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Dodson JA, Ibrahim SA, Rogers H, Council ML, Nehal KS, Tung R, Leffell DJ, Zeitouni NC, Totonchy MB, Fosko SW, Lee Soon S, Blalock TW, Brodland DG, Billingsley EM, Scott JF, Leach BC, Ratner D, Washington C, Hanke CW, Otley CC, Golda N, Nijhawan RI, Brewer J, Demer A, Fish F, Harmon CB, Zitelli J, Knackstedt T, Singh G, Mollet T, Carr DR, Albertini JG, Moody BR, McDonald M, Bordeaux JS, Massey PR, MacCormack MA, Vidimos A, Arpey CJ, Arron ST, Ibrahimi OA, Jiang SB, Miller CJ, Maher IA, Wysong A, Leshin B, Goldman GD, Kibbi N, Feng H, Collins L. Identifying critical quality metrics in Mohs Surgery: A national expert consensus process. J Am Acad Dermatol 2024; 90:798-805. [PMID: 38081390 DOI: 10.1016/j.jaad.2023.10.069] [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] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/16/2023] [Accepted: 10/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Amid a movement toward value-based healthcare, increasing emphasis has been placed on outcomes and cost of medical services. To define and demonstrate the quality of services provided by Mohs surgeons, it is important to identify and understand the key aspects of Mohs micrographic surgery (MMS) that contribute to excellence in patient care. OBJECTIVE The purpose of this study is to develop and identify a comprehensive list of metrics in an initial effort to define excellence in MMS. METHODS Mohs surgeons participated in a modified Delphi process to reach a consensus on a list of metrics. Patients were administered surveys to gather patient perspectives. RESULTS Twenty-four of the original 66 metrics met final inclusion criteria. Broad support for the initiative was obtained through physician feedback. LIMITATIONS Limitations of this study include attrition bias across survey rounds and participation at the consensus meeting. Furthermore, the list of metrics is based on expert consensus instead of quality evidence-based outcomes. CONCLUSION With the goal of identifying metrics that demonstrate excellence in performance of MMS, this initial effort has shown that Mohs surgeons and patients have unique perspectives and can be engaged in a data-driven approach to help define excellence in the field of MMS.
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Affiliation(s)
- Joseph A Dodson
- Rush Medical College of Rush University Medical Center, Chicago, Illinois
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Howard Rogers
- President, American College of Mohs Surgery, CMO, Advanced Dermatology, Norwich, Connecticut
| | - M Laurin Council
- Division of Dermatology, Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kishwer S Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rebecca Tung
- Florida Dermatology and Skin Cancer Centers, Winter Haven, Florida
| | - David J Leffell
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Nathalie C Zeitouni
- Division of Dermatology, Department of Internal Medicine, University of Arizona, Phoenix, Arizona
| | | | - Scott W Fosko
- Department of Dermatology, University of Florida, Gainesville, Florida
| | | | - Travis W Blalock
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | | | | | - Jeffrey F Scott
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brian C Leach
- The Skin Surgery Center of Charleston, Mount Pleasant, South Carolina
| | - Desiree Ratner
- Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Carl Washington
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Partner; Dermatology Associates of Georgia, Decatur, Georgia
| | - C William Hanke
- Laser and Skin Surgery Center of Indiana, Indianapolis, Indiana; Program Director, ACGME Micrographic Surgery/Dermatologic Oncology Fellowship Training Program, Ascension St. Vincent Hospital, Indianapolis, Indiana; Department of Dermatology, University of Iowa-Carver College of Medicine, Iowa City, Iowa
| | - Clark C Otley
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Nicholas Golda
- Dermatology and Skin Cancer Centers, Kansas City, Missouri
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jerry Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Addison Demer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Frederick Fish
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | | | - John Zitelli
- Department of Dermatology, Otolaryngology, and Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Thomas Knackstedt
- Mohs Surgery Unit, Pinehurst Dermatology & Mohs Surgery Center, Pinehurst, North Carolina; Department of Dermatology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | | | - Todd Mollet
- Department of Dermatology, Skin Surgery Center of Oklahoma, Oklahoma City, Oklahoma
| | - David R Carr
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | | | | | - Michel McDonald
- Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio
| | - Jeremy S Bordeaux
- Department of Dermatology, Warren Alpert Medical School at Brown University, Worcester, Massachusetts
| | | | | | - Allison Vidimos
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Omar A Ibrahimi
- Department of Dermatology, Connecticut Skin Institute, Stamford, Connecticut
| | | | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Barry Leshin
- Department of Dermatology, Skin Surgery Center, Winston-Salem, North Carolina
| | | | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
| | - Lindsey Collins
- Department of Dermatology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Isaq NA, Brewer J, Markovic SN, Montane H, Demer AM. Cytokine Storm Due to Intralesional Intelukin-2 Therapy for Cutaneous In-Transit Melanoma. Dermatol Surg 2023; 49:1198-1199. [PMID: 37669243 DOI: 10.1097/dss.0000000000003930] [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] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Affiliation(s)
- Nasro A Isaq
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Jerry Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Division of Dermatologic Surgery, Mayo Clinic, Rochester Minnesota
| | | | | | - Addison M Demer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Division of Dermatologic Surgery, Mayo Clinic, Rochester Minnesota
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Tedbury P, Manfredi C, Conway J, Horwath M, McCracken C, Sorscher A, Moreau S, Wright C, Edwards C, Brewer J, Guarner J, De Wit E, Williamson B, Ong Y, Roback J, Alter D, Degenhardt F, Karlsen T, Franke A, Sarafianos S, Sorscher E, Hong J, Ehrhardt A. 385 Mechanisms by which cystic fibrosis transmembrane conductance regulator may influence SARS-CoV-2 infection. J Cyst Fibros 2022. [PMCID: PMC9527873 DOI: 10.1016/s1569-1993(22)01075-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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Schlessinger DI, Reynolds KA, Dirr MA, Ibrahim SA, Yanes AF, Lazaroff JM, Godinez-Puig V, Chen BR, Kurta AO, Cotseones JK, Chiren SG, Furlan KC, Iyengar S, Behshad R, DeHoratius DM, Denes P, Drucker AM, Dzubow LM, Etzkorn JR, Harwood CA, Kim JYS, Lawrence N, Lee EH, Lissner GS, Marghoob AA, Matin RN, Mattox AR, Mittal BB, Thomas JR, Zhou XA, Zloty D, Schmitt J, Kirkham JJ, Armstrong AW, Basset-Seguin N, Billingsley EM, Bordeaux JS, Brewer J, Brown M, Brown M, Collins SAB, Fargnoli MC, De Azevedo SJ, Dummer R, Eggermont A, Goldman GD, Haedersdal M, Hale E, Hanlon A, Harms KL, Huang CC, Hurst EA, In GK, Kelleners-Smeets N, Kheterpal M, Leshin B, Mcdonald M, Miller SJ, Miller A, Mostow EN, Trakatelli M, Nehal KS, Ratner D, Rogers H, Sarin KY, Soon SL, Stasko T, Storrs PA, Tagliaferri L, Vidimos AT, Wong SL, Yu SS, Zalaudek I, Zeitouni NC, Zitelli JA, Poon E, Sobanko JF, Cartee TV, Maher IA, Alam M. Development of a Core Outcome Set for Basal Cell Carcinoma (BCC), Including Low-Risk and Advanced Tumors. J Am Acad Dermatol 2022; 87:573-581. [PMID: 35551965 DOI: 10.1016/j.jaad.2022.04.059] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is variation in the outcomes reported in clinical studies of basal cell carcinoma (BCC). This can prevent effective meta-analyses to answer important clinical questions. OBJECTIVE To identify a recommended minimum set of core outcomes for BCC clinical trials. METHODS Patient and professional Delphi process to cull a long-list, culminating in a consensus meeting. To be provisionally accepted, outcomes needed to be deemed 'important' (score: 7-9, of maximum of 9) by 70% of each stakeholder group. RESULTS 235 candidate outcomes identified via a systematic literature review and survey of key stakeholders were reduced to 74 that were rated by 100 health care professionals and patients in two Delphi rounds. 27 outcomes were provisionally accepted. The final core set of 5 agreed-upon outcomes after the consensus meeting was: complete response; persistent or serious adverse events; recurrence-free survival; quality of life; and patient satisfaction, including with cosmetic outcome. LIMITATIONS English-speaking patients and professionals rated outcomes extracted from English-language studies. CONCLUSIONS A core outcome set (COS) for basal cell carcinoma has been developed. Use of relevant measures may improve the utility of clinical research and the quality of therapeutic guidance available to clinicians.
