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Michell E, Lam T, Xia T, Nielsen S, Stevens J. The relationship between presurgical opioid type and persistent postoperative opioid use: a retrospective observational linkage study comparing tapentadol and oxycodone. Anaesthesia 2024; 79:203-205. [PMID: 37932877 DOI: 10.1111/anae.16164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 11/08/2023]
Affiliation(s)
- E Michell
- St Vincent's Clinical Campus, Darlinghurst, UNSW Sydney
| | - T Lam
- Eastern Health Clinical School, Monash University, Frankston, VIC, Australia
| | - T Xia
- Eastern Health Clinical School, Monash University, Frankston, VIC, Australia
| | - S Nielsen
- Eastern Health Clinical School, Monash University, Frankston, VIC, Australia
| | - J Stevens
- St Vincent's Clinical School, UNSW Medicine, Darlinghurst, NSW, Australia
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2
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Halloran J, Szilagyi N, Stevens J, Olezeski C. Assessment of Transgender/Gender-Expansive Accessibility in Inpatient Pediatric Mental Health Facilities. Transgend Health 2023; 8:457-466. [PMID: 37810937 PMCID: PMC10551763 DOI: 10.1089/trgh.2021.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose This study surveyed a national sample of inpatient pediatric behavioral health facilities on policies related to care for transgender and gender-expansive (TGE) youth to assess adherence to best practices. Methods Staff/providers at youth inpatient psychiatric facilities were recruited by phone or email. Participants completed an electronic survey on facilities' training policies, staff comfort related to gender diversity, and other policies related to caring for TGE youth. Results Of 479 potential participating facilities, 124 surveys were initiated and 59 were completed. Measures to ensure accessibility to TGE patients are present in many facilities surveyed, with most reporting that their facility had nondiscrimination policies in place (86.2%) and required training on working with TGE patients (52.5%). A minority of participants (12.1%) reported that their facility roomed TGE youth based on sex assigned at birth, although only a small portion roomed based on gender identity alone (19.0%). Slightly more than two-thirds stated that their facility had individual restrooms available. Most participants (74.6%) stated that facility staff were comfortable discussing gender diversity in general, although this was less common for other topics related to TGE patient care. Conclusion Our survey highlights efforts made by inpatient behavioral health facilities to ensure accessibility of services to TGE youth, although our results showed notable differences across facilities. Given inconsistent federal protections for TGE patients, there remains a need for efforts to ensure that TGE youth are receiving all possible support in these treatment settings, such as accessible restrooms and bedroom assignments, as well as the opportunity to room with peers.
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Affiliation(s)
- Justin Halloran
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Pediatric Gender Program, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nathalie Szilagyi
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jaime Stevens
- Affirming Psychiatry LLC, Hobe Sound, Florida, USA
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Christy Olezeski
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Pediatric Gender Program, Yale School of Medicine, New Haven, Connecticut, USA
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3
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Stevens J. Transgender and Gender Diverse Youth in Inpatient and Other Residential Care. Child Adolesc Psychiatr Clin N Am 2023; 32:849-866. [PMID: 37739639 DOI: 10.1016/j.chc.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Inpatient and other residential care environments require special considerations for safety and unique opportunities to provide affirming care to TGD youth. Gender-positive policies, staff training, communication, placement, programming, and discharge planning are imperative; however, data and literature are limited in regard to affirming the care of TGD youth in such environments. This chapter draws from published research and best practice to support the wellness of TGD individuals in inpatient and similar settings. It offers clinical guidance for an organization's clinicians, administrators, educators, and advocates to provide safer and more effective care for TGD youth in such facilities to best support their mental and physical health.
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Affiliation(s)
- Jaime Stevens
- Affirming Psychiatry LLC, University of Hawai'i, PO Box 22148, Honolulu, HI 96823, USA.
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4
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Bolhuis MS, Akkerman OW, Sturkenboom MGG, van Boven JFM, Alffenaar JWC, Stevens J. Bedaquiline exposure in people with drug-resistant TB treated for diabetes: analysis of two phase 2 trials. Int J Tuberc Lung Dis 2023; 27:335-337. [PMID: 37035978 DOI: 10.5588/ijtld.22.0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Affiliation(s)
- M S Bolhuis
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
| | - O W Akkerman
- Department o Pulmonary Diseases and Tuberculosis, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands, TB Center Beatrixoord, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
| | - M G G Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
| | - J F M van Boven
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
| | - J-W C Alffenaar
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia, Westmead Hospital, Westmead, NSW, Australia, Sydney Institute for Infectious Diseases, University of Sydney, Sydney, NSW, Australia
| | - J Stevens
- Department of Clinical Pharmacy and Pharmacology, University Medical Centrum Groningen, University of Groningen, Groningen, The Netherlands
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Lam T, Stevens J, Nielsen S. A call to action: how can we better implement recommendations for non-routine use of modified-release opioid formulations? Anaesthesia 2023; 78:660-661. [PMID: 36756701 DOI: 10.1111/anae.15979] [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] [Accepted: 01/17/2023] [Indexed: 02/10/2023]
Affiliation(s)
- T Lam
- Monash Addiction Research Centre, Monash University, Frankston, Australia
| | - J Stevens
- St Vincent's Clinical School, UNSW Sydney, Darlinghurst, Australia
| | - S Nielsen
- Monash Addiction Research Centre, Monash University, Frankston, Australia
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Lam T, Stevens J, Nielsen S. For complex problems, there are rarely simple solutions, but many pieces of an important puzzle. Anaesthesia 2023; 78:655-656. [PMID: 36718509 DOI: 10.1111/anae.15970] [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] [Accepted: 01/10/2023] [Indexed: 02/01/2023]
Affiliation(s)
- T Lam
- Monash Addiction Research Centre, Monash University, Frankston, Australia
| | - J Stevens
- St Vincent's Clinical School, UNSW Sydney, Darlinghurst, Australia
| | - S Nielsen
- Monash Addiction Research Centre, Monash University, Frankston, Australia
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7
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Saiki K, Lee MJ, Benny P, Gragas A, Stevens J, Yamasato K. Social needs screening and perceived stress scale scores in a pregnant cohort. Am J Obstet Gynecol 2023. [DOI: 10.1016/j.ajog.2022.11.607] [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: 01/08/2023]
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8
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Lindsey M, Liu Y, Cuthbert J, Stevens J, Isom C. 213 Using mRNA from cytoplasmic biopsies to assess molecular maturation and developmental potential of bovine oocytes. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab213] [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: 12/12/2022] Open
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Stevens J, Kostalas M, Chapman A, Prabhudesai S, Ratnasingham K. P-114 INVESTIGATING THE ROLE OF BOTOX IN THE EMERGENCY MANAGEMENT OF COMPLEX ABDOMINAL WALL HERNIAS. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.212] [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: 11/12/2022]
Abstract
Abstract
Aims
Botulinum toxin (Botox) has an established role in the elective management of complex abdominal wall hernia, but its role in the emergency setting has not been investigated. Clinical effects of Botox peak at 2–3 weeks after injection, but effects become apparent within 48 hours. We aimed to determine if these early effects can facilitate the acute reduction of irreducible hernia.
Materials and methods
Patients with irreducible abdominal wall hernias over a 30 month period were considered for Botox therapy. Suitable patients were given 300 units of Botox under ultrasound guidance into the anterolateral muscles bilaterally. Data were collected on outcomes.
Results
Twelve patients received Botox. All had incisional hernias and an ASA of 3 or more. Six were on antiplatelets and/or anticoagulation. All received Botox with standard conservative management. In ten patients, the hernia was reduced and symptoms resolved. One patient required surgery at 48 hours due to bowel ischaemia from inter-sac adhesions. A second patient experienced recurrent obstruction despite successful hernia reduction but was palliated due to advanced age and frailty.
Conclusions
This case series is the first study to investigate the role of Botox in the acute management of irreducible hernias. Our findings suggest that in selected patients, Botox can aid hernia reduction and avoid the morbidity of emergency repair. This is of particular value in high risk patients and those with complex defects who benefit from preoperative optimisation techniques. The accurate identification of strangulation is crucial however, as it excludes patients from this approach.
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Affiliation(s)
- J Stevens
- General Surgery, St Peters Hospital , Chertsey , United Kingdom
| | - M Kostalas
- General Surgery, St Peters Hospital , Chertsey , United Kingdom
| | - A Chapman
- Interventional Radiology, St Peters Hospital , Chertsey , United Kingdom
| | - S Prabhudesai
- Interventional Radiology, St Peters Hospital , Chertsey , United Kingdom
| | - K Ratnasingham
- General Surgery, St Peters Hospital , Chertsey , United Kingdom
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10
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Stevens J, Szombati D, Maffei M, Elouard C, Assouly R, Cottet N, Dassonneville R, Ficheux Q, Zeppetzauer S, Bienfait A, Jordan AN, Auffèves A, Huard B. Energetics of a Single Qubit Gate. Phys Rev Lett 2022; 129:110601. [PMID: 36154409 DOI: 10.1103/physrevlett.129.110601] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
Qubits are physical, a quantum gate thus not only acts on the information carried by the qubit but also on its energy. What is then the corresponding flow of energy between the qubit and the controller that implements the gate? Here we exploit a superconducting platform to answer this question in the case of a quantum gate realized by a resonant drive field. During the gate, the superconducting qubit becomes entangled with the microwave drive pulse so that there is a quantum superposition between energy flows. We measure the energy change in the drive field conditioned on the outcome of a projective qubit measurement. We demonstrate that the drive's energy change associated with the measurement backaction can exceed by far the energy that can be extracted by the qubit. This can be understood by considering the qubit as a weak measurement apparatus of the driving field.
