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Zisook S, Moutier CY, Rush AJ, Johnson GR, Tal I, Chen PJ, Davis LL, Hicks PB, Wilcox J, Planeta B, Lauro KW, Scrymgeour AA, Kasckow J, Mohamed S. Effect of next-step antidepressant treatment on suicidal ideation: findings from the VAST-D trial. Psychol Med 2024; 54:1172-1183. [PMID: 37859623 DOI: 10.1017/s0033291723003008] [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: 10/21/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) contributes to suicide risk. Treating MDD effectively is considered a key suicide prevention intervention. Yet many patients with MDD do not respond to their initial medication and require a 'next-step'. The relationship between next-step treatments and suicidal thoughts and behaviors is uncharted. METHOD The VA Augmentation and Switching Treatments for Depression trial randomized 1522 participants to one of three next-step treatments: Switching to Bupropion, combining with Bupropion, and augmenting with Aripiprazole. In this secondary analysis, features associated with lifetime suicidal ideation (SI) and attempts (SA) at baseline and current SI during treatment were explored. RESULTS Compared to those with SI only, those with lifetime SI + SA were more likely to be female, divorced, or separated, unemployed; and to have experienced more childhood adversity. They had a more severe depressive episode and were more likely to respond to 'next-step' treatment. The prevalence of SI decreased from 46.5% (694/1492) at baseline to 21.1% (315/1492) at end-of-treatment. SI during treatment was associated with baseline SI; low positive mental health, more anxiety, greater severity and longer duration of current MDD episode; being male and White; and treatment with S-BUP or C-BUP as compared to A-ARI. CONCLUSION SI declines for most patients during next-step medication treatments. But about 1 in 5 experienced emergent or worsening SI during treatment, so vigilance for suicide risk through the entire 12-week acute treatment period is necessary. Treatment selection may affect the risk of SI.
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Affiliation(s)
- Sidney Zisook
- University of California San Diego, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | | | - A John Rush
- Duke Medical School, Durham, NC, USA
- Duke-National University of Singapore, Singapore
| | - Gary R Johnson
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ilanit Tal
- VA San Diego Healthcare System, San Diego, CA, USA
| | - P J Chen
- Department of Psychiatry, VA Northeast Ohio Healthcare System, and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Lori L Davis
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
| | - Paul B Hicks
- Department of Psychiatry, Texas A&M College of Medicine, Temple, TX, USA
| | - James Wilcox
- Department of Veterans Affairs, Phoenix, AZ, USA
| | - Beata Planeta
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Alexandra A Scrymgeour
- Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, NM, USA
| | - John Kasckow
- University of Pittsburgh Physicians, Pittsburgh, PA, USA
| | - Somaia Mohamed
- Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA
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2
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Rodriguez NM, Mower WR, Raja AS, Gupta M, Montoy JC, Parry B, Chan V, Wong AHK, Wilcox J, Quiñones A, Rodriguez RM. Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients. Acad Emerg Med 2023; 30:1039-1046. [PMID: 37363986 DOI: 10.1111/acem.14768] [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] [Received: 02/24/2023] [Revised: 05/24/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant injury (CSI) in the abdomen and pelvis among blunt trauma patients presenting to the emergency department (ED). METHODS We collected gestalt data on physicians caring for adult blunt trauma patients who received abdominal/pelvic computed tomography (CT) at three Level I and one Level II trauma centers. The primary outcome of CSI was defined as injury on abdominal/pelvic CT requiring hospitalization or intervention. Physicians evaluating trauma patients estimated the likelihood of CSI prior to abdominal/pelvic CT review (response choices: <2%, 2%-10%, 11%-20%, 21%-40%, >40%). We evaluated potential missed injury rates (prevalence of CSI) and sensitivity for prediction categories, as well as calibration and area under the receiver operating characteristic (AUROC) curve for overall physician gestalt. RESULTS Of 2030 patients, 402 (20%) had an injury on abdominal/pelvic CT and 270 (13%) had CSI. The <2% risk of CSI gestalt cutoff had a potential missed injury rate of 5.6% and a sensitivity of 95.2% (95% confidence interval [CI] 91.7%-97.3%). The 0%-10% cutoff of CSI gestalt had a potential missed injury rate of 6.3% (95% CI, 5.0%-7.9%) and a sensitivity of 75.2% (95% CI 69.5%-80.1%). With an overall AUROC of 0.699 (95% CI 0.679-0.719), physician gestalt was moderately accurate and calibrated for the midranges of predicted risk but poorly calibrated at the extremes. CONCLUSIONS Physician gestalt for the prediction of adult abdominal and pelvic CSI is moderately accurate and calibrated. However, the potential missed CSI rate and low sensitivity of the low perceived risk of injury cutoffs indicate that gestalt by itself is insufficient to direct selective abdominal/pelvic CT use in adult blunt trauma patient evaluation.