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Affiliation(s)
- Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kelly A Reynolds
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL; University of Cincinnati College of Medicine, Cincinnati, OH
| | - McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Arianna F Yanes
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jake M Lazaroff
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Victoria Godinez-Puig
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brian R Chen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Jill K Cotseones
- Medical & Cosmetic Dermatology Service, Northwestern Medicine Regional Medical Group, Naperville, IL
| | - Sarah G Chiren
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karina C Furlan
- Department of Pathology, Rush University Medical Center, Chicago, IL
| | - Sanjana Iyengar
- Department of Dermatology, West Virginia University, Morgantown, WV
| | - Ramona Behshad
- Department of Dermatology, Saint Louis University, St. Louis, MO
| | - Danielle M DeHoratius
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Pablo Denes
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Dermatology, Department of Medicine and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | | | - Jeremy R Etzkorn
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Catherine A Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, UK; Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - John Y S Kim
- Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Naomi Lawrence
- Division of Dermatologic Surgery, Department of Dermatology, Cooper University Hospital, Camden, NJ
| | - Erica H Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gary S Lissner
- Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Ashfaq A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, NY
| | - Rubeta N Matin
- Department of Dermatology, Churchill Hospital, Oxford, UK
| | - Adam R Mattox
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Bharat B Mittal
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - J Regan Thomas
- Department of Otolaryngology- Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Xiaolong Alan Zhou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David Zloty
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jochen Schmitt
- Center for Evidence-based Healthcare, Medical Faculty, Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jamie J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - April W Armstrong
- Keck School of Medicine, Department of Dermatology, University of Southern California Los Angeles
| | | | | | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH, USA
| | | | - Marc Brown
- Professor of Dermatology and Oncology; University of Rochester, MN, USA
| | - Mariah Brown
- Department of Dermatology, University of Colorado Hospital and School of Medicine
| | | | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Sergio Jobim De Azevedo
- Professor, Department of Medicine, Chief of Medical Oncology at Hospital de Clinicas de Porto Alegre, Brazil
| | - Reinhard Dummer
- University Hospital, Skin Cancer Center, Zurich, Switzerland
| | | | | | - Merete Haedersdal
- Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | | | | | - Kelly L Harms
- Department of Dermatology, the Comprehensive Cancer Center University of Michigan Medical School, Ann Arbor
| | - Conway C Huang
- Department of Dermatology, University of Alabama at Birmingham, AL, USA
| | - Eva A Hurst
- Distinctive Dermatology, Fairview Heights, IL, USA
| | - Gino K In
- USC Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | | | | | | | | | | | - Eliot N Mostow
- Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Myrto Trakatelli
- Associate Professor of Dermatology, Papageorgiou Hospital, Aristotle University Department of Medicine, Thessaloniki, Greece
| | - Kishwer S Nehal
- Attending Physician, Memorial Sloan Kettering Cancer Center; Director, Mohs and Dermatological Surgery; Professor of Dermatology, Weill Cornell Medical College, NY, USA
| | | | | | | | | | - Thomas Stasko
- Professor and Chair, The University of Oklahoma Department of Dermatology, OK, USA
| | - Paul A Storrs
- University of Illinois Chicago, Department of Dermatology, IL, USA
| | - Luca Tagliaferri
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Italy
| | | | | | - Siegrid S Yu
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Italy
| | | | - John A Zitelli
- Clinical Associate Professor of Dermatology, Otolaryngology, Plastic Surgery, University of Pittsburgh Medical Center, PA, USA
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Joseph F Sobanko
- Department of Dermatology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA; Division of Dermatologic Surgery, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Todd V Cartee
- Department of Dermatology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Otolaryngology- Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Morton‐Holtham L, Swann N, Brewer J, Moir HJ. A systematic review of physical activity and physical fitness in sarcoidosis. Translational Sports Med 2021. [DOI: 10.1002/tsm2.278] [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: 11/06/2022]
Affiliation(s)
- L. Morton‐Holtham
- Department of Applied & Human Sciences School of Life Sciences Pharmacy & Chemistry Kingston University London UK
| | - N. Swann
- Department of Applied & Human Sciences School of Life Sciences Pharmacy & Chemistry Kingston University London UK
- School of Biosciences and Medicine University of Surrey Guildford UK
| | | | - H. J. Moir
- Department of Applied & Human Sciences School of Life Sciences Pharmacy & Chemistry Kingston University London UK
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White A, Brewer J, Efthimiou E, Khwaja H, Bonanomi G. 883 Modified Framework for The Management of Acute Gallstone Disease During The COVID-19 Pandemic. Br J Surg 2021. [PMCID: PMC8135821 DOI: 10.1093/bjs/znab134.499] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction On 12/03/2020 WHO declared SARS-CoV-2 a global pandemic. PHE and RCS advised non-operative management wherever possible, changing management of acute gallstone disease from early laparoscopic cholecystectomy to conservative treatment and frequent percutaneous drainage. Planning, prioritisation, and implementation of “COVID-Safe” pathways presented multi-factorial challenges throughout the NHS. Method Prospective data of patients admitted with acute gallstone pathology was collected at Chelsea & Westminster Hospital (23/03/2020-16/08/2020), and prioritised using Tokyo, FSSA and RCS Guidance. A restructured “Gallbladder-pathway” was implemented comprising trust-wide referral proforma, weekly clinical planning MDT meetings and dedicated theatre lists. Results Sixty-eight patients were prioritized as either “Urgent” (25), “Expedited” (12) or “Elective” (31); comprising gallstone pancreatitis (11), acute cholecystitis (53), obstructive jaundice (12) and biliary colic (8). 12 patients required cholecystostomies. During the “Peak” (23/3/20-02/06/2020) no cholecystectomies were performed, 10 in “Recovery” (02/06/20-06/07/20) in NCEPOD theatre, 21 in “Resolution” (06/07/20-18/08/20) since implementation of the “Gallbladder-Pathway”. Eleven patients (16%) re-presented while awaiting definitive treatment, none critically ill. The highest number of re-presentations was in “Urgent” patients (36%) and those with cholecystostomy (45%). Conclusions Early adoption of a modified “Gallbladder-pathway” during the pandemic allowed accurate case stratification, efficient resource allocation and safe care. Our model enabled prompt service recovery and a framework to navigate future disruption.
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Affiliation(s)
- A White
- Chelsea & Westminster Hospital, London, United Kingdom
| | - J Brewer
- Chelsea & Westminster Hospital, London, United Kingdom
| | - E Efthimiou
- Chelsea & Westminster Hospital, London, United Kingdom
| | - H Khwaja
- Chelsea & Westminster Hospital, London, United Kingdom
| | - G Bonanomi
- Chelsea & Westminster Hospital, London, United Kingdom
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Kellar D, Lockhart SN, Aisen P, Raman R, Rissman RA, Brewer J, Craft S. Intranasal Insulin Reduces White Matter Hyperintensity Progression in Association with Improvements in Cognition and CSF Biomarker Profiles in Mild Cognitive Impairment and Alzheimer's Disease. J Prev Alzheimers Dis 2021; 8:240-248. [PMID: 34101779 DOI: 10.14283/jpad.2021.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Intranasally administered insulin has shown promise in both rodent and human studies in Alzheimer's disease; however, both effects and mechanisms require elucidation. OBJECTIVE We assessed the effects of intranasally administered insulin on white matter health and its association with cognition and cerebral spinal fluid biomarker profiles in adults with mild cognitive impairment or Alzheimer's disease in secondary analyses from a prior phase 2 clinical trial (NCT01767909). DESIGN A randomized (1:1) double-blind clinical trial. SETTING Twelve sites across the United States. PARTICIPANTS Adults with mild cognitive impairment or Alzheimer's disease. INTERVENTION Participants received either twice daily placebo or insulin (20 IU Humulin R U-100 b.i.d.) intranasally for 12 months. Seventy-eight participants were screened, of whom 49 (32 men) were enrolled. MEASUREMENTS Changes from baseline in global and regional white matter hyperintensity volume and gray matter volume were analyzed and related to changes in cerebral spinal fluid biomarkers, Alzheimer's Disease Assessment Scale-Cognition, Clinical Disease Rating-Sum of Boxes, Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale, and a memory composite. RESULTS The insulin-treated group demonstrated significantly reduced changes in white matter hyperintensity volume in deep and frontal regions after 12 months, with a similar trend for global volume. White matter hyperintensity volume progression correlated with worsened Alzheimer's disease cerebral spinal fluid biomarker profile and cognitive function; however, patterns of correlations differed by treatment group. CONCLUSION Intranasal insulin treatment for 12 months reduced white matter hyperintensity volume progression and supports insulin's potential as a therapeutic option for Alzheimer's disease.