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Affiliation(s)
- J Stevens
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - D Szombati
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - M Maffei
- CNRS and Université Grenoble Alpes, Institut Néel, F-38042 Grenoble, France
| | - C Elouard
- QUANTIC team, INRIA de Paris, 2 Rue Simone Iff, 75012 Paris, France
| | - R Assouly
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - N Cottet
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - R Dassonneville
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - Q Ficheux
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - S Zeppetzauer
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - A Bienfait
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
| | - A N Jordan
- Institute for Quantum Studies, Chapman University, 1 University Drive, Orange, California 92866, USA
- Department of Physics and Astronomy, University of Rochester, Rochester, New York 14627, USA
| | - A Auffèves
- CNRS and Université Grenoble Alpes, Institut Néel, F-38042 Grenoble, France
| | - B Huard
- Ecole Normale Supérieure de Lyon, CNRS, Laboratoire de Physique, F-69342 Lyon, France
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11
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Elliott CP, Commander LE, Merino‐Martín L, Golos PJ, Stevens J, Miller BP. An approach to defining and achieving restoration targets for a threatened plant community. Ecol Appl 2022; 32:e2613. [PMID: 35366034 PMCID: PMC9539575 DOI: 10.1002/eap.2613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Connecting scientific research and government policy is essential for achieving objectives in sustaining biodiversity in an economic context. Our approach to connecting theoretical ecology, applied ecology, and policy was devised using principles of restoration ecology and the requisite methodology to restore biodiverse ecosystems. Using a threatened ecological community (TEC) with >120 plant species, we posit our approach as a guide for interpreting and achieving regulatory compliance (i.e., government conditions) enacted to manage or offset environmental impacts of development. We inform the scientific approach necessary to delivering outcomes appropriate to policy intent and biodiverse restoration through theoretical and applied research into the ecological restoration of the highly endemic flora of banded ironstone formations of the Mid West of Western Australia. Our approach (1) defines scale-appropriate restoration targets that meet regulatory compliance (e.g., Government of Western Australia Ministerial Conditions); (2) determines the optimal method to return individual plant species to the restoration landscape; (3) develops a conceptual model for our system, based on existing restoration frameworks, to optimize and facilitate the pathway to the restoration of a vegetation community (e.g., TEC) using diverse research approaches; and (4) develops an assessment protocol to compare restoration achievements against the expected regulatory outcomes using our experimental restoration trials as a test example. Our approach systematically addressed the complex challenges in setting and achieving restoration targets for an entire vegetation community, a first for a semiarid environment. We interpret our approach as an industry application relevant to policy- or regulator-mediated mine restoration programs that seek to return biodiverse species assemblages at landscape scales.
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Affiliation(s)
- C. P. Elliott
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - L. E. Commander
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - L. Merino‐Martín
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
- Present address:
Departamento de Biología y Geología, Física y Química inorgánicaESCET, Universidad Rey Juan CarlosMadridSpain
| | - P. J. Golos
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - J. Stevens
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - B. P. Miller
- Kings Park Science, Department of BiodiversityConservation and AttractionsKings ParkWestern AustraliaAustralia
- School of Biological SciencesThe University of Western AustraliaCrawleyWestern AustraliaAustralia
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12
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Uden L, Abkur T, Gollins C, Stevens J. The value of systemic examination in the diagnosis of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, Skin disease). QJM 2022; 115:553-554. [PMID: 35511167 DOI: 10.1093/qjmed/hcac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/11/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Uden
- Department of Neurology, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK
| | - T Abkur
- Department of Neurology, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK
| | - C Gollins
- Department of Dermatology, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK
| | - J Stevens
- Department of Neurology, Southmead Hospital, Southmead Rd, Bristol, BS10 5NB, UK
- School of Medicine, University of Bristol, Bristol, BS8 1UD, UK
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13
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Elzeiny H, Agtesta F, Cattrall F, Stevens J, Gardner D. P-003 Sperm retrieved by microdissection testicular sperm extraction (MD-TESE) is associated with altered sex ratio of offspring after intracytoplasmic sperm injection in men with non-obstructive azoospermia. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does the sperm retrieved surgically by MD-TESE of men with Non-Obstructive Azoospermia affect the live birth sex ratio?
Summary answer
Our data indicates that sperm retrieved in men with non-obstructive azoospermia alters the sex ratio in favor of female offspring.
What is known already
Non-Obstructive Azoospermia is the most severe form of male infertility and is the most common cause of Azoospermia. Among the different surgical techniques, MD-TESE gives the highest rate of sperm retrieval and when combined with intracytoplasmic sperm injection (ICSI), live births had been achieved with variable success, Sex ratio of offspring can vary substantially due to several variables, however no studies have investigated the resultant birth sex ratio in this setting.
Study design, size, duration
Retrospective Cohort study. Data were collected between May 2009 and December 2019. A total of 100 consecutive men with non-obstructive Azoospermia underwent MD-TESE for sperm retrieval. 46 couples underwent ICSI and live birth rate, cumulative live birth rate and sex ratio of offspring analysed.
Participants/materials, setting, methods
One-hundred men underwent MD-TESE out of which 46 proceeded with ICSI. Demographic data including male and female age, testicular volumes and serum hormone values are given as mean ± SD with a range (minimum and maximum). Fertility outcomes including sperm retrieval, fertilization rate, number of embryos transferred, and live birth rates and cumulative live birth rates were recorded. Chi-square test was performed to compare the proportions.
Main results and the role of chance
Sperm retrieval was successful in 58%(58/100). Testicular volume and hormonal parameters did not vary among patients with positive or negative sperm retrieval. Histology gave best correlation with sperm retrieval. Hypospermatogenesis yielded the highest sperm retrieval 93%(26/29), followed by Maturation arrest 78%(7/9), then Hyalinosis 46% (6/13) and lastly Sertoli cell only 38%(19/50). 46 couples underwent ICSI cycles where the mean age of patients and their wives were 36.4 ± 3.7y and 33.0 ± 4.3y. Fertilization rate and mean number of transferred embryos were 51.4 % and 1.7. Live birth rate and Cumulative Live Birth rate per Embryo transfer were 60.5% (26/43) and 74.4% (32/43) and per started ICSI cycle were 56.5% (26/46) and 69.6% (32/46), with a twin rate of 15.3%(4/26). Mean gestational length and mean body weight at birth were 39.0 ± 1.4w and 3228.5 ± 5.5 g. Number of live offspring were 36 (Female: Male = 26:10) giving rise to sex ratio of 2.6 to1 in favor of female offspring (P < 0.05). There were no neonatal death, and one baby had phenylketonuria.
Limitations, reasons for caution
This is the first study to test the hypothesis of sex ratio variation related to the source of sperm; the strength of our study is that all procedures were performed by the same surgeon, so there are no operator-dependent differences. This finding needs to be confirmed in larger cohort studies.
Wider implications of the findings
It has been demonstrated that different stressors may alter the sex of the offspring. While in the present study the stressor is the parental hypogonadism associated with non-obstructive azoospermia, We hypothesise that testicular environment may direct spermatogenesis in favor of X carrying sperm around the time of sperm retrieval.
Trial registration number
N/A
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Affiliation(s)
- H Elzeiny
- Melbourne IVF , East Melbourne, Melbourne, Australia
- Royal Women's Hospital, Reproductive Services Unit , Melbourne, Australia
| | - F Agtesta
- Melbourne IVF , East Melbourne, Melbourne, Australia
| | - F Cattrall
- Melbourne IVF , East Melbourne, Melbourne, Australia
| | - J Stevens
- Melbourne IVF , East Melbourne, Melbourne, Australia
| | - D.K Gardner
- Melbourne IVF , East Melbourne, Melbourne, Australia
- University of Melbourne, School of BioSience , Melbourne, Australia
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14
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Brokus C, Kattakuzhy S, Gayle B, Narayanan S, Davis A, Cover A, Eyasu R, Ebah E, Ogbumbadiugha-Weekes O, Hoffmann J, Silk R, Stevens J, Mount J, Gannon C, Nussdorf L, Mathur P, Bijole P, Jones M, Kier R, Sternberg D, Greenblatt A, Weintraub E, Masur H, Kottilil S, Rosenthal E. Suboptimal uptake, retention, and adherence of daily oral PrEP among people with OUD receiving HCV treatment. Open Forum Infect Dis 2021; 9:ofab658. [PMID: 35187191 PMCID: PMC8849288 DOI: 10.1093/ofid/ofab658] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Daily oral preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) prevents human immunodeficiency (HIV) among people who inject drugs (PWID). Despite rising HIV incidence and injection drug use (IDU), PrEP use remains low and there is limited research about uptake, adherence, and retention among PWID. Methods The ANCHOR investigation evaluated a community-based care model collocating hepatitis C virus (HCV) treatment, medication for opioid use disorder (OUD), and PrEP in individuals in Washington, DC, and Baltimore, Maryland. PrEP counseling was conducted from HCV treatment day 0 until week 24. Subjects could start any time during this window, were followed for 48 weeks, and were assessed for adherence by self-report and dried blood spot TDF analysis. Results One hundred ninety-eight participants were enrolled, of whom 185 (93%) were HIV negative. Twenty-nine individuals (15.7% of HIV-negative cohort) initiated PrEP. One hundred sixteen participants (62.7%) met 2014 Centers for Disease Control and Prevention (CDC) PrEP criteria due to IDU (82 [44.3%]), sex (9 [4.9%]), or both practices (25 [13.5%]). Providers recommended PrEP to 94 individuals (50.8%), and recommendation was associated with PrEP uptake. Median treatment duration was 104 days (interquartile range, 28–276 days), with 8 participants retained through week 48. Adherence was variable over time by self-report and declined by TDF analysis. No HIV seroconversions occurred. Conclusions This cohort of people with HCV and OUD experienced low uptake of PrEP despite the majority meeting CDC criteria. High rates of disruption and discontinuation, compounded by variable adherence, made TDF/FTC a suboptimal prevention strategy. Emerging modalities like long-acting formulations may address these barriers, but PWID have been excluded from their development to date.