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Affiliation(s)
| | | | - Ali S Raja
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Malkeet Gupta
- University of California, Los Angeles, California, USA
- Antelope Valley Medical Center, Lancaster, California, USA
| | | | - Blair Parry
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Virginia Chan
- University of California, San Francisco, California, USA
| | | | - James Wilcox
- Antelope Valley Medical Center, Lancaster, California, USA
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Yoshida S, Kim H, Mehta C, Churyla A, Wu T, Harap R, Vorovich E, Rich J, Wilcox J, Pham D. Concomitant Tricuspid Valve Repair During the Implant of Left Ventricular Assist Device: Propensity-Score Matched Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.898] [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: 04/05/2023] Open
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Hofmeyer M, Haas G, Kransdorf E, Ewald G, Morris A, Owens A, Lowes B, Stoller D, Tang W, Garg S, Trachtenberg B, Shah P, Pamboukian S, Sweitzer N, Wheeler M, Wilcox J, Katz S, Pan S, Jimenez J, Smart F, Wang J, Gottlieb S, Judge D, Moore C, Huggins G, Jordan E, Kinnamon D, Ni H, Hershberger R. Genetic Signature of Dilated Cardiomyopathy Severity: The DCM Precision Medicine Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1674] [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: 04/05/2023] Open
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5
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Hughes Z, Youmans Q, Wu T, Harap R, Pawale A, Pham D, Rich J, Ghafourian K, Vorovich E, Wilcox J, Ahmad F, Tibrewala A, Raza Y, Okwuosa I. Risk Factors for Malignancy after Orthotopic Heart Transplant: An Analysis of the UNOS Registry. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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6
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Zisook S, Johnson GR, Hicks P, Chen P, Beresford T, Michalets JP, Rao S, Thase ME, Wilcox J, Sevilimedu V, Mohamed S. Continuation phase treatment outcomes for switching, combining, or augmenting strategies for treatment-resistant major depressive disorder: A VAST-D report. Depress Anxiety 2021; 38:185-195. [PMID: 33225492 DOI: 10.1002/da.23114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 09/18/2020] [Accepted: 10/18/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This secondary analysis of the VA Augmentation and Switching Treatments for Depression study compared the continuation phase treatment outcomes of three commonly used second-step treatment strategies following at least one prior failed medication treatment attempt. METHODS In total, 1522 outpatients with MDD were randomized to switching to bupropion-SR (S-BUP), combining with bupropion-SR (C-BUP), or augmenting with aripiprazole (A-ARI). Following 12 weeks of acute phase treatment, 725 entered the 24-week continuation treatment phase. Depressive symptom severity, relapse, "emergent" remission, anxiety, suicidal ideation, quality of life, health status, and side effects were compared. RESULTS We did not find clinically significant differential treatment effects with the exception that A-ARI was associated with less anxiety than S-BUP or C-BUP. Participants who entered continuation treatment as remitters had milder depressive symptom severity and lower relapse rates than those not in remission; they also experienced more improvement on most other outcomes. A-ARI was associated with less anxiety, insomnia, and dry mouth but more somnolence, extrapyramidal effects, akathisia, abnormal laboratory values, and appetite and weight gain. CONCLUSIONS Continuation treatment is a dynamic period. Regardless of the treatment, participants who entered continuation treatment at Week 12 in full remission continued to have better outcomes over the subsequent 24 weeks than those who were not in remission at the start of the continuation phase.
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Affiliation(s)
- Sidney Zisook
- Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,The Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Gary R Johnson
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Paul Hicks
- The Department of Psychiatry, Texas A&M College of Medicine, Temple, Texas, USA
| | - Peijun Chen
- The Department of Psychiatry, School of Medicine, Louis Stokes VA Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
| | - Thomas Beresford
- Mental Health, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | | | - Sanjai Rao
- Mental Health, VA San Diego Healthcare System, San Diego, California, USA
| | - Michael E Thase
- Mental Health, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA
| | - James Wilcox
- Mental Health, Southern Arizona VA Healthcare System, Tucson, Arizona, USA
| | - Varadan Sevilimedu
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Somaia Mohamed
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
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Haynes PL, Skobic I, Epstein DR, Emert S, Parthasarathy S, Perkins S, Wilcox J. Cognitive Processing Therapy for Posttraumatic Stress Disorder Is Associated with Negligible Change in Subjective and Objective Sleep. Behav Sleep Med 2020; 18:809-819. [PMID: 31739686 DOI: 10.1080/15402002.2019.1692848] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Patients receiving Cognitive Processing Therapy (CPT), an evidence based therapy for posttraumatic stress disorder (PTSD), report improved sleep quality. However, the majority of studies have examined residual sleep disturbance via self-report surveys or separate items on PTSD measures. This study examined whether CPT delivered to veterans in a VA setting improved sleep indices using state-of-the-art objective and subjective insomnia measures. Participants: Participants were war veterans with a current PTSD diagnosis scheduled to begin outpatient individual or group CPT at two Veteran's Affairs (VA) locations (n = 37). Methods: Sleep symptom severity was assessed using the recommended research consensus insomnia assessment, the consensus daily sleep diary and actigraphy. PTSD symptomatology pre- and post-treatment were assessed using the Clinician Administered PTSD Scale. Results: A small to moderate benefit was observed for the change in PTSD symptoms across treatment (ESRMC = .43). Effect sizes for changes on daily sleep diary and actigraphy variables after CPT were found to be negligible (Range ESRMC = - .16 to .17). Sleep indices remained at symptomatic clinical levels post-treatment. Discussion: These findings support previous research demonstrating a need for independent clinical attention to address insomnia either before, during, or after PTSD treatment.