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Affiliation(s)
- D Kellar
- Suzanne Craft, PhD, Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC 27157,
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Jurgens A, Guru S, Guo R, Brewer J, Bridges A, Jakub J, Comfere N. Tumoral Melanosis in the Setting of Targeted Immunotherapy for Metastatic Melanoma-A Single Institutional Experience and Literature Review. Am J Dermatopathol 2021; 43:9-14. [PMID: 32149829 DOI: 10.1097/dad.0000000000001612] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Tumoral melanosis clinically resembles metastatic melanoma, occurs in the context of regressed disease, and requires evaluation to rule out underlying melanoma and metastatic disease. Histopathology demonstrates a nodular infiltrate of melanophages in the dermis, subcutaneous tissue, deep soft tissue, or lymph nodes in the absence of viable melanocytes. Recent limited reports of tumoral melanosis in the context of immunotherapy with ipilimumab (monoclonal antibody targeting CTLA-4) as well as nivolumab and pembrolizumab (humanized monoclonal antibodies against programmed death 1 receptor) highlight a unique presentation representative of treatment-related tumor regression and an association with a favorable clinical response. OBJECTIVE To describe our experience with tumoral melanosis in the setting of immunotherapy for metastatic melanoma and elucidate the clinical and histopathological features. METHODS Retrospective case series from a single tertiary care institution. RESULTS We describe 10 cases of patients with metastatic melanoma who received treatment with immunotherapy before the development of tumoral melanosis. Length of time between the initiation of therapy and the onset of tumoral melanosis ranged from 2 to 20 months with a mean time of 10 months. At the end of the follow-up period, 8 patients were classified as having a complete or partial response to treatment with immunotherapy. One patient had progression of visceral and cutaneous disease on ipilimumab despite developing tumoral melanosis, and 1 patient had yet to undergo repeat imaging. Furthermore, at the end of follow-up, 3 patients were alive with no evidence of active disease, 5 patients were alive with disease, and 1 patient was deceased, although this patient died of a cardiovascular event unrelated to his underlying melanoma. Of the patients who were classified as alive with disease, 2 patients had minimal remaining disease, and 2 patients had an almost complete response on immunotherapy with recurrence of visceral metastases after immunotherapy was discontinued. One patient developed new peritoneal and cutaneous metastases on pembrolizumab despite development of tumoral melanosis. CONCLUSIONS The underlying biologic mechanisms and prognostic implications of tumoral melanosis in the setting of immunotherapy remain to be elucidated. Further prospective studies with a larger cohort and prolonged follow-up are necessary to better understand the incidence, prevalence, and oncologic outcomes in patients with tumoral melanosis who receive immunotherapy.
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Affiliation(s)
| | | | - Ruifeng Guo
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Alina Bridges
- Departments of Dermatology; and
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Nneka Comfere
- Departments of Dermatology; and
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Potyrailo RA, Brewer J, Cheng B, Carpenter MA, Houlihan N, Kolmakov A. Bio-inspired gas sensing: boosting performance with sensor optimization guided by "machine learning". Faraday Discuss 2020; 223:161-182. [PMID: 32749434 PMCID: PMC7986473 DOI: 10.1039/d0fd00035c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The performance of existing gas sensors often degrades in field conditions because of the loss of measurement accuracy in the presence of interferences. Thus, new sensing approaches are required with improved sensor selectivity. We are developing a new generation of gas sensors, known as multivariable sensors, that have several independent responses for multi-gas detection with a single sensor. In this study, we analyze the capabilities of natural and fabricated photonic three-dimensional (3-D) nanostructures as sensors for the detection of different gaseous species, such as vapors and non-condensable gases. We employed bare Morpho butterfly wing scales to control their gas selectivity with different illumination angles. Next, we chemically functionalized Morpho butterfly wing scales with a fluorinated silane to boost the response of these nanostructures to the vapors of interest and to suppress the response to ambient humidity. Further, we followed our previously developed design rules for sensing nanostructures and fabricated bioinspired inorganic 3-D nanostructures to achieve functionality beyond natural Morpho scales. These fabricated nanostructures have embedded catalytically active gold nanoparticles to operate at high temperatures of ≈300 °C for the detection of gases for solid oxide fuel cell (SOFC) applications. Our performance advances in the detection of multiple gaseous species with specific nanostructure designs were achieved by coupling the spectral responses of these nanostructures with machine learning (a.k.a. multivariate analysis, chemometrics) tools. Our newly acquired knowledge from studies of these natural and fabricated inorganic nanostructures coupled with machine learning data analytics allowed us to advance our design rules for sensing nanostructures toward the required gas selectivity for numerous gas monitoring scenarios at room and high temperatures for industrial, environmental, and other applications.
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Affiliation(s)
| | - J Brewer
- GE Research, Niskayuna, NY, USA.
| | - B Cheng
- GE Research, Niskayuna, NY, USA.
| | | | - N Houlihan
- SUNY Polytechnic Institute, Albany, NY, USA
| | - A Kolmakov
- National Institute of Standards and Technology, Gaithersburg, MD, USA
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10
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Kumar AB, Aguilera JV, Velazquez A, Yan Y, Jakub J, Brewer J, Hieken T, Block M, McWilliams R, Otley C, Markovic S, Kottschade L. The role of serum lactate dehydrogenase level as a prognostic indicator in resected, high risk melanoma. Dermatol Ther 2019; 32:e12813. [PMID: 30620137 DOI: 10.1111/dth.12813] [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] [Received: 12/07/2018] [Accepted: 01/05/2019] [Indexed: 11/27/2022]
Affiliation(s)
| | | | - Ana Velazquez
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Yiyi Yan
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - James Jakub
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Jerry Brewer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Tina Hieken
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Matthew Block
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Clark Otley
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | - Lisa Kottschade
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
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11
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Gentile N, Kaufman TK, Maxson J, Klein DM, Merten S, Price M, Swenson L, Weaver AL, Brewer J, Rajjo T, Narr C, Ziebarth S, Lynch BA. The Effectiveness of a Family-Centered Childhood Obesity Intervention at the YMCA: A Pilot Study. ACTA ACUST UNITED AC 2018; 8. [PMID: 29732240 DOI: 10.4172/2161-0711.1000591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective Community-based, family-centered obesity prevention/treatment initiatives have been shown to be effective in reducing body mass index (BMI) and improving healthy habits in children if implemented with high intensity and sufficient duration. Let's Go! 5-2-1-0 Program (5-2-1-0) was incorporated into family-centered, monthly physical activity classes and cooking classes over six months delivered by Young Men's Christian Association (YMCA) staff. We hypothesized that implementation of this intervention would improve 5-2-1-0 knowledge attainment, increase healthy behavior (based on 5- 2-1-0 curriculum), and improve BMI and waist circumference measurements in children. Methods Children attending YMCA summer camps in Rochester, MN, during 2016 were recruited via study packets mailed to their families. Height, weight, and waist circumference measurements as well as the results of the Modified Healthy Habits Survey and the 5-2-1-0 Knowledge Acquisition Survey were recorded for each participating child at baseline and 6-month follow-up. The intervention group received monthly healthy habit reminder emails, and was invited to monthly evening cooking and physical activity classes for 7 sessions over a 6-month period. Results Fifteen families in the intervention group attended classes. Of those, 13 families regularly participated in (attended at least 5 out of 7) both the monthly physical activity and cooking classes. The children in the intervention group had a significant improvement in the number of Knowledge Acquisition Survey questions answered correctly (p<0.001), while there was no improvement in the control group. As compared to children in the control group, there was no significant change in BMI or waist circumference or healthy habits in the intervention group. Conclusion Our study findings indicate that our intervention resulted in improved knowledge about healthy habits, but did not significantly impact healthy habits or BMI. Potential reasons for this were the small sample size and the attenuated length and/or intensity of the intervention.