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Affiliation(s)
- C Brokus
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - S Kattakuzhy
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - B Gayle
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - S Narayanan
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Davis
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Cover
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Eyasu
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Ebah
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - O Ogbumbadiugha-Weekes
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - J Hoffmann
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Silk
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - J Stevens
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - J Mount
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - C Gannon
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - L Nussdorf
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
| | - P Mathur
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - P Bijole
- HIPS, org, Washington, DC, United States
| | - M Jones
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - R Kier
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - D Sternberg
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - A Greenblatt
- Department of Family & Community Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Weintraub
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
| | - H Masur
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - S Kottilil
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - E Rosenthal
- DC Partnership for HIV/AIDS Progress, Washington, DC, United States
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
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15
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Sieunarine A, Lloyd-Evans J, Stevens J. P.67 A review of fluid balance documentation in high-risk obstetric women on our maternal high dependency unit. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103065] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Awadalla R, Liu S, Kemp-Casey A, Gnjidic D, Patanwala A, Stevens J, Begley D, Bugeja B, Penm J. Impact of an Australian/New Zealand organisational position statement on extended-release opioid prescribing among surgical inpatients: a dual centre before-and-after study. Anaesthesia 2021; 76:1607-1615. [PMID: 33954980 DOI: 10.1111/anae.15500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/23/2022]
Abstract
Extended-release opioids are often prescribed to manage postoperative pain despite being difficult to titrate to analgesic requirements and their association with long-term opioid use. An Australian/New Zealand organisational position statement released in March 2018 recommended avoiding extended-release opioid prescribing for acute pain. This study aimed to evaluate the impact of this organisational position statement on extended-release opioid prescribing among surgical inpatients. Secondary objectives included predictors and clinical outcomes of prescribing extended-release opioids among surgical inpatients. We conducted a retrospective, dual centre, 11-month before-and-after study and time-series analysis by utilising electronic medical records from two teaching hospitals in Sydney, Australia. The primary outcome was the proportion of patients prescribed an extended-release opioid. For surgical patients prescribed any opioid (n = 16,284), extended-release opioid prescribing decreased after the release of the position statement (38.4% before vs. 26.6% after, p < 0.001), primarily driven by a reduction in extended-release oxycodone (31.1% before vs. 14.1% after, p < 0.001). There was a 23% immediate decline in extended-release opioid prescribing after the position statement release (p < 0.001), followed by an additional 0.2% decline per month in the following months. Multivariable regression showed that the release of the position statement was associated with a decrease in extended-release opioid prescribing (OR 0.54, 95%CI 0.50-0.58). Extended-release opioid prescribing was also associated with increased incidence of opioid-related adverse events (OR 1.52, 95%CI 1.35-1.71); length of stay (RR 1.44, 95%CI 1.39-1.51); and 28-day re-admission (OR 1.26, 95%CI 1.12-1.41). Overall, a reduction in extended-release opioid prescribing was observed in surgical inpatients following position statement release.
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Affiliation(s)
- R Awadalla
- Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - S Liu
- Department of Pharmacy, Prince of Wales Hospital, Randwick, NSW, Australia
| | - A Kemp-Casey
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - D Gnjidic
- Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - A Patanwala
- Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW, Australia
| | - J Stevens
- University of New South Wales, Sydney, NSW, Australia.,University of Notre Dame, Sydney, NSW, Australia
| | - D Begley
- Department of Pain Management, Prince of Wales Hospital, Randwick, NSW, Australia
| | - B Bugeja
- Department of Pain Management, Prince of Wales Hospital, Randwick, NSW, Australia
| | - J Penm
- Department of Pharmacy, Prince of Wales Hospital, Randwick, NSW, Australia.,Faculty of Medicine and Health, School of Pharmacy, University of Sydney, Sydney, NSW, Australia
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17
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Hughes HJJ, Stevens J. Initial naval officer training: enhancing physical preparedness through an improved joining instruction process. BMJ Mil Health 2021; 168:239-240. [PMID: 33542141 DOI: 10.1136/bmjmilitary-2020-001707] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/03/2022]
Affiliation(s)
| | - J Stevens
- 42 Commando RM, Bickleigh Barracks, Plymouth, UK
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18
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Svetnik V, Wang T, Ceesay P, Ceren O, Snyder E, Bliwise D, Budd K, Hutzelmann J, Stevens J, Lines C, Michelson D, Herring W. 0487 Effects of Suvorexant on Sleep Architecture in Patients with Alzheimer’s Disease and Insomnia. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Suvorexant, an orexin receptor antagonist that enables sleep to occur via competitive antagonism of wake-promoting orexins, improved total sleep time (TST) in a sleep laboratory polysomnography (PSG) study of patients with AD and insomnia. Here we report on the effects of suvorexant on sleep architecture in the study.
Methods
This was a randomized, double-blind, 4-week trial (ClinicalTrials.gov NCT02750306). Participants who met diagnostic criteria for both probable AD dementia (of mild to moderate severity) and insomnia were randomized to suvorexant 10mg (could be increased to 20mg based on clinical response) or matching placebo. Overnight sleep laboratory PSG was performed on 3 nights: screening, baseline, and Night-29 (last night of dosing). Suvorexant differences from placebo in changes-from-baseline at Night-29 for sleep architecture were analyzed as exploratory endpoints.
Results
A total of 274 participants were included in the analysis (suvorexant N=135, placebo N=139). At Night-29, suvorexant improved TST by 28 minutes versus placebo (p=0.001). There were no significant differences between suvorexant and placebo in the % of TST spent in REM (1.3%, 95% CI: -0.5, 3.0), N1 (0.6%, 95% CI: -1.2, 2.5), N2 (-1.0%, 95% CI: -3.2, 1.2), or N3 (-0.6%, 95% CI: -1.8, 0.6). There was no significant difference between suvorexant and placebo in latency to REM (-5.4 minutes, 95% CI: -23.4, 12.7).
Conclusion
Suvorexant improves TST without altering the underlying sleep architecture in AD patients with insomnia.
Support
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA
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Affiliation(s)
| | - T Wang
- Merck & Co., Inc., Kenilworth, NJ
| | - P Ceesay
- Merck & Co., Inc., Kenilworth, NJ
| | - O Ceren
- Merck & Co., Inc., Kenilworth, NJ
| | - E Snyder
- Merck & Co., Inc., Kenilworth, NJ
| | - D Bliwise
- Emory University School of Medicine, Atlanta, GA
| | - K Budd
- Merck & Co., Inc., Kenilworth, NJ
| | | | | | - C Lines
- Merck & Co., Inc., Kenilworth, NJ
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19
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Svetnik V, Wang T, Ceesay P, Snyder E, Ceren O, Bliwise D, Budd K, Hutzelmann J, Stevens J, Lines C, Michelson D, Herring W. 0488 Pilot Evaluation of an Actigraphy Watch Compared to Polysomnography in a Clinical Trial of Suvorexant for Treating Insomnia in Patients with Alzheimer’s Disease. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.485] [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
Abstract
Introduction
Suvorexant, an orexin receptor antagonist, improved total sleep time (TST) in a sleep laboratory polysomnography (PSG) study of patients with Alzheimer’s disease (AD) and insomnia. The study included a pilot evaluation of an actigraphy watch for continuously recording patient’s sleep and daytime activity. We report on the utility of the watch for assessing sleep in relation to gold-standard PSG.
Methods
This was a randomized, double-blind, 4-week trial (ClinicalTrials.gov NCT02750306). Participants who met diagnostic criteria for both probable AD dementia and insomnia were randomized to suvorexant 10-20mg or placebo. Overnight sleep laboratory PSG was performed on 3 nights: screening, baseline, and Night-29 (last dose). An actigraphy watch (Garmin vívosmart® HR) was worn continuously by the patient. Separate analyses were performed for PSG and watch. We compared treatment effects on change-from-baseline in PSG-TST at Night-29 and WATCH-TST at Week-4 (average TST per night over Week-4). We also analyzed Night-29 data only with watch data restricted to the PSG recording time.
Results
A total of 274 participants were included in the Night-29 PSG analysis (suvorexant=135, placebo=139) and 223 in the Week-4 watch analysis (suvorexant=113, placebo=110). Suvorexant improved Night-29 PSG-TST by 28 minutes versus placebo (p=0.001) and Week-4 WATCH-TST by 17 minutes versus placebo (p=0.144). In the subgroup who had usable data for both assessments at Night-29 (suvorexant=57, placebo=50), the watch overestimated TST compared to PSG (e.g. placebo baseline scores = 412 minutes for WATCH-TST and 265 minutes for PSG-TST) and underestimated change-from-baseline treatment effects: the suvorexant versus placebo difference was 35 minutes for PSG-TST (p=0.057) and 20 minutes for WATCH-TST (p=0.405).
Conclusion
The watch was less sensitive than PSG for evaluating treatment effects on TST. However, results obtained with the watch were directionally similar to PSG in indicating a benefit of suvorexant versus placebo for improving TST in AD patients with insomnia.