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Affiliation(s)
- Patricia L Haynes
- Department of Health Promotion Sciences, University of Arizona , Tucson.,Southern Arizona VA Health Care System, Mental Health Service Line , Tucson
| | - Iva Skobic
- Department of Health Promotion Sciences, University of Arizona , Tucson
| | - Dana R Epstein
- School of Nutrition and Health Promotion, Arizona State University , Tempe.,Research Service, Phoenix VA Health Care System , Phoenix
| | - Sarah Emert
- Department of Psychology, University of Alabama , Tuscaloosa.,Biomedical Research Foundation of Southern Arizona , Tucson
| | - Sairam Parthasarathy
- Department of Medicine, University of Arizona , Tucson.,Southern Arizona VA Health Care System,Research Service Line , Tucson
| | - Suzanne Perkins
- Southern Arizona VA Health Care System, Mental Health Service Line , Tucson
| | - James Wilcox
- Southern Arizona VA Health Care System, Mental Health Service Line , Tucson
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8
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Rubino P, Ruiz de Assin Alonso R, Konate N, Tapia L, Mazmanian K, Guan L, Dearden L, Thiel A, Moon C, Kolb B, Norian J, Nelson J, Wilcox J, Tan T. OOCYTE VITRIFICATION IMPACTS THE EMBRYO DEVELOPMENT BUT NOT THE EUPLOIDY RATE. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.02.056] [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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9
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Rubino P, Ruiz de Assin Alonso R, Dearden L, Guan L, Mazmanian K, Tapia L, Thiel A, Kolb B, Wilcox J, Nelson J, Norian J, Tan T. The blastocyst re-expansion status after thawing do not seem to affect the clinical outcomes in freeze all preimplantation genetic testing (PGT) cycles. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.02.073] [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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10
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Kelemen P, Aines R, Bennett E, Benson S, Carter E, Coggon J, de Obeso J, Evans O, Gadikota G, Dipple G, Godard M, Harris M, Higgins J, Johnson K, Kourim F, Lafay R, Lambart S, Manning C, Matter J, Michibayashi K, Morishita T, Noël J, Okazaki K, Renforth P, Robinson B, Savage H, Skarbek R, Spiegelman M, Takazawa E, Teagle D, Urai J, Wilcox J. In situ carbon mineralization in ultramafic rocks: Natural processes and possible engineered methods. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.egypro.2018.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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11
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Wilcox J, Baker R, Kenter K. Keen Pain and a Moveable Mass in Basketball Player. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536334.11307.fc] [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: 11/21/2022]
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12
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Ruiz De Assin Alonso R, Rubino P, Mazmanian K, Guan L, Dearden L, Tapia L, Thiel A, Kolb B, Nelson J, Norian J, Wilcox J, Li X, Lew J, Sinogaya P, Tih T. Preimplantation genetic screening (PGS) in egg donor (ED) cycles: is it a valid option? Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.02.091] [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: 11/17/2022]
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13
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Rubino P, Li X, Ruiz De Assin Alonso R, Mazmanian K, Guan L, Dearden L, Tapia L, Thiel A, Kolb B, Nelson J, Norian J, Wilcox J, Lew J, Sinogaya P, Tih T. Embryos classified as low-grade mosaic (<50%) after preimplantation genetic screening (PGS) by means of high resolution next-generation screening (hr-NGS), can have the same competence of producing healthy newborns as euploid embryos. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.02.090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Haynes PL, Emert SE, Epstein D, Perkins S, Parthasarathy S, Wilcox J. The Effect of Sleep Disorders, Sedating Medications, and Depression on Cognitive Processing Therapy Outcomes: A Fuzzy Set Qualitative Comparative Analysis. J Trauma Stress 2017; 30:635-645. [PMID: 29160555 DOI: 10.1002/jts.22233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 05/21/2017] [Accepted: 07/01/2017] [Indexed: 11/10/2022]
Abstract
Cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) is an effortful process requiring engagement in cognitive restructuring. Sleep disorders may lead to avoidance of effortful tasks and cognitive performance deficits. We explored whether sleep disorders, as assessed by polysomnography, were consistently associated with treatment response in combination with other factors. This study included 32 U.S. veterans who were examined both before and after CPT for combat-related PTSD. We employed a novel, case-comparative technique, fuzzy set qualitative comparative analysis (fsQCA), to identify combinations of fuzzy and crisp factors (recipes) that achieve a clinically significant outcome. Approximately one-quarter of cases experiencing clinically significant change were either (a) Vietnam era veterans without sedating medications, moderate sleep disordered breathing, and severe depression; or (b) non-Vietnam era veterans with sedating medications and without severe periodic limb movements (or significant periodic limb movement arousals). Recipes involving the absence of the relevant sleep disorder were associated with the highest coverage values. These results using fsQCA (a) provide valuable information about the heterogeneity of CPT response and (b) suggest that sleep disorders are important factors to consider in theoretical discussions of who responds to CPT for PTSD.