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Affiliation(s)
- N Gentile
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - T K Kaufman
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - J Maxson
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - D M Klein
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - S Merten
- Viterbo University, La Crosse, WI, USA
| | - M Price
- Viterbo University, La Crosse, WI, USA
| | - L Swenson
- Office of Patient Education, Mayo Clinic, Rochester, MN, USA
| | - A L Weaver
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - J Brewer
- Rochester Area Family YMCA, Rochester, MN, USA
| | - T Rajjo
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - C Narr
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - S Ziebarth
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - B A Lynch
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
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12
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Long B, Schmitt AR, Weaver AL, McGree M, Bakkum-Gamez JN, Brewer J, Cliby WA. A matter of margins: Surgical and pathologic risk factors for recurrence in extramammary Paget's disease. Gynecol Oncol 2017; 147:358-363. [DOI: 10.1016/j.ygyno.2017.09.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 11/26/2022]
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13
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Abstract
There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream.
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Affiliation(s)
- R S Crane
- Centre for Mindfulness Research and Practice, School of Psychology, Bangor University,Brigantia Building,Gwynedd,UK
| | - J Brewer
- Department of Medicine,Center for Mindfulness in Medicine, Health Care, and Society,University of Massachusetts Medical School,Worcester, MA,USA
| | - C Feldman
- Freelance Teacher and Writer,Totnes,Devon,UK
| | - J Kabat-Zinn
- Department of Medicine,Center for Mindfulness in Medicine, Health Care, and Society,University of Massachusetts Medical School,Worcester, MA,USA
| | - S Santorelli
- Department of Medicine,Center for Mindfulness in Medicine, Health Care, and Society,University of Massachusetts Medical School,Worcester, MA,USA
| | - J M G Williams
- Oxford Mindfulness Centre,University Department of Psychiatry,University of Oxford, Warneford Hospital,Oxford,UK
| | - W Kuyken
- Oxford Mindfulness Centre,University Department of Psychiatry,University of Oxford, Warneford Hospital,Oxford,UK
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14
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Brewer J, Gelfand M, Jackson JC, MacDonald IF, Peregrine PN, Richerson PJ, Turchin P, Whitehouse H, Wilson DS. Grand challenges for the study of cultural evolution. Nat Ecol Evol 2017; 1:70. [PMID: 28812714 DOI: 10.1038/s41559-017-0070] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J Brewer
- Cognitive Policy Works, Seattle, Washington 98122, USA
| | - M Gelfand
- University of Maryland, College Park, Maryland 20742, USA
| | - J C Jackson
- University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - I F MacDonald
- Binghamton University, Binghamton, New York 13902, USA
| | - P N Peregrine
- Lawrence University, Appleton, Wisconsin 54911 USA, and the Santa Fe Institute, Santa Fe, New Mexico 87501, USA
| | - P J Richerson
- University of California, Davis, California 95616, USA
| | - P Turchin
- University of Connecticut, Storrs, Connecticut 06269, USA
| | | | - D S Wilson
- Binghamton University, Binghamton, New York 13902, USA
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15
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Seibert T, Karunamuni R, Kaifi S, Burkeen J, Krishnan A, McDonald C, White N, Farid N, Bartsch H, Nguyen T, Moiseenko V, Brewer J, Dale A, Hattangadi J. Selective Vulnerability of Cerebral Cortex Regions to Radiation Dose–Dependent Atrophy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.445] [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: 10/20/2022]
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16
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Pettersson N, Karunamuni R, Connor M, Moiseenko V, Dale A, Bartsch H, Brewer J, Krishnan A, Kuperman J, Hagler D, McDonald C, Farid N, White N, Hattangadi-Gluth J, Cervino L. SU-F-T-118: Characterization of Change in Fractional Anisotropy After Radiation Therapy: Does Nearby Disruption Predict for White Matter Damage? Med Phys 2016. [DOI: 10.1118/1.4956254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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17
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Pettersson N, Bartsch H, Brewer J, Cervino L, Connor M, Dale A, Hagler D, Karunamuni R, Krishnan A, Kuperman J, McDonald C, Farid N, White N, Hattangadi-Gluth J, Moiseenko V. PV-0476: Fractional anisotropy dose-response relationship of the corpus callosum. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31725-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: 10/21/2022]
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18
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Houston SA, Cerovic V, Thomson C, Brewer J, Mowat AM, Milling S. The lymph nodes draining the small intestine and colon are anatomically separate and immunologically distinct. Mucosal Immunol 2016; 9:468-78. [PMID: 26329428 DOI: 10.1038/mi.2015.77] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/19/2015] [Indexed: 02/04/2023]
Abstract
Dendritic cells (DCs) in the small intestine (SI) and colon are fundamental to direct intestinal immune responses; they migrate to the mesenteric lymph nodes (MLNs) and prime T cells. We demonstrate anatomical segregation of lymphatic drainage from the intestine, specifically that DCs from the SI and colon migrate to different nodes within the MLN, here called the sMLN and cMLN. As a consequence, different frequencies of DC subsets observed in the SI and colon are reflected among the DCs in the sMLN and cMLN. Consistent with the SI's function in absorbing food, fed antigen is presented in the sMLN, but not in the cMLN. Furthermore, the levels of expression of CCR9 and α4β7 are increased on T cells in the sMLN compared with the cMLN. DCs from the cMLN and colon are unable to metabolize vitamin A to retinoic acid (RA); thus, DCs may contribute to the differential expression of tissue homing markers observed in the sMLN and cMLN. In summary, the sMLN and cMLN, and the DCs that migrate to these LNs are anatomically and immunologically separate. This segregation allows immune responses in the SI and colon to be controlled independently.
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Affiliation(s)
- S A Houston
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - V Cerovic
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - C Thomson
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - J Brewer
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A M Mowat
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S Milling
- Centre for Immunobiology, Institute for Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Zwald F, Leitenberger J, Zeitouni N, Soon S, Brewer J, Arron S, Bordeaux J, Chung C, Abdelmalek M, Billingsley E, Vidimos A, Stasko T. Recommendations for Solid Organ Transplantation for Transplant Candidates With a Pretransplant Diagnosis of Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma and Melanoma: A Consensus Opinion From the International Transplant Skin Cancer Collaborative (ITSCC). Am J Transplant 2016; 16:407-13. [PMID: 26820755 DOI: 10.1111/ajt.13593] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 10/09/2015] [Accepted: 10/14/2015] [Indexed: 01/25/2023]
Abstract
Advancements in solid organ transplantation successfully extend the lives of thousands of patients annually. The tenet of organ stewardship aims to prevent the futile expenditure of scarce donor organs in patient populations with high mortality risk, to the detriment of potential recipients with greater predicted life expectancy. The development of skin cancer posttransplantation portends tremendous morbidity, adversely affecting quality of life for many transplant recipients. This special article, provided by of members of the International Transplant Skin Cancer Collaborative (ITSCC), will provide the transplant professional with a consensus opinion and recommendations as to an appropriate wait period pretransplantation for transplant candidates with a history of either cutaneous squamous cell carcinoma, malignant melanoma, or Merkel cell carcinoma.