Support
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA
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Affiliation(s)
| | - T Wang
- Merck & Co., Inc., Kenilworth, NJ
| | - P Ceesay
- Merck & Co., Inc., Kenilworth, NJ
| | - E Snyder
- Merck & Co., Inc., Kenilworth, NJ
| | - O Ceren
- Merck & Co., Inc., Kenilworth, NJ
| | - D Bliwise
- Emory University School of Medicine, Atlanta, GA
| | - K Budd
- Merck & Co., Inc., Kenilworth, NJ
| | | | | | - C Lines
- Merck & Co., Inc., Kenilworth, NJ
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20
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Herring W, Ceesay P, Snyder E, Bliwise D, Budd K, Hutzelmann J, Stevens J, Michelson D. A randomized controlled trial of suvorexant for treating insomnia in patients with Alzheimer's disease: effects on objective sleep measures. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.419] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Abernethy G, Otter D, Arnold K, Austad J, Christiansen S, Ferreira I, Irvine F, Marsh C, Massom LR, Otter D, Pearce K, Stevens J, Szpylka J, Vyas P, Woollard D, Wu C. Determination of Immunoglobulin G in Bovine Colostrum and Milk Powders, and in Dietary Supplements of Bovine Origin by Protein G Affinity Liquid Chromatography: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/93.2.622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
An AOAC collaborative study was conducted to evaluate an affinity LC procedure for measuring immunoglobulin G (IgG) in selected dairy powders. The powders were extracted with 0.15 M sodium chloride solution and the pH was adjusted to 4.6 to precipitate caseins, which would otherwise lead to an overestimation of IgG. The analyte was then bound to a commercially available Protein G affinity cartridge and selectively eluted with a glycine buffer at pH 2.5. Detection was at 280 nm and quantification was made against a calibration curve prepared from bovine serum IgG. The samples analyzed included the likely matrixes for which this assay will find commercial use, namely, high- and low-protein-content colostrum powders, tablets containing colostrum powder, and some IgG-containing dairy powders; milk protein isolate, whey protein concentrate, and skim milk powder. Eleven laboratories provided data for the study and assayed blind duplicates of six materials. The repeatability RSD values ranged from 2.1 to 4.2 and the reproducibility RSD values ranged from 6.4 to 18.5. The Protein G method with casein removal has adequate reproducibility for measuring IgG in colostrum-derived powders that are traded on the basis of IgG content as a colostral marker.
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Affiliation(s)
- Grant Abernethy
- Fonterra Co-operative Group Ltd, Private Bag 11029, Palmerston North 4442, New Zealand
| | - Don Otter
- AgResearch Ltd, Grasslands Research Centre, Tennent Dr, Private Bag 11008, Palmerston North 4442, New Zealand
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Veres P, Bhat PN, Briggs MS, Cleveland WH, Hamburg R, Hui CM, Mailyan B, Preece RD, Roberts OJ, von Kienlin A, Wilson-Hodge CA, Kocevski D, Arimoto M, Tak D, Asano K, Axelsson M, Barbiellini G, Bissaldi E, Dirirsa FF, Gill R, Granot J, McEnery J, Omodei N, Razzaque S, Piron F, Racusin JL, Thompson DJ, Campana S, Bernardini MG, Kuin NPM, Siegel MH, Cenko SB, O’Brien P, Capalbi M, Daì A, De Pasquale M, Gropp J, Klingler N, Osborne JP, Perri M, Starling RLC, Tagliaferri G, Tohuvavohu A, Ursi A, Tavani M, Cardillo M, Casentini C, Piano G, Evangelista Y, Verrecchia F, Pittori C, Lucarelli F, Bulgarelli A, Parmiggiani N, Anderson GE, Anderson JP, Bernardi G, Bolmer J, Caballero-García MD, Carrasco IM, Castellón A, Segura NC, Castro-Tirado AJ, Cherukuri SV, Cockeram AM, D’Avanzo P, Di Dato A, Diretse R, Fender RP, Fernández-García E, Fynbo JPU, Fruchter AS, Greiner J, Gromadzki M, Heintz KE, Heywood I, van der Horst AJ, Hu YD, Inserra C, Izzo L, Jaiswal V, Jakobsson P, Japelj J, Kankare E, Kann DA, Kouveliotou C, Klose S, Levan AJ, Li XY, Lotti S, Maguire K, Malesani DB, Manulis I, Marongiu M, Martin S, Melandri A, Michałowski MJ, Miller-Jones JCA, Misra K, Moin A, Mooley KP, Nasri S, Nicholl M, Noschese A, Novara G, Pandey SB, Peretti E, del Pulgar CJP, Pérez-Torres MA, Perley DA, Piro L, Ragosta F, Resmi L, Ricci R, Rossi A, Sánchez-Ramírez R, Selsing J, Schulze S, Smartt SJ, Smith IA, Sokolov VV, Stevens J, Tanvir NR, Thöne CC, Tiengo A, Tremou E, Troja E, de Ugarte Postigo A, Valeev AF, Vergani SD, Wieringa M, Woudt PA, Xu D, Yaron O, Young DR. Observation of inverse Compton emission from a long γ-ray burst. Nature 2019; 575:459-463. [DOI: 10.1038/s41586-019-1754-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 10/18/2019] [Indexed: 11/09/2022]
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23
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Paul PA, Salgado JD, Bergstrom G, Bradley CA, Byamukama E, Byrne AM, Chapara V, Cummings JA, Chilvers MI, Dill-Macky R, Friskop A, Kleczewski N, Madden LV, Nagelkirk M, Stevens J, Smith M, Wegulo SN, Wise K, Yabwalo D. Integrated Effects of Genetic Resistance and Prothioconazole + Tebuconazole Application Timing on Fusarium Head Blight in Wheat. Plant Dis 2019; 103:223-237. [PMID: 30484755 DOI: 10.1094/pdis-04-18-0565-re] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Integrated Fusarium head blight (FHB) management programs consisting of different combinations of cultivar resistance class and an application of the fungicide prothioconazole + tebuconazole at or after 50% early anthesis were evaluated for efficacy against FHB incidence (INC; percentage of diseased spikes), index (IND; percentage of diseased spikelets per spike), Fusarium damaged kernel (FDK), deoxynivalenol (DON) toxin contamination, grain yield, and test weight (TW) in inoculated field trials conducted in 11 U.S. states in 2014 and 2015. Mean log response ratios and corresponding percent control values for INC, IND, FDK, and DON, and mean differences in yield and TW relative to a nontreated, inoculated susceptible check (S_CK), were estimated through network meta-analyses as measures of efficacy. Results from the analyses were then used to estimate the economic benefit of each management program for a range of grain prices and fungicide applications costs. Management programs consisting of a moderately resistant (MR) cultivar treated with the fungicide were the most efficacious, reducing INC by 60 to 69%, IND by 71 to 76%, FDK by 66 to 72%, and DON by 60 to 64% relative to S_CK, compared with 56 to 62% for INC, 68 to 72% for IND, 66 to 68% for FDK, and 58 to 61% for DON for programs with a moderately susceptible (MS) cultivar. The least efficacious programs were those with a fungicide application to a susceptible (S) cultivar, with less than a 45% reduction of INC, IND, FDK, or DON. All programs were more efficacious under conditions favorable for FHB compared with less favorable conditions, with applications made at 50% early anthesis being of comparable efficacy to those made 2 to 7 days later. Programs with an MS cultivar resulted in the highest mean yield increases relative to S_CK (541 to 753 kg/ha), followed by programs with an S cultivar (386 to 498 kg/ha) and programs with an MR cultivar (250 to 337 kg/ha). Integrated management programs with an MS or MR cultivar treated with the fungicide at or after 50% early anthesis were the most likely to result in a 50 or 75% control of IND, FDK, or DON in a future trial. At a fixed fungicide application cost, these programs were $4 to $319/MT more economically beneficial than corresponding fungicide-only programs, depending on the cultivar and grain price. These findings demonstrate the benefits of combining genetic resistance with a prothioconazole + tebuconazole treatment to manage FHB, even if that treatment is applied a few days after 50% early anthesis.