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Affiliation(s)
- Patricia L Haynes
- Health Promotion Sciences, University of Arizona, Tucson, Arizona, USA.,Mental Health Care Line, Southern Arizona VA Health Care System, Tucson, Arizona, USA
| | - Sarah E Emert
- Biomedical Research Foundation of Southern Arizona, Tucson, Arizona, USA.,Department of Psychology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Dana Epstein
- Nursing Services, Phoenix VA Health Care System, Phoenix, Arizona, USA.,School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona, USA
| | - Suzanne Perkins
- Mental Health Care Line, Southern Arizona VA Health Care System, Tucson, Arizona, USA
| | - Sairam Parthasarathy
- Department of Medicine, University of Arizona, Tucson, Arizona, USA.,Research Service, Southern Arizona VA Health Care System, Tucson, Arizona, USA
| | - James Wilcox
- Mental Health Care Line, Southern Arizona VA Health Care System, Tucson, Arizona, USA
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15
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Wilcox J, Hunt J. Arm Swelling - Volleyball. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487028.04840.3c] [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: 11/21/2022]
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16
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Reilly E, Wilcox J, Maggs T, Mackay K. AB1117 24 Hour Crystal Microscopy Improves Diagnosis in Cases of CPPD. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1433] [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: 11/04/2022]
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17
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Snyder RJ, Frykberg RG, Rogers LC, Applewhite AJ, Bell D, Bohn G, Fife CE, Jensen J, Wilcox J. The management of diabetic foot ulcers through optimal off-loading: building consensus guidelines and practical recommendations to improve outcomes. J Am Podiatr Med Assoc 2014; 104:555-67. [PMID: 25514266 DOI: 10.7547/8750-7315-104.6.555] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND We sought to develop a consensus statement for the use of off-loading in the management of diabetic foot ulcers (DFUs). METHODS A literature search of PubMed for evidence regarding off-loading of DFUs was initially conducted, followed by a meeting of authors on March 15, 2013, in Philadelphia, Pennsylvania, to draft consensus statements and recommendations using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach to assess quality of evidence and develop strength of recommendations for each consensus statement. RESULTS Evidence is clear that adequate off-loading increases the likelihood of DFU healing and that increased clinician use of effective off-loading is necessary. Recommendations are included to guide clinicians on the optimal use of off-loading based on an initial comprehensive patient/wound assessment and the necessity to improve patient adherence with off-loading devices. CONCLUSIONS The likelihood of DFU healing is increased with off-loading adherence, and, current evidence favors the use of nonremovable casts or fixed ankle walking braces as optimum off-loading modalities. There currently exists a gap between what the evidence supports regarding the efficacy of DFU off-loading and what is performed in clinical practice despite expert consensus on the standard of care.
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Affiliation(s)
| | - Robert G. Frykberg
- Carl T. Hayden Veteran Affairs Medical Center, Phoenix, AZ
- Midwestern University School of Podiatric Medicine, Glendale, AZ
| | - Lee C. Rogers
- Amputation Prevention Center, Sherman Oaks Hospital, Los Angeles, CA
| | | | - Desmond Bell
- Save a Leg, Save a Life Foundation, Jacksonville, FL
- Limb Salvage Institute and Wound Care on Wheels, Jacksonville, FL
- *Memorial Hospital of Jacksonville, St. Vincent's Medical Center Southside and Specialty Hospital of Jacksonville, Jacksonville, FL
| | - Gregory Bohn
- †Trinity Center for Wound Care and Hyperbaric Medicine, Trinity Bettendorf and Moline Clinics, Trinity Regional Medical Center, Bettendorf, IA
| | - Caroline E. Fife
- ‡Intellicure Inc, The Woodlands, TX
- §St. Luke's Wound Care Clinic, The Woodlands, TX
| | - Jeffrey Jensen
- Barry University School of Podiatric Medicine, Miami Shores, FL
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Alikani M, McCulloh D, Barritt J, Wilcox J, Penzias A, Kettel M, Munne S. Are euploidy rates different in blastocysts from donor oocytes and those from young infertile patients? Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.209] [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: 11/16/2022]
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19
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Brandt AR, Heath GA, Kort EA, O'Sullivan F, Pétron G, Jordaan SM, Tans P, Wilcox J, Gopstein AM, Arent D, Wofsy S, Brown NJ, Bradley R, Stucky GD, Eardley D, Harriss R. Methane Leaks from North American Natural Gas Systems. Science 2014; 343:733-5. [PMID: 24531957 DOI: 10.1126/science.1247045] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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20
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Abstract
This is a retrospective examination of former users of alpha-methyltryptamine (AMT). A scale of questions was given to subjects who were familiar with the effects of AMT and the outcome was analyzed. Most subjects agreed that AMT had strong hallucinogenic qualities. The most common unwanted effects included anxiety, nausea and moderately severe dysphoria. Several subjects reported significant depression associated with use of AMT. Use of alpha-methyltryptamine could be dangerous in individuals prone to depression.