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Key Words
- cancer, malignancy, neoplasia
- clinical research, practice
- dermatology
- malignancy
- melanoma, cancer, malignancy, neoplasia
- metastatic disease
- neoplasia
- organ transplantation in general
- risk factors, cancer, malignancy, neoplasia
- skin, nonmelanoma, cancer
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Affiliation(s)
- F Zwald
- Piedmont Transplant Institute, Atlanta, GA
| | | | - N Zeitouni
- Department of Dermatology, University of Arizona, Tucson, AZ
| | - S Soon
- Department of Dermatology, Scripps Clinic, La Jolla, CA
| | - J Brewer
- Department of Dermatology, Mayo Clinic, Rochester, MN
| | - S Arron
- Department of Dermatology, UCSF, San Francisco, CA
| | - J Bordeaux
- Department of Dermatology, Case Medical Center, Cleveland, OH
| | - C Chung
- Department of Dermatology, Drexel University, Philadelphia, PA
| | - M Abdelmalek
- Department of Dermatology, Drexel University, Philadelphia, PA
| | | | - A Vidimos
- Department of Dermatology, Cleveland Clinic, Cleveland, OH
| | - T Stasko
- Department of Dermatology, Oklahoma University, Oklahoma City, OK
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Marshall D, Karunamuni R, White N, McDonald C, Moiseenko V, Bartsch H, Seibert T, Farid N, Brewer J, Krishnan A, Dale A, Hattangadi J. Quantitative Analysis of Radiation Induced Microstructural Injury to White Matter and Hippocampus in Brain Tumor Patients. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Karunamuni R, Bartsch H, White N, Moiseenko V, Carmona R, Marshall D, Seibert T, McDonald C, Farid N, Krishnan A, Brewer J, Dale A, Hattangadi J. Dose-Dependent Cortical Thinning After Partial-Brain Radiation in Glioblastoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Cambrook H, MacRitchie N, Grassia G, Sabir S, Ialenti A, Maddaluno M, Brewer J, Garside P, Maffia P. Antigen presenting cell phenotype is altered in the aorta of apolipoprotein-E deficient mice during atherosclerosis. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.219] [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: 11/25/2022]
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Abstract
Neurodegenerative disease is a progressive loss of neurons from central nervous system and has a huge impact on health care system. Various causes have been proposed of which inflammation has been suggested to be a probable key factor in the most of such conditions. The involvement of immune cells including lymphocytes in such diseased condition of the CNS supports this notion. The effective therapy for these diseases has been sought for more than a half century but still lacking such therapy. On such basis this review article has mainly focussed on evidence of the involvement of immune cells in various neurodegenerative diseases including Alzheimer's disease, Parkinson's diseases and Multiple sclerosis and suggests a possible therapy of such diseased conditions of the CNS by the modulation of immune system.
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Affiliation(s)
- R Shrestha
- Department of Pharmacology, Dhulikhel Hospital - Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - S Shakya Shrestha
- Department of Pharmacology, Dhulikhel Hospital - Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - O Millingtona
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde Glasgow, UK
| | - J Brewer
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - T Bushell
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde Glasgow, UK
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24
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Shrestha R, Millington O, Brewer J, Bushell T. Lymphocytes Protect Cortical Neurons Against Excitotoxicity Mediated by Kainic Acid, an in vitro Model for Neurodegeneration. ACTA ACUST UNITED AC 2015; 11:132-8. [DOI: 10.3126/kumj.v11i2.12488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
Background Neurodegenerative disease is a progressive loss of neurons from the central nervous system (CNS). Various conditions have been implicated for such conditions including ageing, inflammation, stress and genetic predisposition. Recently, studies have linked neurodegeneration with inflammation. Some studies have suggested the harmful effect of immune response while others have argued its neuroprotective role in neurodegeneration of the CNS. However, the precise role of inflammation and immune cells in such condition is still not clear. Objective To investigate the role of lymphocytes in neurodegeneration of the CNS and determine the underlying mechanism. Method We have used 4-7 days old mouse pups (C57Bl6) to prepare organotypic slice cultures which were cultured for 13-15 days prior to experiment. To induced cell death kainic acid was used and considered as an in vitro model for neurodegeneration. Lymphocytes were obtained from peripheral lymph nodes of 5-10 weeks old adult mouse which were used in the current study. Propidium iodide was used as a fluorescent dye to determine cell death in brain slice cultures. Result Lymphocytes do not induce cell death in slice cultures in the absence of any toxic insult whereas, after applying toxic insult to the slice cultures using kainic acid, lymphocytes show neuroprotection against such insult. Similarly, purified non-activated and purified activated T cells along with T cells depleted lymphocyte preparation also exhibit neuroprotection against kainic acid-induced cell death. We further, have demonstrated that the observed neuroprotection is contact-independent and soluble mediators released from lymphocytes are responsible for the observed neuroprotection. Moreover, our study has revealed that soluble mediators exhibiting neuroprotection act via astrocytes. Conclusion Lymphocyte preparations are neuroprotective and the observed neuroprotection is contact-independent. Soluble mediators released from lymphocytes are responsible for the observed neuroprotection. DOI: http://dx.doi.org/10.3126/kumj.v11i2.12488 Kathmandu University Medical Journal Vol.11(2) 2013: 132-138
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25
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Goncalves-Alves E, Saferding V, Puchner A, Benson R, Kurowska-Stolarska M, Brewer J, Schliehe C, Bergthaler A, Smolen JS, Redlich K, Blüml S. A6.3 The role of micro-RNA 155 in autoimmune arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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26
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Brewer J, Mcquinn D, Lohse C, Hassani J. Tanning Bed Perception Survey: A Questionnaire-based Study. J Clin Aesthet Dermatol 2015; 8:23-27. [PMID: 25852811 PMCID: PMC4382142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study was intended to investigate the perception of tanning bed use among college students. DESIGN A 15-question survey was given to young adults regarding tanning perceptions. SETTING Rochester Community College in Rochester, Minnesota. PARTICIPANTS Forty-four respondents between 18 and 51 years of age. MEASUREMENTS Data was collected via a self-reported questionnaire. RESULTS In this study, 50 percent of participants were not educated on the risks of melanoma, and 68 percent were not interested in receiving information on melanoma and completing a follow-up survey. More specifically, 63 percent versus 89 percent of participants with no tanning bed versus some tanning bed use did not want information regarding melanoma, respectively. This study also shows that more tanning bed users believe tanning helps prevent burning than non-tanning bed users. Fifty-seven percent of the 35 participants who had never used a tanning bed thought that they never prevent sunburn, while only 11 percent of the nine participants who had used a tanning bed in the past thought that they never prevent sunburn, which was statistically significant.
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Affiliation(s)
- Jerry Brewer
- Mayo Clinic, Department of Dermatology, Rochester Minnesota
| | - Donna Mcquinn
- Mayo Clinic, Department of Health Sciences Research, Rochester, Minnesota
| | - Christine Lohse
- Mayo Clinic, Department of Health Sciences Research, Rochester, Minnesota
| | - John Hassani
- New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, New York
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27
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Abstract
The central nervous system (CNS) was once considered to be an immune-privileged area. However, increasing evidence shows that the central nervous system is not an immune-privileged but is an active surveillance site. There is a bi-directional communication between the central nervous system and immune system. Normally, immune cells migrate into the central nervous system microenvironment through choroid plexus and interact with the central nervous system resident cells through either through neuromediators or immunomediators. This finding has led to a significant interest in neuroimmunological interactions and investigation onto the role of the immune system in the pathology of various neurological disorders and examine whether it can be targeted to produce novel therapeutic strategies.
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Affiliation(s)
- R Shrestha
- Clinical Biochemsitry, College of Medical Sciences Teaching Hospital, Bharatpur, Chitwan
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Pandey MB, Porenta T, Brewer J, Burkart A, Copar S, Zumer S, Smalyukh II. Self-assembly of skyrmion-dressed chiral nematic colloids with tangential anchoring. Phys Rev E Stat Nonlin Soft Matter Phys 2014; 89:060502. [PMID: 25019708 DOI: 10.1103/physreve.89.060502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Indexed: 06/03/2023]
Abstract
We describe dipolar nematic colloids comprising mutually bound solid microspheres, three-dimensional skyrmions, and point defects in a molecular alignment field of chiral nematic liquid crystals. Nonlinear optical imaging and numerical modeling based on minimization of Landau-de Gennes free energy reveal that the particle-induced skyrmions resemble torons and hopfions, while matching surface boundary conditions at the interfaces of liquid crystal and colloidal spheres. Laser tweezers and videomicroscopy reveal that the skyrmion-colloidal hybrids exhibit purely repulsive elastic pair interactions in the case of parallel dipoles and an unexpected reversal of interaction forces from repulsive to attractive as the center-to-center distance decreases for antiparallel dipoles. The ensuing elastic self-assembly gives rise to colloidal chains of antiparallel dipoles with particles entangled by skyrmions.