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Affiliation(s)
- P A Paul
- Department of Plant Pathology, The Ohio State University, Ohio Agricultural Research and Development Center, Wooster, OH 44691
| | - J D Salgado
- Department of Plant Pathology, The Ohio State University, Ohio Agricultural Research and Development Center, Wooster, OH 44691
| | - G Bergstrom
- Plant Pathology and Plant-Microbe Biology Section, School of Integrative Plant Science, Cornell University, Ithaca, NY 14853
| | - C A Bradley
- Department of Plant Pathology, University of Kentucky Research and Education Center, Princeton, KY 42445
| | - E Byamukama
- South Dakota State University, Department of Agronomy, Horticulture, and Plant Sciences, Brookings, SD 57007
| | - A M Byrne
- Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing, MI 48824
| | - V Chapara
- North Dakota State University, Langdon Research Extension Center, Langdon, ND 58249
| | - J A Cummings
- Plant Pathology and Plant-Microbe Biology Section, School of Integrative Plant Science, Cornell University, Ithaca, NY 14853
| | - M I Chilvers
- Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing, MI 48824
| | - R Dill-Macky
- Department of Plant Pathology, University of Minnesota, Saint Paul, MN 55108
| | - A Friskop
- North Dakota State University, Department of Plant Pathology, Fargo, ND 58102
| | - N Kleczewski
- Department of Plant and Soil Sciences, The University of Delaware, Newark, DE 19719
| | - L V Madden
- Department of Plant Pathology, The Ohio State University, Ohio Agricultural Research and Development Center, Wooster, OH 44691
| | - M Nagelkirk
- Michigan State University Extension, Sandusky, MI 48471
| | - J Stevens
- University of Nebraska-Lincoln, Department of Plant Pathology, NE 68538
| | - M Smith
- Department of Plant Pathology, University of Minnesota, Northwest Research and Outreach Center, Crookston, MN 56716
| | - S N Wegulo
- University of Nebraska-Lincoln, Department of Plant Pathology, NE 68538
| | - K Wise
- Department of Plant Pathology, University of Kentucky Research and Education Center, Princeton, KY 42445
| | - D Yabwalo
- South Dakota State University, Department of Agronomy, Horticulture, and Plant Science, Brookings, SD 57007
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24
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Stevens J, Trimboli A, Samios P, Steele N, Welch S, Thompson P, Halvorsen C, Kerr S. A sustainable method to reduce postoperative oxycodone discharge prescribing in a metropolitan tertiary referral hospital. Anaesthesia 2019; 74:292-299. [DOI: 10.1111/anae.14570] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/28/2022]
Affiliation(s)
- J. Stevens
- Brian Dwyer Department of Anaesthetics; St Vincent's Public Hospital; Darlinghurst NSW Australia
| | - A. Trimboli
- Prince of Wales Hospital; Sydney NSW Australia
| | - P. Samios
- Justice Health and Forensic Mental Health Network; Sydney NSW Australia
| | - N. Steele
- Brian Dwyer Department of Anaesthetics; St Vincent's Public Hospital; Darlinghurst NSW Australia
| | - S. Welch
- Brian Dwyer Department of Anaesthetics; St Vincent's Public Hospital; Darlinghurst NSW Australia
| | - P. Thompson
- Brian Dwyer Department of Anaesthetics; St Vincent's Public Hospital; Darlinghurst NSW Australia
| | - C. Halvorsen
- Royal Australian Air Force Base; Townsville Health Centre; Currajong QLD Australia
| | - S. Kerr
- Faculty of Medicine; Chulalongkorn University; Bangkok Thailand
- Biostatistics Centre, Research Affairs, Faculty of Medicine, The Kirby Institute; University of New South Wales; Sydney NSW Australia
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Prevot G, Stevens J, Leguay A, Brier T, Meijer J, Aguilaniu B. OPALE accompagnement des patients traités pour une fibrose pulmonaire idiopathique. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.298] [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: 10/27/2022]
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Reynolds KR, Stevens J, Cai J, Lewis CE, Choh AC, Czerwinski SA. External Validation of Equations that Use Demographic and Anthropometric Measurements to Predict Percent Body Fat. Obes Sci Pract 2018; 4:515-525. [PMID: 30574345 PMCID: PMC6298207 DOI: 10.1002/osp4.300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Numerous equation to predict percent body fat using demographics and anthropometrics have been published but external validation of these equations is limited. The objective of this study was to validate published equations that use anthropometrics for prediction of percent body fat using external data. METHODS Data were from the Visceral Fat, Metabolic Rate, and Coronary Heart Disease Risk I (VIM I) Study and the Fels Longitudinal Study (Fels). VIM I was conducted in a subset of subjects from the CARDIA study and included black and white adults 28-40 years (n = 392). Fels consisted of white participants 8-88 years (n = 1,044). Percent body fat assessed by dual X-ray absorptiometry (DXA) in these two studies was compared to results calculated using 13 equations from Stevens et al. and nine other published equations. RESULTS In general, the Stevens equations performed better than equations from other studies. For example, equation "I" in women in VIM I, Fels adults, and Fels youth, R2 estimates were 0.765, 0.757 and 0.789, respectively. In men the estimates were 0.702 in VIM I, 0.822 in Fels adults and 0.905 in Fels youth. None of the results from the nine published equations showed R2 this high in corresponding groups. CONCLUSIONS Our results indicate that several of the Stevens equations have external validity superior to that of nine other published equations among varying age groups, genders and races.
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Affiliation(s)
- K. R. Reynolds
- Departments of EpidemiologyUniversity of North CarolinaChapel HillNCUS
| | - J. Stevens
- Departments of EpidemiologyUniversity of North CarolinaChapel HillNCUS
- Departments of NutritionUniversity of North CarolinaChapel HillNCUS
| | - J. Cai
- Departments of BiostatisticsUniversity of North CarolinaChapel HillNCUS
| | - C. E. Lewis
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirminghamALUS
| | - A. C. Choh
- School of Public HealthUniversity of Texas Health Science Center at HoustonBrownsvilleTXUS
| | - S. A. Czerwinski
- School of Public HealthUniversity of Texas Health Science Center at HoustonBrownsvilleTXUS
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Korostelev M, Sejean K, Lepage C, Stevens J, Bonan B, Beuzeboc P, Scotté F. Patient reported outcomes: Web-monitoring versus nurse assessment to improve anticancer therapies. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.057] [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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28
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Stevens J, Khetarpal S. Platelet-rich plasma for androgenetic alopecia: A review of the literature and proposed treatment protocol. Int J Womens Dermatol 2018; 5:46-51. [PMID: 30809579 PMCID: PMC6374694 DOI: 10.1016/j.ijwd.2018.08.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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: 05/15/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 12/13/2022] Open
Abstract
Androgenetic alopecia (AGA) is a common hair loss disorder caused by genetic and hormonal factors that are characterized by androgen-related progressive thinning of scalp hair in a defined pattern. By the age of 60 years, 45% of men and 35% of women develop AGA. Currently, U.S. Food and Drug Administration-approved treatments for AGA include oral finasteride and topical minoxidil. Due to the limited number of effective therapies for AGA, platelet-rich plasma (PRP) has become an effective alternative treatment. PRP is an autologous concentration of platelets in plasma with numerous growth factors that contribute to hair regeneration. The growth factors contained within the alpha granules of platelets act on stem cells in the bulge area of the hair follicles and stimulate the development of new follicles along with neovascularization. PRP has become a promising treatment modality for AGA. Although there have been several studies previously reported, a standard practice for PRP preparation and administration as well as a method to evaluate results have not been established. This literature review was conducted to evaluate the effectiveness of PRP for AGA and discuss the various treatment protocols that have been proposed.
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Affiliation(s)
- J Stevens
- Northeast Ohio Medical University, Rootstown, Ohio
| | - S Khetarpal
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
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Gallus A, Cade J, Ockelford P, Hepburn S, Maas M, Magnani H, Bucknall T, Stevens J, Porteous F. Orgaran (Org 10172) or Heparin for Preventing Venous Thrombosis after Elective Surgery for Malignant Disease? A Double-Blind, Randomised, Multicentre Comparison. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1649627] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThis double-blind, randomised, multicentre trial in 513 patients having elective surgery for intra-abdominal or intrathoracic malignancy compared the efficacy and safety of venous thrombosis (VT) prophylaxis using 750 anti-factor Xa units of Orgaran (a mixture of low molecular weight heparinoids) given subcutaneously (sc) twice-daily with that of twice-daily injections of 5,000 units Standard heparin. The main study endpoints were the development of postoperative VT detected by 125I-fibrinogen leg scanning, and the onset of clinically significant venous thromboembolism or bleeding. “Intent to treat” analysis showed a statistically non-significant trend towards less VT during Orgaran prophylaxis (10.4%) than after heparin (14.9%) and there was no difference in bleeding complications between the two study groups. Results remained similar if only patients who completed the intended course of therapy (“compliant patients”) were analysed. Other trials have shown that Orgaran prevents VT after hip surgery and stroke. We now show it is also safe and effective in patients having major surgery for cancer.
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Affiliation(s)
- A Gallus
- The Flinders Medical Centre, Adelaide, Australia
| | - J Cade
- The Royal Melbourne Hospital and Austin Hospitals, Melbourne, Australia
| | - P Ockelford
- The Middlemore Hospital, Auckland, New Zealand
| | | | - M Maas
- Medical Research and Development Unit, Organon International, Oss, The Netherlands
| | - H Magnani
- Medical Research and Development Unit, Organon International, Oss, The Netherlands
| | - T Bucknall
- The Royal Melbourne Hospital and Austin Hospitals, Melbourne, Australia
| | - J Stevens
- The Flinders Medical Centre, Adelaide, Australia
| | - F Porteous
- The Middlemore Hospital, Auckland, New Zealand
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Ruff R, Kerr S, Kerr D, Zalcberg D, Stevens J. Occupational exposure to methoxyflurane administered for procedural sedation: an observational study of 40 exposures. Br J Anaesth 2018; 120:1435-1437. [PMID: 29793614 DOI: 10.1016/j.bja.2018.01.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/21/2018] [Accepted: 01/30/2018] [Indexed: 11/27/2022] Open
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Stark N, Kerr S, Stevens J. Prevalence and Predictors of Persistent Post-Surgical Opioid Use: A Prospective Observational Cohort Study. Anaesth Intensive Care 2017; 45:700-706. [DOI: 10.1177/0310057x1704500609] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use. Patients underwent surgery with routine perioperative care, and were followed up at 90 to 120 days after surgery to determine opioid use. Factors associated with opioid use were assessed with logistic regression. We had an overall response rate of 95.8% (n=970) of patients, of whom 10.5% (n=102) continued to use opioids at >90 days after surgery. On surgical subtype analysis, the prevalence of persistent opioid use was 23.6% after spinal surgery, and 13.7% after orthopaedic surgery. Four factors were independently associated with persistent post-surgical opioid use in a multivariate model: having orthopaedic (odds ratio [OR] 4.6, 95% confidence interval [CI] 2.0 to 10.8, P <0.001) or spinal surgery (OR 4.0, 95% CI 1.7 to 9.2, P <0.001), anxiety (OR 2.1, 95% CI 1.1 to 4.1, P=0.03), attending pre-admission clinic (OR 3.7, 95% CI 1.6 to 8.6, P=0.002), and higher self-reported pain score at >90 days after surgery (P <0.001). More than 10% of opioid-naïve patients undergoing elective surgery experience persistent post-surgical opioid use. Identification of factors associated with persistent post-surgical opioid use may allow development of a risk stratification tool to predict those at highest risk.