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21
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Wilcox J, Winokur G, Tsuang M. Predictive value of thought disorder in new-onset psychosis. Compr Psychiatry 2012; 53:674-8. [PMID: 22341649 DOI: 10.1016/j.comppsych.2011.12.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 12/08/2011] [Accepted: 12/13/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE This research addresses the relationship of formal thought disorder in the early stages of psychotic illness to the long-term outcome of mental health many years later. The specific topic of concern was to evaluate the prognostic significance of thought disorder on the severity of psychosis over time. METHODS Subjects with new-onset psychosis were evaluated on a variety of measures including education, physical health, Brief Psychiatric Rating Scale scores. They were also given the Thought, Language, and Communication Scale to evaluate thought disorder. Subjects were interviewed again at 10 and 20 years to evaluate variations in outcome. Appropriate statistical methods were used to evaluate changes in the level of functioning over time. RESULTS Thought disorder was not unique to schizophrenia. Bipolar patients presented with significant positive thought disorder at the onset of psychosis. Overtime positive thought disorder gradually improved in most patients. Negative thought disorder was more persistent, especially in subjects with schizophrenia. Initial psychosis with thought disorder characterized by poverty of content seemed to be associated with poor long-term outcome. CONCLUSION Formal thought disorder can predict outcome in some cases of psychosis. Not all types of thought disorder have the same prognostic implication. Positive forms of thought disorder (pressured speech, tangentiality) had no significant predictive value. Negative thought disorder (particularly poverty of speech and poverty of content) tend to predict a chronic, more unrelenting course of illness.
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Affiliation(s)
- R Vawda
- Department of University Health Network, Toronto Western Hospital, Toronto, Canada, ON M5T 2S8
| | - J Wilcox
- Department of University Health Network, Toronto Western Hospital, Toronto, Canada, ON M5T 2S8
| | - MG Fehlings
- Department of University Health Network, Toronto Western Hospital, Toronto, Canada, ON M5T 2S8
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van der Pligt P, K.Campbell, Wilcox J, Denney-Wilson E. Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioner's perspectives. Obes Res Clin Pract 2011. [DOI: 10.1016/j.orcp.2011.08.036] [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: 10/17/2022]
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24
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Sherif K, Song J, Wilcox J. A social status perspective of network utility over electronic channels in academic communities. International Journal of Information Management 2009. [DOI: 10.1016/j.ijinfomgt.2009.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ivakhnenko V, Kolb B, Nelson J, Tourgeman D, Wilcox J, Behr B. Morphological dynamic of the nucleoli in human pronuclear oocytes. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.352] [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: 10/21/2022]
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Behr B, Tran C, Kolb B, Nelson J, Wilcox J, Ivakhnenko V. Frequency of Abnormal Hatching in PGD Embryos. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.02.032] [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: 10/22/2022]
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Wilcox J. Prospective, randomized, controlled, multicenter clinical trial comparing cetrorelix acetate (CET) and ganirelix acetate (GAN) in a flexible protocol for the prevention of premature leutinizing hormone (LH) surge in ART − interim results. Fertil Steril 2004. [DOI: 10.1016/j.fertnstert.2004.07.091] [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: 10/26/2022]
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Abstract
Our subjects consisted of 14 autistic individuals and 14 controls ranging in age from 3 to 37 years. A (99m)Tc HMPAO single photon emission computed tomogram (SPECT) was used to examine blood flow variations between autistic subjects, compared to an age- and gender-matched control group. We found significant hypoperfusion in the prefrontal areas of autistic individuals as compared to normals in every case (p < 0.01). As the age of the autistic individuals increased the hypoperfusion of verbal-associated areas in the left temporal lobe and frontal areas became more evident. The findings were significant at the p < 0.001 level. The changes in perfusion over time correlated with language development and acquisition as individuals matured. We conclude that autistic individuals have a deficiency in prefrontal areas associated with word identification and language formation skills. This subsequently prevents development of true verbal fluency and development in the temporal and frontal areas associated with speech and communication.
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Affiliation(s)
- James Wilcox
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso, Tex 79905, USA.
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Affiliation(s)
- J Wilcox
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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Wilcox J. [Not Available]. Munstersche Beitr Gesch Theor Med 2001; 15:79-86. [PMID: 11637362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Affiliation(s)
- E McIntyre
- Department of Gastroenterology, Royal Children's Hospital, Brisbane, Queensland, Australia
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Norbryhn G, Feinman M, Nelson J, Potter D, Wilcox J, Batzofin J. Clinical scientific and ethical dilemmas in a prospective randomized study to evaluate the efficacy of blastocyst transfer as a possible modality to reduce multiple gestation. Fertil Steril 2001. [DOI: 10.1016/s0015-0282(01)02595-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- J Wilcox
- Mailman School of Public Health, Columbia University, 722 W 168 St, Room 937, New York, NY 10032, USA.