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Affiliation(s)
- M B Pandey
- Department of Physics and Liquid Crystal Materials Research Center, University of Colorado, Boulder, Colorado 80309, USA and Department of Physics, VSSD College, Kanpur 208 002, India
| | - T Porenta
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, 1000 Ljubljana, Slovenia
| | - J Brewer
- Department of Physics and Liquid Crystal Materials Research Center, University of Colorado, Boulder, Colorado 80309, USA
| | - A Burkart
- Department of Physics and Liquid Crystal Materials Research Center, University of Colorado, Boulder, Colorado 80309, USA
| | - S Copar
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, 1000 Ljubljana, Slovenia and Jozef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia
| | - S Zumer
- Faculty of Mathematics and Physics, University of Ljubljana, Jadranska 19, 1000 Ljubljana, Slovenia and Jozef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia
| | - Ivan I Smalyukh
- Department of Physics and Liquid Crystal Materials Research Center, University of Colorado, Boulder, Colorado 80309, USA and Department of Electrical, Computer, and Energy Engineering and Materials Science and Engineering Program, University of Colorado, Boulder, Colorado 80309, USA and Renewable and Sustainable Energy Institute, National Renewable Energy Laboratory and University of Colorado, Boulder, Colorado 80309, USA
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Broughan J, Downs S, Crawshaw T, Upton P, Brewer J, Clifton-Hadley R. Mycobacterium bovis infections in domesticated non-bovine mammalian species. Part 1: Review of epidemiology and laboratory submissions in Great Britain 2004–2010. Vet J 2013; 198:339-45. [DOI: 10.1016/j.tvjl.2013.09.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 09/05/2013] [Accepted: 09/07/2013] [Indexed: 10/26/2022]
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30
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Broughan J, Crawshaw T, Downs S, Brewer J, Clifton-Hadley R. Mycobacterium bovis infections in domesticated non-bovine mammalian species. Part 2: A review of diagnostic methods. Vet J 2013; 198:346-51. [DOI: 10.1016/j.tvjl.2013.09.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 09/05/2013] [Accepted: 09/07/2013] [Indexed: 11/28/2022]
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Jones RM, Ashford R, Cork J, Palmer S, Wood E, Spyvee P, Parks S, Bennett A, Brewer J, Delahay R, Chambers M, Sawyer J. Evaluation of a method to detect Mycobacterium bovis in air samples from infected Eurasian badgers (Meles meles) and their setts. Lett Appl Microbiol 2013; 56:361-5. [PMID: 23384280 DOI: 10.1111/lam.12055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/24/2013] [Accepted: 01/31/2013] [Indexed: 11/29/2022]
Abstract
Environmental air sampling was evaluated as a method to detect the presence of M. bovis in the vicinity of infected badgers and their setts. Airborne particles were collected on gelatine filters using a commercially available air sampling instrument and tested for the presence of M. bovis using bacteriological culture and real-time PCR. The sensitivity of bacteriological culture was broadly similar to that of real-time PCR when testing samples artificially spiked with M. bovis. Sampling was undertaken from directly under the muzzles of badgers which had been experimentally infected with M. bovis (37 samples), within enclosures housing the experimentally infected animals (50 samples), and in the vicinity of setts with resident infected wild badgers (52 samples). The methods employed did not detect M. bovis from either infected badgers or artificial or natural setts known to contain infected animals. However, samples taken at four of the six natural setts were positive for Mycobacterium gordonae.
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Affiliation(s)
- R M Jones
- Animal Health and Veterinary Laboratories Agency Weybridge, Addlestone, UK
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McDonald KL, Rapkins RW, Olivier J, Zhao L, Nozue K, Lu D, Tiwari S, Kuroiwa-Trzmielina J, Brewer J, Wheeler HR, Hitchins MP. The T genotype of the MGMT C>T (rs16906252) enhancer single-nucleotide polymorphism (SNP) is associated with promoter methylation and longer survival in glioblastoma patients. Eur J Cancer 2012; 49:360-8. [PMID: 22975219 DOI: 10.1016/j.ejca.2012.08.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 12/18/2022]
Abstract
Clinical studies in patients with newly diagnosed glioblastoma treated with temozolomide have shown that the methylation status of the O(6)-methylguanine-DNA methyltransferase (MGMT) gene is both predictive and prognostic of outcome. Methylation of the promoter region of MGMT is the most clinically relevant measure of MGMT expression and its assessment has become integral in current and planned clinical trials in glioblastoma. Our study confirmed that MGMT methylation, assessed by pyrosequencing, is associated with a significant survival benefit in glioblastoma patients treated with temozolomide (either concurrently with radiotherapy or sequential treatment). More interestingly, our study demonstrated that a promoter variant, the c.-56C>T (rs16906252) single nucleotide polymorphism (SNP) located within a cis-acting enhancer element at the proximal end of MGMT, is associated with the presence of MGMT promoter methylation in de novo glioblastoma. Furthermore, we show that the overall survival of patients carrying both the SNP and MGMT methylation showed a strong survival benefit when compared to either molecular event on their own. Promoter reporter experiments in MGMT methylated glioblastoma cell lines showed the T allele conferred a ∼30% reduction in normalised MGMT promoter activity compared to the wild-type haplotype. This might account for the propensity of the T allele to undergo promoter methylation, and in turn, the improved survival observed in carriers of the T allele. An independent validation on larger cohorts is required to confirm the prognostic and predictive value of individuals carrying the T allele.
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Affiliation(s)
- K L McDonald
- Prince of Wales Clinical School, University of NSW, Australia.
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Cooper C, Brewer J. Laparoscopic Repair of Diaphragm Injury in Acute Trauma. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tan K, Brewer J, Rowe DB, Jenkins B, Powers JM, Buckland ME. Adult onset leucodystrophy with neuroaxonal spheroids and pigmented glia (ALSP): report of a new kindred. Neuropathol Appl Neurobiol 2012; 38:95-100. [DOI: 10.1111/j.1365-2990.2011.01173.x] [Citation(s) in RCA: 4] [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: 11/27/2022]
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Patakas A, Benson R, Conigliaro P, Brewer J, McInnes I, Garside P. Breach of self tolerance in rheumatoid arthritis: a role for Th17 effector T cells? Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.148981.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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36
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Tam Tam KB, Keiser SD, Sims S, Brewer J, Owens MY, Martin JN. Antepartum eclampsia <34 weeks case series: advisable to postpone delivery to administer corticosteroids for fetal pulmonary benefit? J Perinatol 2011; 31:161-5. [PMID: 21072041 DOI: 10.1038/jp.2010.118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine if postponement of delivery to administer fetal lung maturation corticosteroids (PDACs) in mothers with antepartum eclampsia <34 weeks gestation benefits the fetus without compromising the mother. STUDY DESIGN A case series of 37 maternal-perinatal pairs over a 9-year period with antepartum eclampsia between 24 and 34 weeks gestation from a single tertiary center were reviewed retrospectively. Duration of PDAC, clinical course and maternal-fetal outcomes, including impact of duration of PDAC on neonatal pulmonary function, were recorded for each case. Group assignment was based on length of corticosteroid treatment course before delivery: Group A, 0 to ≤ 24 h, n=28; B, 24 to <48 h, n=5; C, ≥ 48 h, n=4. Data were collected and analyzed by one-way analysis of variance (ANOVA), ANOVA on ranks, χ(2)-test and Fisher's exact tests where appropriate; statistical significance was determined by a P-value <0.05. RESULT Overall, 37 of 68 eclampsia patients in 1999 to 2007 met inclusion criteria. No adverse maternal or fetal event occurred while delivery was postponed. Immediate neonatal intubation or continuous positive airway pressure was required for 23/28 in A, 4/5 in B and 2/4 in C; room air was sufficient at birth for 5/28 in A, 1/5 in B and 2/4 in C. No newborn >33 weeks gestation required INI. Prolonged (that is, >1 day) mechanical ventilation was not required for any infant with a gestational age ≥ 32 weeks or PDAC ≥ 48 h. Two of three neonatal deaths in group A were attributed to pulmonary insufficiency. CONCLUSION PDAC for antepartum preterm eclampsia, especially ≤ 32 weeks gestation, appears to offer notable fetal pulmonary benefit without significantly increasing maternal or fetal risk.