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Affiliation(s)
- N. Stark
- School of Medicine, University of Notre Dame Sydney, Sydney, New South Wales
| | - S. Kerr
- The Kirby Institute, University of New South Wales, Sydney, New South Wales
| | - J. Stevens
- Anaesthetist and Pain Medicine Specialist, Department of Anaesthetics, St Vincent's Private Hospital Sydney, Sydney, New South Wales
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Ducore J, Lawrence JB, Simpson M, Boggio L, Bellon A, Burggraaf J, Stevens J, Moerland M, Frieling J, Reijers J, Wang M. Safety and dose-dependency of eptacog beta (activated) in a dose escalation study of non-bleeding congenital haemophilia A or B patients, with or without inhibitors. Haemophilia 2017; 23:844-851. [PMID: 28984010 DOI: 10.1111/hae.13357] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Varying initial doses of activated eptacog beta (recombinant human FVIIa, rhFVIIa) may provide therapeutic options when treating bleeding in patients with congenital haemophilia who have developed inhibitory antibodies to factor VIII (FVIII) or factor IX (FIX). This study evaluated escalated doses of a new rhFVIIa product as a prelude to selecting the doses for clinical efficacy evaluation in haemophilia patients. AIM To assess the safety, pharmacokinetics, and laboratory pharmacodynamics of 3 doses of rhFVIIa in non-bleeding patients with congenital haemophilia A or B with or without inhibitors. METHODS Adult male patients (18-75 years old) with congenital haemophilia A or B (with or without inhibitors) received infusions of rhFVIIa at doses of 25, 75 or 225 μg/kg body weight. Ten patients were treated at each dose level, and each patient received 2 different dose levels. Descriptive methods were used to analyse the data. RESULTS Administration of rhFVIIa at all doses was well tolerated. Pharmacokinetic analyses showed that peak FVIIa plasma levels (Cmax ) were approximately proportional to dose and correlated well with peak thrombin generation. Total AUC0-inf also was approximately dose proportional. Clot formation and duration correlated with FVIIa activity. Repeat doses did not produce an immunological response. CONCLUSION In the first dose-escalation study of rhFVIIa to support product registration, eptacog beta at doses of 25, 75, and 225 μg/kg was pharmacodynamically active and well tolerated in non-bleeding patients with congenital haemophilia A or B.
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Affiliation(s)
- J Ducore
- University of California, Davis Health System, Sacramento, CA, USA
| | | | - M Simpson
- Rush University Medical Center, Chicago, IL, USA
| | - L Boggio
- Rush University Medical Center, Chicago, IL, USA
| | | | - J Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J Stevens
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Moerland
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - J Reijers
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Wang
- Hemophilia & Thrombosis Center, University of Colorado, Aurora, CO, USA
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Mincher N, Richards C, Subash F, Forde J, Stevens J, McClelland L, Hodzovic I. Evaluation of the effectiveness of rapid O2, ventrain and manujet oxygen delivery devices in can't intubate can't oxygenate scenario. Trends in Anaesthesia and Critical Care 2017. [DOI: 10.1016/j.tacc.2017.10.032] [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: 10/18/2022]
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Scotté F, Elaidi R, Haboudagga H, Thibault C, Stevens J, Bonan B, Oudard S. Anticipative approach to improve safety: An innovative daily hospital organisation. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.002] [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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Hawryluk RJ, Mueller D, Hosea J, Barnes CW, Beer M, Bell MG, Bell R, Biglari H, Bitter M, Boivin R, Bretz NL, Budny R, Bush CE, Chen L, Cheng CZ, Cowley S, Dairow DS, Efthimion PC, Fonck RJ, Fredrickson E, Furth HP, Greene G, Grek B, Grisham LR, Hammett G, Heidbrink W, Hill KW, Hoffman D, Hulse RA, Hsuan H, Janos A, Jassby DL, Jobes FC, Johnson DW, Johnson LC, Kamperschroer J, Kesner J, Phillips CK, Kilpatrick SJ, Kugel H, LaMarche PH, LeBlanc B, Manos DM, Mansfield DK, Marmar ES, Mazzucato E, McCarthy MP, Machuzak J, Mauel M, McCune D, McGuire KM, Medley SS, Monticello DR, Mikkelsen D, Nagayama Y, Navratil GA, Nazikian R, Owens DK, Park H, Park W, Paul S, Perkins F, Pitcher S, Rasmussen D, Redi MH, Rewoldt G, Roberts D, Roquemore AL, Sabbagh S, Schilling G, Schivell J, Schmidt GL, Scott SD, Snipes J, Stevens J, Stratton BC, Strachan JD, Stodiek W, Synakowski E, Tang W, Taylor G, Terry J, Timberlake JR, Ulrickson HH, Towner M, von Goeler S, Wieland R, Wilson JR, Wong KL, Woskov P, Yamada M, Young KM, Zamstorff MC, Zweben SJ. Status and Plans for TFTR. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst92-a29907] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R. J. Hawryluk
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Mueller
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Hosea
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - M. Beer
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. G. Bell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Bell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Biglari
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. Bitter
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Boivin
- Massachusetts Institute of Technology, Cambridge, MA
| | - N. L. Bretz
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Budny
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - C. E. Bush
- Oak Ridge National Laboratory, Oak Ridge, TN
| | - L. Chen
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - C. Z. Cheng
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Cowley
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. S. Dairow
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. C. Efthimion
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - E. Fredrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. P. Furth
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Greene
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. Grek
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - L. R. Grisham
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Hammett
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - K. W. Hill
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Hoffman
- Oak Ridge National Laboratory, Oak Ridge, TN
| | - R. A. Hulse
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Hsuan
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - A. Janos
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. L. Jassby
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - F. C. Jobes
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. W. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - L. C. Johnson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Kamperschroer
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Kesner
- Massachusetts Institute of Technology, Cambridge, MA
| | - C. K. Phillips
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. J. Kilpatrick
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Kugel
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. H. LaMarche
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. LeBlanc
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. M. Manos
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. K. Mansfield
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - E. S. Marmar
- Massachusetts Institute of Technology, Cambridge, MA
| | - E. Mazzucato
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. P. McCarthy
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Machuzak
- Massachusetts Institute of Technology, Cambridge, MA
| | - M. Mauel
- Columbia University, New York, NY
| | - D.C. McCune
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. M. McGuire
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. S. Medley
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. R. Monticello
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. Mikkelsen
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | | | - R. Nazikian
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - D. K. Owens
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. Park
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Park
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Paul
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - F. Perkins
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. Pitcher
- Canadian Fusion Fuels Technology Project, Toronto, Canada
| | | | - M. H. Redi
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Rewoldt
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - A. L. Roquemore
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | | | - G. Schilling
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Schivell
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. L. Schmidt
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. D. Scott
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Snipes
- Massachusetts Institute of Technology, Cambridge, MA
| | - J. Stevens
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - B. C. Stratton
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. D. Strachan
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Stodiek
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - E. Synakowski
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - W. Tang
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - G. Taylor
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. Terry
- Massachusetts Institute of Technology, Cambridge, MA
| | - J. R. Timberlake
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - H. H. Ulrickson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. Towner
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. von Goeler
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - R. Wieland
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - J. R. Wilson
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. L. Wong
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - P. Woskov
- Massachusetts Institute of Technology, Cambridge, MA
| | - M. Yamada
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - K. M. Young
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - M. C. Zamstorff
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
| | - S. J. Zweben
- Plasma Physics Laboratory, Princeton University P.O. Box 451 Princeton, N.J. 08543 USA (609) 243-3306
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Tan E, Stevens J. EVIDENCE FOR THE NEED TO DISRUPT AGING: IMPACT OF PERCEPTIONS OF AGING AND AGING STEREOTYPES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3892] [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: 11/12/2022] Open
Affiliation(s)
- E. Tan
- AARP, Washington, District of Columbia
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Abstract
PURPOSE Dysplasia epiphysealis hemimelica (DEH) is a rare developmental disorder resulting in epiphyseal overgrowth. Based on histological appearance, it is often described as an osteochondroma or osteochondroma-like lesion, although clinical differences exist between DEH and osteochondromas. The aim of this study was to test whether DEH and osteochondromas are histologically identical diseases. METHODS Tissue samples of two age- and gender-matched cases with DEH and hereditary multiple exostoses were histologically compared. Sections were stained with Safranin-O for detection of proteoglycans and immunohistochemistry was performed for detection of collagen type II, collagen type X as a marker of hypertrophic chondrocytes and Sox9 as a marker of proliferative chondrocytes. Due to the rarity, descriptions of the included DEH patients were outlined. RESULTS Histologically, chondrocyte clusters in a fibrillary matrix, a thick disorganised cartilage cap and ossification centres with small amounts of unabsorbed cartilage, were observed in DEH. In contrast, cartilage organisation of osteochondromas displays characteristics of the normal growth plate. Collagen type II was clearly detected in the cartilaginous extracellular matrix in osteochondromas, while weak expression was observed in DEH. Collagen type X was not detected in DEH, while expressed in the matrix surrounding hypertrophic chondrocytes in osteochondromas. Sox9 staining was positive in hypertrophic chondrocytes in osteochondromas, while expressed in nuclei of chondrocyte clusters in DEH. CONCLUSION Both morphological and immunohistological differences were observed in histological sections of DEH and osteochondromas. These results support the previously identified clinical, radiological and genetic differences and imply a different aetiology between DEH and osteochondroma formation.