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Norbryhn G, Fontanilla T, Rogoff R, Nelson J, Wilcox J, Batzofin J. Establishment of a Primary Care Nursing Team in a Rapidly Expanding Multi-Site Reproductive Endocrine Center. Fertil Steril 2000. [DOI: 10.1016/s0015-0282(00)00744-5] [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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Wotton MJ, Trocki O, Thomas BJ, Hammond P, Shepherd RW, Lewindon PJ, Wilcox J, Murphy AJ, Cleghorn GJ. Changes in body composition in adolescents with anorexia nervosa. Comparison of bioelectrical impedance analysis and total body potassium. Ann N Y Acad Sci 2000; 904:418-9. [PMID: 10865782 DOI: 10.1111/j.1749-6632.2000.tb06493.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M J Wotton
- Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane, Australia.
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Seidensticker D, Wilcox J, Gagne P. Treatment of May-Thurner syndrome with catheter-directed thrombolysis and stent placement, complicated by heparin-induced thrombocytopenia. Cardiovasc Surg 1998; 6:607-13. [PMID: 10395265 DOI: 10.1016/s0967-2109(98)00086-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
May-Thurner syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis and severe leg edema. We report the case of a 41-year-old female who presented with severe left leg edema present for 1 day. One week earlier she had experienced acute shortness of breath and pleuritic chest pain. Duplex ultrasound revealed a left iliofemoral deep vein thrombosis. A computed tomography (CT) scan performed for abdominal pain revealed thrombosis of the entire left common and external iliac veins. A ventilation-perfusion scan diagnosed a pulmonary embolism. The patient was treated with systemic intravenous heparin and catheter-directed thrombolysis of the iliofemoral deep vein thrombosis. Complete thrombolysis and iliofemoral vein patency was achieved over 5 days. A persistent stenosis in the left common iliac vein consistent with May-Thurner syndrome was alleviated with percutaneous balloon angioplasty and placement of a Wallstent. Heparin therapy was terminated at the time of stenting because of suspected heparin-induced thrombocytopenia. The patient was started on a continuous infusion of 10% dextran 40, and warfarin therapy was initiated. Heparin-induced antibodies were confirmed by a C-14 serotonin release assay. The endovascular reconstruction remains patent 4 months later. Heparin-induced thrombocytopenia complicating endovascular reconstruction of the iliofemoral venous system in a patient with May-Thurner Syndrome is an uncommon occurrence. This case and a review of the literature are discussed.
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Affiliation(s)
- D Seidensticker
- Department of Surgery, Naval Medical Center, Portsmouth, Virginia 23708, USA
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Trocki O, Wilcox J, Shepherd R. Use of Indirect Calorimetry in Nutritional Rehabilitation of Adolescents With Anorexia Nervosa. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0002-8223(97)00490-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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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Shoemaker RC, Polzin K, Labate J, Specht J, Brummer EC, Olson T, Young N, Concibido V, Wilcox J, Tamulonis JP, Kochert G, Boerma HR. Genome duplication in soybean (Glycine subgenus soja). Genetics 1996; 144:329-38. [PMID: 8878696 PMCID: PMC1207505 DOI: 10.1093/genetics/144.1.329] [Citation(s) in RCA: 204] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Restriction fragment length polymorphism mapping data from nine populations (Glycine max x G. soja and G. max x G. max) of the Glycine subgenus soja genome led to the identification of many duplicated segments of the genome. Linkage groups contained up to 33 markers that were duplicated on other linkage groups. The size of homoeologous regions ranged from 1.5 to 106.4 cM, with an average size of 45.3 cM. We observed segments in the soybean genome that were present in as many as six copies with an average of 2.55 duplications per segment. The presence of nested duplications suggests that at least one of the original genomes may have undergone an additional round of tetraploidization. Tetraploidization, along with large internal duplications, accounts for the highly duplicated nature of the genome of the subgenus. Quantitative trait loci for seed protein and oil showed correspondence across homoeologous regions, suggesting that the genes or gene families contributing to seed composition have retained similar functions throughout the evolution of the chromosomes.
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Affiliation(s)
- R C Shoemaker
- Department of Agronomy, Iowa State University, Ames 50011, USA.