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Affiliation(s)
- K B Tam Tam
- Department of Obstetrics and Gynecology, Winfred L Wiser Hospital for Women and Infants, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Taber-Doughty T, Shurr J, Brewer J, Kubik S. Standard care and telecare services: comparing the effectiveness of two service systems with consumers with intellectual disabilities. J Intellect Disabil Res 2010; 54:843-859. [PMID: 20712698 DOI: 10.1111/j.1365-2788.2010.01314.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Onsite standard care and remote telecare supports were provided to adults with intellectual disabilities living in integrated community settings and evaluated in terms of effectiveness as consumers completed a series of novel household activities. METHODS Using an alternating treatment design with baseline and follow-up conditions in this single-case study, investigators compared the prompting effectiveness provided by onsite standard care staff and a remote telecare provider. RESULTS While both types of supports resulted in consumers completing tasks, results indicated consumers achieved slightly more independence when prompted by the telecare support provider. Additionally, telecare supports resulted in greater duration for task completion per consumer. CONCLUSIONS Although consumers completed tasks with greater independence using telecare supports, caution should be used when interpreting results due to the small number of participants. The potential for this technology certainly exists in supporting consumers in their own homes thus, suggestions for future investigations are provided.
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Affiliation(s)
- T Taber-Doughty
- Department of Educational Studies, Purdue University, West Lafayette, IN 47907-2098, USA.
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Nettiksimmons J, Harvey D, Brewer J, Carmichael O, DeCarli C, Jack CR, Petersen R, Shaw LM, Trojanowski JQ, Weiner MW, Beckett L. Subtypes based on cerebrospinal fluid and magnetic resonance imaging markers in normal elderly predict cognitive decline. Neurobiol Aging 2010; 31:1419-28. [PMID: 20542598 DOI: 10.1016/j.neurobiolaging.2010.04.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Revised: 04/19/2010] [Accepted: 04/23/2010] [Indexed: 11/29/2022]
Abstract
Cerebrospinal fluid (CSF) and structural magnetic resonance imaging (MRI) show patterns of change in Alzheimer's disease (AD) that precede dementia. The Alzheimer's Disease Neuroimaging Initiative (ADNI) studied normal controls (NC), subjects with mild cognitive impairment (MCI), and subjects with AD to identify patterns of biomarkers to aid in early diagnosis and effective treatment of AD. Two hundred twenty-two NC underwent baseline MRI and clinical examination at baseline and at least one follow-up. One hundred twelve also provided CSF at baseline. Unsupervised clustering based on initial CSF and MRI measures was used to identify clusters of participants with similar profiles. Repeated measures regression modeling assessed the relationship of individual measures, and of cluster membership, to cognitive change over 3 years. Most individuals showed little cognitive change. Individual biomarkers had limited predictive value for cognitive decline, but membership in the cluster with the most extreme profile was associated with more rapid decline in ADAS-cog. Subtypes among NC based on multiple biomarkers may represent the earliest stages of subclinical cognitive decline and AD.
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Affiliation(s)
- J Nettiksimmons
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA 95616, USA
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Kinsella J, O’Brien W, Mullins G, Brewer J, Whyte S. Primary angiitis of the central nervous system with diffuse cerebral mass effect and giant cells. J Clin Neurosci 2010; 17:674-6. [DOI: 10.1016/j.jocn.2009.09.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 08/11/2009] [Accepted: 09/24/2009] [Indexed: 10/19/2022]
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Pitts M, Martinez A, Brewer J, Hillyard S. Early stages of figure-ground segregation: ERP components associated with face-vase perception. J Vis 2010. [DOI: 10.1167/9.8.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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41
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Walhovd KB, Fjell AM, Brewer J, McEvoy LK, Fennema-Notestine C, Hagler DJ, Jennings RG, Karow D, Dale AM. Combining MR imaging, positron-emission tomography, and CSF biomarkers in the diagnosis and prognosis of Alzheimer disease. AJNR Am J Neuroradiol 2010; 31:347-54. [PMID: 20075088 DOI: 10.3174/ajnr.a1809] [Citation(s) in RCA: 226] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Different biomarkers for AD may potentially be complementary in diagnosis and prognosis of AD. Our aim was to combine MR imaging, FDG-PET, and CSF biomarkers in the diagnostic classification and 2-year prognosis of MCI and AD, by examining the following: 1) which measures are most sensitive to diagnostic status, 2) to what extent the methods provide unique information in diagnostic classification, and 3) which measures are most predictive of clinical decline. MATERIALS AND METHODS ADNI baseline MR imaging, FDG-PET, and CSF data from 42 controls, 73 patients with MCI, and 38 patients with AD; and 2-year clinical follow-up data for 36 controls, 51 patients with MCI, and 25 patients with AD were analyzed. The hippocampus and entorhinal, parahippocampal, retrosplenial, precuneus, inferior parietal, supramarginal, middle temporal, lateral, and medial orbitofrontal cortices were used as regions of interest. CSF variables included Abeta42, t-tau, p-tau, and ratios of t-tau/Abeta42 and p-tau/Abeta42. Regression analyses were performed to determine the sensitivity of measures to diagnostic status as well as 2-year change in CDR-SB, MMSE, and delayed logical memory in MCI. RESULTS Hippocampal volume, retrosplenial thickness, and t-tau/Abeta42 uniquely predicted diagnostic group. Change in CDR-SB was best predicted by retrosplenial thickness; MMSE, by retrosplenial metabolism and thickness; and delayed logical memory, by hippocampal volume. CONCLUSIONS All biomarkers were sensitive to the diagnostic group. Combining MR imaging morphometry and CSF biomarkers improved diagnostic classification (controls versus AD). MR imaging morphometry and PET were largely overlapping in value for discrimination. Baseline MR imaging and PET measures were more predictive of clinical change in MCI than were CSF measures.
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Affiliation(s)
- K B Walhovd
- Department of Psychology, CSHC, University of Oslo, Oslo, Norway.
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Walhovd KB, Fjell AM, Dale AM, McEvoy LK, Brewer J, Karow DS, Salmon DP, Fennema-Notestine C. Multi-modal imaging predicts memory performance in normal aging and cognitive decline. Neurobiol Aging 2008; 31:1107-21. [PMID: 18838195 DOI: 10.1016/j.neurobiolaging.2008.08.013] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 07/03/2008] [Accepted: 08/19/2008] [Indexed: 10/21/2022]
Abstract
This study (n=161) related morphometric MR imaging, FDG-PET and APOE genotype to memory scores in normal controls (NC), mild cognitive impairment (MCI) and Alzheimer's disease (AD). Stepwise regression analyses focused on morphometric and metabolic characteristics of the episodic memory network: hippocampus, entorhinal, parahippocampal, retrosplenial, posterior cingulate, precuneus, inferior parietal, and lateral orbitofrontal cortices. In NC, hippocampal metabolism predicted learning; entorhinal metabolism predicted recognition; and hippocampal metabolism predicted recall. In MCI, thickness of the entorhinal and precuneus cortices predicted learning, while parahippocampal metabolism predicted recognition. In AD, posterior cingulate cortical thickness predicted learning, while APOE genotype predicted recognition. In the total sample, hippocampal volume and metabolism, cortical thickness of the precuneus, and inferior parietal metabolism predicted learning; hippocampal volume and metabolism, parahippocampal thickness and APOE genotype predicted recognition. Imaging methods appear complementary and differentially sensitive to memory in health and disease. Medial temporal and parietal metabolism and morphometry best explained memory variance. Medial temporal characteristics were related to learning, recall and recognition, while parietal structures only predicted learning.