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Affiliation(s)
- J. Stevens
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - T. J. M. Welting
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A. M. Witlox
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - L. W. van Rhijn
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - H. M. Staal
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, Maastricht, The Netherlands,Correspondence should be sent to: Dr H. M. Staal, Department of Orthopaedic Surgery, Maastricht University Medical Centre+ P. Debyelaan 25, P.O. Box 5800, 6202AZ Maastricht, The Netherlands. E-mail:
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Hartman MR, Keller ST, Reese SR, Robinson B, Stevens J, Matos JE, Marcum WR, Palmer TS, Woods BG. Neutronic Analysis of the Oregon State TRIGA Reactor in Support of Conversion from HEU Fuel to LEU Fuel. NUCL SCI ENG 2017. [DOI: 10.13182/nse12-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. R. Hartman
- University of Michigan, Department of Nuclear Engineering and Radiological Sciences Ann Arbor, Michigan 48109
| | - S. T. Keller
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
| | - S. R. Reese
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
| | - B. Robinson
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
| | - J. Stevens
- Argonne National Laboratory, Argonne, Illinois 60439
| | - J. E. Matos
- Argonne National Laboratory, Argonne, Illinois 60439
| | - W. R. Marcum
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
| | - T. S. Palmer
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
| | - B. G. Woods
- Oregon State University, Department of Nuclear Engineering and Radiation Health Physics Corvallis, Oregon 97331
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Jarin J, Pine-Twaddell E, Trotman G, Stevens J, Conard LA, Tefera E, Gomez-Lobo V. Cross-Sex Hormones and Metabolic Parameters in Adolescents With Gender Dysphoria. Pediatrics 2017; 139:peds.2016-3173. [PMID: 28557738 DOI: 10.1542/peds.2016-3173] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [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] [Accepted: 02/14/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Endocrine Society states that adolescents with gender dysphoria may start cross-sex hormones. The goal of this study was to identify patterns in metabolic parameters in transgender adolescents receiving cross-sex hormones. METHODS Data from adolescents aged 14 to 25 years seen in 1 of 4 clinical sites between 2008 and 2014 were retrospectively analyzed. Subjects were divided into affirmed male (female-to-male) patients taking testosterone and affirmed female (male-to-female) patients taking estrogen. Previously recorded measurements of blood pressure, BMI, testosterone, estradiol, prolactin, lipids, electrolytes, liver function tests, hemoglobin/hematocrit, and hemoglobin A1c were reviewed. These values were obtained from before the start of therapy, at 1 to 3 months after initiation, at 4 to 6 months, and at 6 months and beyond. Repeated measures analysis of variance models were used to evaluate changes over time. RESULTS One hunderd and sixteen adolescents were included (72 female-to-male subjects and 44 male-to-female subjects). Of the 72 subjects taking testosterone, a significant increase in hemoglobin/hematocrit levels and BMI, as well as a decrease in high-density lipoprotein level, was recorded at each visit. No significant changes in any other parameter tested were found. Of the 44 subjects taking estrogen, no statistically significant changes were noted in the measured metabolic parameters. CONCLUSIONS Testosterone use was associated with increased hemoglobin and hematocrit, increased BMI, and lowered high-density lipoprotein levels; estrogen was associated with lower testosterone and alanine aminotransferase levels. Otherwise, cross-sex hormone administration in adolescents was not associated with significant differences in the selected metabolic parameters over time.
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Affiliation(s)
- Jason Jarin
- Obstetrics and Gynecology, University of Texas Southwestern and Children's Health, Dallas, Texas
| | - Elyse Pine-Twaddell
- University of Maryland, Baltimore, Maryland.,Chase Brexton Health Care, Baltimore, Maryland
| | | | | | - Lee Ann Conard
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Eshetu Tefera
- MedStar Health Research Institute, Hyattsville, Maryland; and
| | - Veronica Gomez-Lobo
- MedStar Washington Hospital Center/Children's National Medical Center, Washington, District of Columbia
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Stevens J, Rausch J, Webster Cheng S, Splaingard D, Splaingard ML. 0903 A RANDOMIZED TRIAL OF A SELF ADMINISTERED PARENTING INTERVENTION FOR INFANT AND TODDLER INSOMNIA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.902] [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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Gotter AL, Stevens J, Garson SL, Fox SV, Svetnik V, Tannenbaum PL, Forman MS, Coleman PJ, Herring WJ, Renger JJ, Winrow CJ. 0103 REM SLEEP IS INDUCED BY DUAL AND OREXIN 2 RECEPTOR ANTAGONISTS VIA MECHANISMS BEYOND ALPHA1-NORADRENERGIC SIGNALING. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.102] [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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Wilson I, Stevens J, Gnananandan J, Nabeebaccus A, Sandison A, Hunter A. Triticeal cartilage: the forgotten cartilage. Surg Radiol Anat 2017; 39:1135-1141. [PMID: 28314939 PMCID: PMC5610663 DOI: 10.1007/s00276-017-1841-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/21/2016] [Accepted: 02/27/2017] [Indexed: 11/16/2022]
Abstract
Introduction The triticeal cartilage (TC) is a small cartilage found within the thyrohyoid membrane. The TC has a variable prevalence between and within individuals. It has been suggested that absence of a TC results from its failure to separate from the superior horn of the thyroid cartilage (SHTC) and that individuals without a TC will have a longer SHTC. This study aims to identify the prevalence of the TC and investigate the relationship between the length of the SHTC and presence of a TC. Methods Eighty seven adult cadavers underwent dissection. Data were collected on presence or absence of a TC and lengths of SHTC. Results A TC was identified in 28 cadavers (33%). In cadavers with a unilateral TC, there was no significant difference between the lengths of the SHTC on sides with a TC (1.6 mm, ±SEM 0.12 mm) to sides without a TC (1.7 mm, ±SEM 0.10 mm) (P = 0.47). In cadavers with no TCs, the length of the SHTCs (1.8 mm, ±SEM 0.04 mm) was significantly longer than the SHTCs of cadavers with a TC present bilaterally (1.4 mm, ±SEM 0.12 mm) (P = 0.02). Conclusions A TC was found in 33% of cadavers. This study demonstrates a relationship between the presence of a TC and the length of the SHTC only in cadavers with a TC present or absent bilaterally.
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Affiliation(s)
- Iain Wilson
- Department of Anatomy, School of Biomedical Sciences, Guy's Campus, King's College London, London, SE1 1UL, UK.
| | - J Stevens
- Department of Anatomy, School of Biomedical Sciences, Guy's Campus, King's College London, London, SE1 1UL, UK
| | - J Gnananandan
- Department of Anatomy, School of Biomedical Sciences, Guy's Campus, King's College London, London, SE1 1UL, UK
| | - A Nabeebaccus
- Cardiovascular Division, King's College London, London, UK
| | - A Sandison
- Department of Histopathology, Imperial College Healthcare NHS Trust, London, UK
| | - A Hunter
- Department of Anatomy, School of Biomedical Sciences, Guy's Campus, King's College London, London, SE1 1UL, UK
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Goldfarb SB, Konner J, Stevens J, Brouwer S, Narain NR, Ye R, Ravipaty S, Sarangarajan R, Akmaev VR, Jimenez JJ, Belum VR, 'Kitts S, Ciccolini K, Berman B, Lacouture ME. Abstract P5-11-11: A phase I safety study of topical calcitriol (BPM31543) for the prevention of chemotherapy-induced alopecia (CIA). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-11-11] [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: 11/16/2022]
Abstract
Abstract
Background: Chemotherapy induced alopecia (CIA) may lead to significant psychosocial and quality of life issues. Currently there are no FDA approved oral or topical agents available to prevent CIA. In murine studies, topical calcitriol reduced CIA, due to arrest of cell cycle in healthy hair follicles, and reduction in the sensitivity of follicular epithelium to chemotherapy.
Methods: A prospective dose escalation study is being performed in up to 31 women with breast cancer, gynecologic cancer and sarcomas. Each patient is applying 1mL of BPM31543 to her scalp bid, ≥ 5 days prior to initiation of taxane-based chemotherapy for at least 3 months or until the completion of chemotherapy. The study cohorts are: 5/10/20/40/60/80μg/mL. The first 5 cohorts are completely enrolled and the final cohort is currently being enrolled. Each patient undergoes pk analysis, adverse event (AE) monitoring, patient self-assessment diaries (1-10 scale), and blinded photographic assessments. Efficacy and pK data are still being collected and analyzed for the patients on study, but will be available by December.
Results: Twenty-four subjects have been enrolled so far (evaluable at this time, n = 13). Pk data (n = 16; 5-40μg/mL) showed inter-individual variability, but no significant dose-dependent increase in systemic absorption (range, < 20-110 pg/mL). Treatment-related AEs (probably/possibly) were mild/moderate in nature and included scalp pain (n = 1; 5 μg/mL), elevated vitamin D levels in 1 patient (20μg/mL) and passage of renal calculus in another (n = 1; 40μg/mL). All subjects reported changes in overall hair fullness, thickness, and volume of hair during chemotherapy. At the 5/10 μg/mL dose level, ≥ 75% hair loss was reported in 85% of patients. At the ≥ 20 μg/mL dose level, ≥ 75% hair loss was seen only in 43% of patients. Hair loss/ thinning caused all subjects to change their hair style (onset, week 2; peak, weeks 5-6).