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Abachi S, Abbott B, Abolins M, Acharya BS, Adam I, Adams DL, Adams M, Ahn S, Aihara H, Alitti J, Álvarez G, Alves GA, Amidi E, Amos N, Anderson EW, Aronson SH, Astur R, Avery RE, Baden A, Balamurali V, Balderston J, Baldin B, Bantly J, Bartlett JF, Bazizi K, Bendich J, Beri SB, Bertram I, Bezzubov VA, Bhat PC, Bhatnagar V, Bhattacharjee M, Bischoff A, Biswas N, Blazey G, Blessing S, Bloom P, Boehnlein A, Bojko NI, Borcherding F, Borders J, Boswell C, Brandt A, Brock R, Bross A, Buchholz D, Burtovoi VS, Butler JM, Casey D, Castilla-Valdez H, Chakraborty D, Chang SM, Chekulaev SV, Chen LP, Chen W, Chevalier L, Chopra S, Choudhary BC, Christenson JH, Chung M, Claes D, Clark AR, Cobau WG, Cochran J, Cooper WE, Cretsinger C, Cullen-Vidal D, Cummings MAC, Cutts D, Dahl OI, De K, Demarteau M, Demina R, Denisenko K, Denisenko N, Denisov D, Denisov SP, Dharmaratna W, Diehl HT, Diesburg M, Di Loreto G, Dixon R, Draper P, Drinkard J, Ducros Y, Dugad SR, Durston-Johnson S, Edmunds D, Ellison J, Elvira VD, Engelmann R, Eno S, Eppley G, Ermolov P, Eroshin OV, Evdokimov VN, Fahey S, Fahland T, Fatyga M, Fatyga MK, Featherly J, Feher S, Fein D, Ferbel T, Finocchiaro G, Fisk HE, Fisyak Y, Flattum E, Forden GE, Fortner M, Frame KC, Franzini P, Fuess S, Galjaev AN, Gallas E, Gao CS, Gao S, Geld TL, Genik RJ, Genser K, Gerber CE, Gibbard B, Glaubman M, Glebov V, Glenn S, Gobbi B, Goforth M, Goldschmidt A, Gómez B, Goncharov PI, Gordon H, Goss LT, Graf N, Grannis PD, Green DR, Green J, Greenlee H, Griffin G, Grossman N, Grudberg P, Grünendahl S, Gu W, Guida JA, Guida JM, Guryn W, Gurzhiev SN, Gutnikov YE, Hadley NJ, Haggerty H, Hagopian S, Hagopian V, Hahn KS, Hall RE, Hansen S, Hatcher R, Hauptman JM, Hedin D, Heinson AP, Heintz U, Hernández-Montoya R, Heuring T, Hirosky R, Hobbs JD, Hoeneisen B, Hoftun JS, Hsieh F, Hu T, Hu T, Huehn T, Igarashi S, Ito AS, James E, Jaques J, Jerger SA, Jiang JZY, Joffe-Minor T, Johari H, Johns K, Johnson M, Johnstad H, Jonckheere A, Jones M, Jöstlein H, Jun SY, Jung CK, Kahn S, Kang JS, Kehoe R, Kelly ML, Kernan A, Kerth L, Kim CL, Kim SK, Klatchko A, Klima B, Klochkov BI, Klopfenstein C, Klyukhin VI, Kochetkov VI, Kohli JM, Koltick D, Kostritskiy AV, Kotcher J, Kourlas J, Kozelov AV, Kozlovski EA, Krishnaswamy MR, Krzywdzinski S, Kunori S, Lami S, Landsberg G, Lanou RE, Lebrat JF, Leflat A, Li H, Li J, Li YK, Li-Demarteau QZ, Lima JGR, Lincoln D, Linn SL, Linnemann J, Lipton R, Liu YC, Lobkowicz F, Loken SC, Lökös S, Lueking L, Lyon AL, Maciel AKA, Madaras RJ, Madden R, Mandrichenko IV, Mangeot P, Mani S, Mansoulié B, Mao HS, Margulies S, Markeloff R, Markosky L, Marshall T, Martin MI, Marx M, May B, Mayorov AA, McCarthy R, McKibben T, McKinley J, Melanson HL, de Mello Neto JRT, Merritt KW, Miettinen H, Milder A, Mincer A, de Miranda JM, Mishra CS, Mohammadi-Baarmand M, Mokhov N, Mondal NK, Montgomery HE, Mooney P, Mudan M, Murphy C, Murphy CT, Nang F, Narain M, Narasimham VS, Narayanan A, Neal HA, Negret JP, Neis E, Nemethy P, Nešić D, Norman D, Oesch L, Oguri V, Oltman E, Oshima N, Owen D, Padley P, Pang M, Para A, Park CH, Park YM, Partridge R, Parua N, Paterno M, Perkins J, Peryshkin A, Peters M, Piekarz H, Pischalnikov Y, Pluquet A, Podstavkov VM, Pope BG, Prosper HB, Protopopescu S, Pušeljić D, Qian J, Quintas PZ, Raja R, Rajagopalan S, Ramirez O, Rao MVS, Rapidis PA, Rasmussen L, Read AL, Reucroft S, Rijssenbeek M, Rockwell T, Roe NA, Rubinov P, Ruchti R, Rusin S, Rutherfoord J, Santoro A, Sawyer L, Schamberger RD, Schellman H, Sculli J, Shabalina E, Shaffer C, Shankar HC, Shivpuri RK, Shupe M, Singh JB, Sirotenko V, Smart W, Smith A, Smith RP, Snihur R, Snow GR, Snyder S, Solomon J, Sood PM, Sosebee M, Souza M, Spadafora AL, Stephens RW, Stevenson ML, Stewart D, Stoianova DA, Stoker D, Streets K, Strovink M, Taketani A, Tamburello P, Tarazi J, Tartaglia M, Taylor TL, Teiger J, Thompson J, Trippe TG, Tuts PM, Varelas N, Varnes EW, Virador PRG, Vititoe D, Volkov AA, Vorobiev AP, Wahl HD, Wang J, Wang LZ, Warchol J, Wayne M, Weerts H, Wenzel WA, White A, White JT, Wightman JA, Wilcox J, Willis S, Wimpenny SJ, Wirjawan JVD, Womersley J, Won E, Wood DR, Xu H, Yamada R, Yamin P, Yanagisawa C, Yang J, Yasuda T, Yoshikawa C, Youssef S, Yu J, Yu Y, Zhang Y, Zhou YH, Zhu Q, Zhu YS, Zhu ZH, Zieminska D, Zieminski A, Zylberstejn A. Top quark search with the D0 1992-1993 data sample. Phys Rev D Part Fields 1995; 52:4877-4919. [PMID: 10019713 DOI: 10.1103/physrevd.52.4877] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Mann J, Chisholm A, Crooke M, Jackson R, Neutze J, North D, Swinburn B, White H, Wilcox J. Management of patients with dyslipidaemia. N Z Med J 1995; 108:444. [PMID: 7478355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