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Affiliation(s)
- K B Walhovd
- Center for the Study of Human Cognition, Department of Psychology, University of Oslo, Norway.
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Abstract
Nanoscaled, needle-shaped frequency doublers have been generated via self-assembled surface growth from functionalized quaterphenylene molecules with a designed large hyperpolarizability. The nanofiber frequency doublers exhibit very weak fluorescence centered around 430 nm but emit a strong, resonance-enhanced second-harmonic signal when excited with infrared 80 fs laser pulses. The frequency doublers are employed to correlate second-harmonic response and morphology via two-dimensional true second-harmonic images of individual nanoaggregates obtained with the help of a femtosecond laser scanning microscope.
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Affiliation(s)
- J Brewer
- Department of Chemistry and Physics, University of Southern Denmark, DK-5230 Odense M, Denmark
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Armstrong A, Brewer J, Newman C, Alakhov V, Pietrzynski G, Campbell S, Corrie P, Ranson M, Valle JW. SP1049C as first-line therapy in advanced (inoperable or metastatic) adenocarcinoma of the oesophagus: A phase II window study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4080] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4080 Background: SP1049C (a block co-polymer incorporating doxorubicin) has demonstrated broad in vitro activity and superior anti-tumour activity in 9/9 in vivo animal tumour models compared to doxorubicin. Methods: Chemotherapy- or radiotherapy-naïve patients with measurable, inoperable, recurrent or metastatic adenocarcinoma of the oesophagus; KP ≥60; normal cardiac LVEF; adequate swallowing and adequate renal, hepatic and bone marrow function were eligible. SP1049C 75mg/m2 IV 30-minute infusion was given q3w, for up to 6 cycles. Radiological response was assessed after cycles 2, 4 and 6. Upon disease progression (PD) patients were offered standard chemotherapy. QoL (by QLQ-C30 and QLQ-OES24 questionnaires), toxicity, disease-related symptoms and cardiac function were also prospectively assessed. Results: From February 2002 to December 2004, 21 patients (all male), median age 62 years (range 38–78) with stage 3 (n = 1) of stage IV (n = 20) disease were enrolled. Response rate (WHO criteria) in 19 patients eligible for efficacy analysis (radiologically re-assessed after ≥2 cycles of treatment) included: PR 9/19 (47%), SD (8/19) 42% and PD (2/19) 11% by investigator assessment (confirmed PR 41%, unconfirmed PR 12% and SD 29% by independent review, RECIST criteria). One responding patient underwent salvage resection of a pT2N0 (Stage 2A) tumour. All patients are evaluable for toxicity. Toxicity (Gd 1–2/3–4, by patient) included: neutropaenia 24%/62%, leucopaenia 19%/29%, anaemia 38%/5% and thrombocytopaenia 9.5%/0% (resulting in 9 (43%) patients being dose-reduced to 55 mg/m2 at cycle 2), nausea 81%/19%, vomiting 62%/24%, anorexia 52.4%/14%, lethargy 81%/14%, febrile neutropaenia -/29%, mucositis 48%/5%, and Gd 1–2 alopecia in 67%. Grade I cardiotoxicity (fall in LVEF by 10–19% from baseline, CTC v2.0) was seen in 4 (19%) patients. The median overall survival (all patients) is 10 months; four patients received 2nd-line chemotherapy. Conclusions: SP1049C appears to have activity in monotherapy in this patient group and combination studies with other active agents are warranted. [Table: see text]
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Affiliation(s)
- A. Armstrong
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - J. Brewer
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - C. Newman
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - V. Alakhov
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - G. Pietrzynski
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - S. Campbell
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - P. Corrie
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - M. Ranson
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
| | - J. W. Valle
- Christie Hospital NHS Trust, Manchester, United Kingdom; Supratek Pharma Inc., Dorval, PQ, Canada; Addenbrooke’s NHS Trust, Cambridge, United Kingdom
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45
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Abstract
A 64 year old man presented with progressive impairment of right sided cranial nerves. Chronic immunosuppression for renal transplantation had resulted in multiple squamous cell carcinomata of the head and neck. Magnetic resonance imaging and subsequent right facial nerve biopsy confirmed perineural spread of a squamous cell carcinoma as the cause of the multiple cranial neuropathies.
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Affiliation(s)
- J H Nogajski
- Department of Neurology, Pacific Laboratory Medicine Services, Royal North Shore Hospital, Level 4, Suite 8, Westbourne Street, St. Leonards, Sydney, New South Wales 2065, Australia
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47
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Brewer J, Maibohm C, Jozefowski L, Bagatolli L, Rubahn HG. A 3D view on free-floating, space-fixed and surface-bound para-phenylene nanofibres. Nanotechnology 2005; 16:2396-401. [PMID: 20818024 DOI: 10.1088/0957-4484/16/10/067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Nanofibres from para-hexaphenylene and functionalized quaterphenylene molecules are grown on mica surfaces and are thereafter transferred into solution, where they either freely rotate in water or are space-fixed in sucrose. From freely rotating aggregates highly anisotropic angular intensity distributions of emitted light for individual aggregates are determined. Luminescence is enhanced at the nanofibre tip as compared to the broad side by about an order of magnitude probably due to waveguiding along the long axis of the aggregates. For dense arrays of nanofibres on mica the increase of emitted intensity towards the substrate plane in the direction of the long axes of the nanofibres is smaller and it depends on the effective thickness of the nanofibre films. The difference between individual aggregates and aggregate arrays is interpreted in terms of light scattering at surface roughness inside the nanofibre film and on the border of the underlying mica substrate. Aggregates fixed in solution, with the help of femtosecond laser scanning microscopy, allow us to obtain two-photon absorption spectra of functionalized nanofibres between 720 and 900 nm as well as morphological features from three-dimensional optical images. The lateral resolution is about 400 nm.
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Affiliation(s)
- J Brewer
- Fysisk Institut, Syddansk Universitet, DK-5230 Odense M, Denmark. MEMPHYS-Center for Biomembrane Physics, Odense, Denmark
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Valle JW, Lawrance J, Brewer J, Clayton A, Corrie P, Alakhov V, Ranson M. A phase II, window study of SP1049C as first-line therapy in inoperable metastatic adenocarcinoma of the oesophagus. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4195] [Citation(s) in RCA: 7] [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: 11/20/2022] Open
Affiliation(s)
- J. W. Valle
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - J. Lawrance
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - J. Brewer
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - A. Clayton
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - P. Corrie
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - V. Alakhov
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
| | - M. Ranson
- Christie Hospital NHS Trust, Manchester, United Kingdom; Addenbrooke's NHS Trust, Cambridge, United Kingdom; Supratek Pharma Inc, Dorval, PQ, Canada
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Chakhalian JA, Kiefl RF, Miller R, Brewer J, Dunsiger SR, Morris G, MacFarlane WA, Sonier JE, Eggert S, Affleck I, Keren A, Verdaguer M. Local magnetic susceptibility of the positive muon in the quasi-one-dimensional S=1/2 antiferromagnet dichlorobis (pyridine) copper (II). Phys Rev Lett 2003; 91:027202. [PMID: 12906505 DOI: 10.1103/physrevlett.91.027202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2003] [Indexed: 05/24/2023]
Abstract
We report muon spin rotation measurements of the local magnetic susceptibility around a positive muon in the paramagnetic state of the quasi-one-dimensional spin 1/2 antiferromagnet dichlorobis (pyridine) copper (II). Signals from three distinct sites are resolved and have a temperature dependent frequency shift which is significantly different than the magnetic susceptibility. This difference is attributed to a muon induced perturbation of the spin 1/2 chain. The obtained frequency shifts are compared with transfer matrix density-matrix renormalization-group numerical simulations.
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Affiliation(s)
- J A Chakhalian
- Department of Physics and Astronomy, UBC, Vancouver, BC, Canada V6T 1Z1
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Mcinnes I, Leung B, Gracie J, Xu D, Wei X, Brewer J, Liew F. Arthritis Res Ther 2003; 5:68. [DOI: 10.1186/ar869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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