Conclusions: Data have shown that the twice daily application of BPM31543 in patients receiving taxane-based chemotherapy was safe and well-tolerated. Efficacy data from the preliminary analysis was promising and led to the amendment of the study to evaluate two additional higher dose cohorts: 60 and 80 μg/ml.
Citation Format: Goldfarb SB, Konner J, Stevens J, Brouwer S, Narain NR, Ye R, Ravipaty S, Sarangarajan R, Akmaev VR, Jimenez JJ, Belum VR, 'Kitts S, Ciccolini K, Berman B, Lacouture ME. A phase I safety study of topical calcitriol (BPM31543) for the prevention of chemotherapy-induced alopecia (CIA) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-11.
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Affiliation(s)
- SB Goldfarb
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - J Konner
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - J Stevens
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - S Brouwer
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - NR Narain
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - R Ye
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - S Ravipaty
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - R Sarangarajan
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - VR Akmaev
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - JJ Jimenez
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - VR Belum
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - S 'Kitts
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - K Ciccolini
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - B Berman
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
| | - ME Lacouture
- Memorial Sloan Kettering Cancer Center, New York, NY; Berg, Framingham, MA; University of Miami, Miami, FL
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Dijkmans AC, Kuiper SG, Burggraaf J, Mouton JW, Wilms EB, Touw DJ, Stevens J, van Nieuwkoop C, Kamerling IMC. [Fosfomycin, an old antibiotic with new possibilities]. Ned Tijdschr Geneeskd 2017; 161:D973. [PMID: 28612692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
- Fosfomycin is a broad-spectrum antibiotic agent used orally for uncomplicated cystitis. The intravenous form of administration has recently been authorised in the Netherlands.- Thanks to its broad spectrum and extensive tissue penetration, fosfomycin offers possibilities for the treatment of infections in different organs.- Infections with multidrug-resistant bacteria pose a significant threat to public health. Many of these multidrug-resistant bacteria are sensitive to fosfomycin, which means fosfomycin may be an option for the treatment of infections with multidrug-resistant bacteria. - There is a lack of knowledge about the pharmacological properties of fosfomycin to establish a good dosing schedule. Knowledge is also lacking about the safety of fosfomycin and the extent of its tolerability in the treatment of different infections. - More research is needed before fosfomycin can be used in the battle against multidrug-resistant bacteria.
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Brichko L, Schneider H, Seah J, Smit D, Stevens J, Mitra B. Rapid and Safe Discharge From the Emergency Department: A Single Troponin to Exclude Acute Myocardial Infarction. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The design and construction of an electrogoniometer for measuring angular displacements of the hip is discussed. Data from the goniometer are recorded on magnetic tape and are processed and printed out in graphical format by mini-computer. Sample results are presented for normal and arthritic subjects involved in a number of activities, namely level walking, climbing and descending stairs, and sitting and rising from a chair. It is intended that the goniometer be used to provide prognostic and therapeutic guidelines in the clinical environment.
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Affiliation(s)
- T A Gore
- Research Assistant, Department of Engineering Science, University of Durham
| | - M Flynn
- Consultant Orthopaedic Surgeon, Orthopaedic Department, Ardkeen Hospital, Waterford, Ireland
| | - J Stevens
- Professor of Orthopaedic Surgery, Royal Victoria Infirmary, Newcastle-upon-Tyne
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Kanhai K, Goulooze SC, Stevens J, Hay JL, Dent G, Verma A, Hankemeier T, de Boer T, Meijering H, Chavez JC, Cohen AF, Groeneveld GJ. Quantifying Beta-Galactosylceramide Kinetics in Cerebrospinal Fluid of Healthy Subjects Using Deuterium Labeling. Clin Transl Sci 2016; 9:321-327. [PMID: 27743499 PMCID: PMC5351000 DOI: 10.1111/cts.12424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/08/2016] [Indexed: 12/12/2022] Open
Abstract
Therapeutics promoting myelin synthesis may enhance recovery in demyelinating diseases, such as multiple sclerosis. However, no suitable method exists to quantify myelination. The turnover of galactosylceramide (myelin component) is indicative of myelination in mice, but its turnover has not been determined in humans. Here, six healthy subjects consumed 120 mL 70% D2O daily for 70 days to label galactosylceramide. We then used mass spectrometry and compartmental modeling to quantify the turnover rate of galactosylceramide in cerebrospinal fluid. Maximum deuterium enrichment of body water ranged from 1.5–3.9%, whereas that of galactosylceramide was much lower: 0.05–0.14%. This suggests a slow turnover rate, which was confirmed by the model‐estimated galactosylceramide turnover rate of 0.00168 day−1, which corresponds to a half‐life of 413 days. Additional studies in patients with multiple sclerosis are needed to investigate whether galactosylceramide turnover could be used as an outcome measure in clinical trials with remyelination therapies.
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Affiliation(s)
- Kms Kanhai
- Centre for Human Drug Research, Leiden, The Netherlands
| | - S C Goulooze
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J Stevens
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J L Hay
- Centre for Human Drug Research, Leiden, The Netherlands
| | - G Dent
- Experimental Medicine, Biogen Cambridge, Massachusetts, USA
| | - A Verma
- Experimental Medicine, Biogen Cambridge, Massachusetts, USA
| | - T Hankemeier
- Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - T de Boer
- Analytical Biochemical Laboratory BV, Assen, The Netherlands
| | - H Meijering
- Analytical Biochemical Laboratory BV, Assen, The Netherlands
| | - J C Chavez
- Experimental Medicine, Biogen Cambridge, Massachusetts, USA
| | - A F Cohen
- Centre for Human Drug Research, Leiden, The Netherlands
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Kervezee L, Gotta V, Stevens J, Birkhoff W, Kamerling I, Danhof M, Meijer JH, Burggraaf J. Levofloxacin-Induced QTc Prolongation Depends on the Time of Drug Administration. CPT Pharmacometrics Syst Pharmacol 2016; 5:466-74. [PMID: 27479699 PMCID: PMC5036421 DOI: 10.1002/psp4.12085] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/24/2016] [Indexed: 12/21/2022]
Abstract
Understanding the factors influencing a drug's potential to prolong the QTc interval on an electrocardiogram is essential for the correct evaluation of its safety profile. To explore the effect of dosing time on drug‐induced QTc prolongation, a randomized, crossover, clinical trial was conducted in which 12 healthy male subjects received levofloxacin at 02:00, 06:00, 10:00, 14:00, 18:00, and 22:00. Using a pharmacokinetic‐pharmacodynamic (PK‐PD) modeling approach to account for variations in PKs, heart rate, and daily variation in baseline QT, we find that the concentration‐QT relationship shows a 24‐hour sinusoidal rhythm. Simulations show that the extent of levofloxacin‐induced QT prolongation depends on dosing time, with the largest effect at 14:00 (1.73 (95% prediction interval: 1.56–1.90) ms per mg/L) and the smallest effect at 06:00 (−0.04 (−0.19 to 0.12) ms per mg/L). These results suggest that a 24‐hour variation in the concentration‐QT relationship could be a potentially confounding factor in the assessment of drug‐induced QTc prolongation.
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Affiliation(s)
- L Kervezee
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands.,Centre for Human Drug Research, Leiden, The Netherlands.,Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - V Gotta
- Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - J Stevens
- Centre for Human Drug Research, Leiden, The Netherlands
| | - W Birkhoff
- Centre for Human Drug Research, Leiden, The Netherlands
| | - Imc Kamerling
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Danhof
- Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands
| | - J H Meijer
- Laboratory for Neurophysiology, Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands. .,Division of Pharmacology, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands.
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Franks PJ, Moody M, Moffatt CJ, Patton J, Bradley L, Chaloner D, Stevens J. Quality of life in a trial of short stretch versus four-layer bandaging in the management of chronic venous ulceration. Phlebology 2016. [DOI: 10.1258/026835504323080371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To evaluate health-related quality of life (HRQoL) in a prospective randomized trial of patients suffering from venous ulceration comparing a generic four-layer elastic bandage (4LB) with a new cohesive short stretch bandage system (CSSB). Methods: Randomized prospective open parallel groups trial in community leg ulcer clinics within twelve trusts in England and Northern Ireland. Patients newly presenting for treatment suffering from chronic venous ulceration, with ankle brachial pressure index (ABPI) >0.8 were entered into the trial. Patients were asked to complete the Nottingham Health Profile (NHP) at entry, at end of trial period (withdrawal or healing), and at 24 weeks. Principal analysis was the comparison of final NHP scores using linear regression with baseline scores entered as a covariate. Results: In all, 154 of the 156 patients who entered the trial completed the initial questionnaire, with 139/154 (90.2%) patients completing at least one follow-up questionnaire. Improvements were noted for all scores after 24 weeks. The improvements were significantly greater in the 114 patients whose ulcers had healed compared with the 40 whose ulcers remained open in the domains of bodily pain (mean difference [d]=13.2, 95% CI 3.6-22.9, P =0.008), emotional reactions (d=10.5, 95% CI 2.8-18.1, P =0.007) and social isolation (d=8.5, 95% CI 1.2-15.9, P =0.024). There were similar mean scores between the 72 patients treated with the 4LB and the 82 patients treated with CSSB for all domains of the NHP, the largest adjusted difference favoured CSSB for energy (d=3.6, 95% CI-4.3-11.4, P =0.37). Conclusions: Patients suffering from leg ulceration show improvements in perceived health following effective ulcer management. The two bandage systems achieved similar improvements in perceived health over 24 weeks.
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Dugo E, Yedjou C, Stevens J, Tchounwou P. P-018 Assessment of therapeutic potential of arsenic trioxide in the management of human hepatocellular carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.18] [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: 11/12/2022] Open
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