Divalproex sodium was given to a series of agitated individuals with a variety of psychiatric illnesses. Objective measures of agitation were then used to assess the effect of the divalproex sodium on such behavior. Demographic, diagnostic, medical, and physiological data were compiled on the subjects and the variation in the amount of time spent in an agitated state was evaluated in an attempt to account for the variation. We found that divalproex sodium reduced agitation in a variety of psychiatric conditions. It seems to be especially effective in the treatment of the agitated patient with bipolar illness or borderline personality disorder.
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Affiliation(s)
- J Wilcox
- Department of Psychiatry, Texas Tech University Medical Center, El Paso 79905
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Wilcox J. Nursing assessment: more than merely 'doing the obs'. Contemp Nurse 1994; 3:41. [PMID: 8136639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Wilcox J. Health expenditure and health reforms. N Z Med J 1992; 105:502. [PMID: 1461614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Wilcox J, Wilcox E. Training volunteers for maximum hospital advantage. Volunt Leader 1992; 33:8-9. [PMID: 10122645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Wilcox J. Erosion of the role of the nurse. Contemp Nurse 1992; 1:33. [PMID: 1596610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
The occurrence of intrusive auditory perceptions has rarely been addressed in the study of posttraumatic stress disorder. This study examined the background of 59 individuals with combat-related posttraumatic stress disorder. Subjects with and without auditory hallucinations were compared on demographic military and symptom variables. The occurrence of hallucinations among veterans with posttraumatic stress disorder appears to be more frequent among subjects of Hispanic ethnicity. This may have been related to higher combat exposure or social stresses. The occurrence of hallucinations was unrelated to drug abuse and did not appear to be associated with any particular war.
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Affiliation(s)
- J Wilcox
- Department of Psychiatry, Texas Tech University Health Sciences Center, El Paso 79905
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Fava RA, Casey TT, Wilcox J, Pelton RW, Moses HL, Nanney LB. Synthesis of transforming growth factor-beta 1 by megakaryocytes and its localization to megakaryocyte and platelet alpha-granules. Blood 1990; 76:1946-55. [PMID: 2242422] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We have directly demonstrated that megakaryocytes are a major site of synthesis and storage of transforming growth factor-beta 1 (TGF/beta 1) by combined immunohistochemical, immunocytochemical, and in situ hybridization methods. The presence of TGF/beta 1 messenger RNA (mRNA) in mature megakaryocytes in adult rat spleen and bone marrow (BM) was established by in situ hybridization. Localization of TGF/beta 1 protein to intact alpha-granules of megakaryocytes, its putative storage site, was accomplished in glycol-methacrylate embedded porcine BM with an immunoperoxidase technique and light microscopy. The TGF/beta 1 was sequestered in intracytoplasmic granules in a pattern virtually identical to that of another alpha-granule marker protein, fibrinogen. This observation strongly suggests packaging of TGF/beta 1 into this organelle within megakaryocytes. That TGF/beta 1 mRNA was localized to megakaryocytes suggests that the TGF/beta 1 found in the alpha-granules in platelets originates with megakaryocyte synthesis. The alpha-granule localization of TGF/beta 1, as well as fibrinogen, was also demonstrated in isolated platelets at the ultrastructural level by electronmicroscopy (EM) and postembedding colloidal-gold immunocytochemistry, thus directly demonstrating that alpha-granules are the final storage site for TGF/beta 1 in mature platelets.
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Affiliation(s)
- R A Fava
- Department of Cell Biology, Vanderbilt University School of Medicine, Nashville, TN
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