-0.73), representing 33.5% of predicted cases. CONCLUSIONS Cascade screening conducted by a specialist hospital clinic within its population catchment area did not substantially increase the prevalence of diagnosed familial hypercholesterolaemia. To maximize response rates, clinic staff need to approach relatives directly. Validated age, sex and country-specific diagnostic criteria should be defined, possibly with access to DNA-based tests, to help resolve diagnostic uncertainty.
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Affiliation(s)
- D Marks
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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O'Rourke RW, Kay T, Lyle EA, Traxler SA, Deveney CW, Jobe BA, Roberts CT, Marks D, Rosenbaum JT. Alterations in peripheral blood lymphocyte cytokine expression in obesity. Clin Exp Immunol 2006; 146:39-46. [PMID: 16968396 PMCID: PMC1809726 DOI: 10.1111/j.1365-2249.2006.03186.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Obesity is characterized by alterations in immune and inflammatory function. In order to evaluate the potential role of cytokine expression by peripheral blood mononuclear cells (PBMC) in obesity-associated inflammation, we studied serum protein levels and mRNA levels in PBMC of interleukin (IL)-6, IL-1beta, tumour necrosis factor (TNF)-alpha and IL-1Ra in nine lean and 10 obese subjects. Serum IL-1beta was undetectable, IL-1Ra serum levels were elevated, serum levels of TNF-alpha were decreased and serum levels of IL-6 were similar in obese subjects compared to lean subjects, while transcript levels of IL-6, IL-1beta and TNF-alpha, but not IL-1Ra, were decreased in PBMC from obese subjects. PBMC from obese subjects did, however, up-regulate cytokine expression in response to leptin. Thus, obesity-associated changes in IL-1Ra serum levels and IL-6 mRNA levels were not correlated with changes in cognate mRNA and serum levels, respectively, while TNF-alpha serum levels and PBMC mRNA levels were both decreased in obese patients. While immune alterations in obesity are manifest in peripheral blood lymphocytes, the general lack of correlation between altered serum levels and altered PBMC gene expression suggests that PBMC may not be the source of aberrant serum cytokine levels in obesity.
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Affiliation(s)
- R W O'Rourke
- Department of Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
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Wayman GA, Impey S, Marks D, Saneyoshi T, Grant WF, Derkach V, Soderling TR. Activity-dependent dendritic arborization mediated by CaM-kinase I activation and enhanced CREB-dependent transcription of Wnt-2. Neuron 2006; 50:897-909. [PMID: 16772171 DOI: 10.1016/j.neuron.2006.05.008] [Citation(s) in RCA: 365] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Revised: 04/11/2006] [Accepted: 05/02/2006] [Indexed: 01/22/2023]
Abstract
Members of the Wnt signaling family are important mediators of numerous developmental events, including activity-dependent dendrite development, but the pathways regulating expression and secretion of Wnt in response to neuronal activity are poorly defined. Here, we identify an NMDA receptor-mediated, Ca2+-dependent signaling pathway that couples neuronal activity to dendritic arborization through enhanced Wnt synthesis and secretion. Activity-dependent dendritic outgrowth and branching in cultured hippocampal neurons and slices is mediated through activation by CaM-dependent protein kinase kinase (CaMKK) of the membrane-associated gamma isoform of CaMKI. Downstream effectors of CaMKI include the MAP-kinase pathway of Ras/MEK/ERK and the transcription factor CREB. A serial analysis of chromatin occupancy screen identified Wnt-2 as an activity-dependent CREB-responsive gene. Neuronal activity enhances CREB-dependent transcription of Wnt-2, and expression of Wnt-2 stimulates dendritic arborization. This novel signaling pathway contributes to dynamic remodeling of the dendritic architecture in response to neuronal activity during development.
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Affiliation(s)
- Gary A Wayman
- Vollum Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA
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Duarte RF, Pamphilon D, Cornish J, Shaw BE, Samson D, Craddock C, Marks D, Mufti GJ, Powles RL, Apperley JF, Madrigal JA, Goldman JM. Topical issues in unrelated donor haematopoietic stem cell transplants: a report from a workshop convened by the Anthony Nolan Trust in London - 2005. Bone Marrow Transplant 2006; 37:901-8. [PMID: 16670700 DOI: 10.1038/sj.bmt.1705365] [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: 11/08/2022]
Abstract
Over more than three decades, The Anthony Nolan Trust (ANT) has provided an unrelated donor (UD) for over 4000 children and adults lacking a suitable family member donor, and has remained at the forefront of developments in haematopoietic stem cell transplantation (HSCT) and bone marrow register management. These three decades have seen major changes in clinical practice of UD-HSCT, including new indications, increased use of alternative haematopoietic cell sources, significant improvement of the outcome as a result of better support care, less-toxic conditioning regimens, and better donor selection, and expansion to older patients with higher comorbidities. In order to foster our goal of improving UD-HSCT availability and outcome in a progressively more complex clinical scenario, a new initiative from ANT was launched in 2005 to convene an experts workshop to address the topical issues in this field. Four consecutive panels addressed factors influencing donor selection and transplant outcome, the use of cord blood, regulatory and accreditation issues, and future developments in this field. This report summarizes the discussions held in this workshop, which will likely develop into a periodic event where transplant clinicians, scientists and registry members will meet to share their experience and vision in the field of UD-HSCT.
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Affiliation(s)
- R F Duarte
- The Anthony Nolan Trust, Royal Free Hospital, London, UK.
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Xi C, Marks D, Schlachter S, Luo W, Boppart SA. High-resolution three-dimensional imaging of biofilm development using optical coherence tomography. J Biomed Opt 2006; 11:34001. [PMID: 16822051 DOI: 10.1117/1.2209962] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We describe the use of optical coherence tomography (OCT) for high-resolution, real-time imaging of three-dimensional structure and development of a Pseudomonas aeruginosa biofilm in a standard capillary flow-cell model. As the penetration depth of OCT can reach several millimeters in scattering samples, we are able to observe complete biofilm development on all surfaces of a 1 mm x 1 mm flow-cell. We find that biofilm growing at the bottom of the tube has more structural features including voids, outward projections, and microcolonies while the biofilm growing on the top of the tube is relatively flat and contains less structural features. Volume-rendered reconstructions of cross-sectional OCT images also reveal three-dimensional structural information. These three-dimensional OCT images are visually similar to biofilm images obtained with confocal laser scanning microscopy, but are obtained at greater depths. Based on the imaging capabilities of OCT and the biofilm imaging data obtained, OCT has potential to be used as a non-invasive, label-free, real-time, in-situ and/or in-vivo imaging modality for biofilm characterization.
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Affiliation(s)
- Chuanwu Xi
- University of Illinois at Urbana-Champaign, Department of Civil and Environmental Engineering, Biophotonics Imaging Laboratory, Beckman Institute for Advanced Science and Technology, 61801, USA
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Marks D, Carney PS. Near-field diffractive elements. Opt Lett 2005; 30:1870-2. [PMID: 16092373 DOI: 10.1364/ol.30.001870] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A novel near-field imaging system is proposed and simulated. It is seen that a significant improvement in performance in the presence of noise is possible without loss of resolution.
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Affiliation(s)
- Daniel Marks
- The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA.
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