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Anthes VB, Schwartz M, Cusimano MD, Radovanovic I, Kulkarni AV, Laperriere NJ, Payne D, Heaton RK, van Prooijen M, Das S, Tsang DSC. Effect of Cobalt-60 Calibration Dose-Rate on Arteriovenous Malformation Obliteration after Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e83-e84. [PMID: 37786194 DOI: 10.1016/j.ijrobp.2023.06.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic radiosurgery (SRS) dose rate - how old the cobalt-60 sources are - is known to influence outcomes for some neurologic conditions and benign tumors, but it is not known if SRS dose rate influences arteriovenous malformation (AVM) obliteration. The objective of this study is to determine the association between cobalt-60 calibration dose rate and cerebral AVM obliteration in patients treated with SRS. Our hypothesis is that higher SRS dose rates are associated with increased incidence of cerebral AVM obliteration. MATERIALS/METHODS We performed a retrospective study of 361 patients undergoing 411 AVM-directed SRS treatments between 2005 and 2019 at a single institution. Obliteration was confirmed with digital subtraction angiogram or MRI (if patient refused angiography). Lesion characteristics, SRS treatment details, and post-treatment obliteration and toxicities were recorded. Univariate and multivariate proportional hazards regression models of AVM outcomes with regard to SRS dose rate were performed, controlling for factors such as Spetzler-Martin Grade, maximum AVM extent, prior hemorrhage and prior embolization. RESULTS At 10 years post-SRS, 68% of AVMs were obliterated on follow-up imaging. Dose rates >2.9 Gy/min were found to be significantly associated with AVM obliteration compared to those <2.1 Gy/min (p = 0.034, Gray's test). AVM size or Spetzler-Martin grade were also associated with obliteration, with obliteration more likely for smaller lesions, particularly those <3 cm in maximal diameter, or with lower Spetzler-Martin grade. Higher dose rates were not associated with development of post-SRS radiologic or symptomatic edema, though larger AVM volume was associated with both types of edema. CONCLUSION Patients with cerebral AVMs treated with higher SRS dose rates (from fresh cobalt-60 sources) experience higher incidences of obliteration, without a significant change in the risk of post-treatment edema. These findings suggest that clinics offering SRS for AVMs should regularly renew cobalt-60 radiation sources to maintain high therapeutic dose rates.
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Affiliation(s)
- V B Anthes
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - M Schwartz
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M D Cusimano
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - I Radovanovic
- Division of Neurosurgery, University Health Network, Toronto, ON, Canada
| | - A V Kulkarni
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - N J Laperriere
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - D Payne
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - R K Heaton
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - M van Prooijen
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - S Das
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON, Canada
| | - D S C Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre and Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Schwartz M, Xue D, Collins D, Kauffman M, Dunbar M, Crowder K, Project DA, Ruple A. Big data from small animals: integrating multi-level environmental data into the Dog Aging Project. REV SCI TECH OIE 2023; 42:65-74. [PMID: 37232318 DOI: 10.20506/rst.42.3349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Environmental exposures can have large impacts on health outcomes. While many resources have been dedicated to understanding how humans are influenced by the environment, few efforts have been made to study the role of built and natural environmental features on animal health. The Dog Aging Project (DAP) is a longitudinal community science study of aging in companion dogs. Using a combination of owner-reported surveys and secondary sources linked through geocoded coordinates, DAP has captured home, yard and neighbourhood variables for over 40,000 dogs. The DAP environmental data set spans four domains: the physical and built environment; chemical environment and exposures; diet and exercise; and social environment and interactions. By combining biometric data, measures of cognitive function and behaviour, and medical records, DAP is attempting to use a big-data approach to transform the understanding of how the surrounding world affects the health of companion dogs. In this paper, the authors describe the data infrastructure developed to integrate and analyse multi-level environmental data that can be used to improve the understanding of canine co-morbidity and aging.
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Schwartz M, Desbrosses K, Theurel J, Mornieux G. Using passive or active back-support exoskeletons during a repetitive lifting task: influence on cardiorespiratory parameters. Eur J Appl Physiol 2022; 122:2575-2583. [PMID: 36074202 DOI: 10.1007/s00421-022-05034-x] [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: 05/20/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022]
Abstract
The objective of this laboratory study was to assess the cardiorespiratory consequences related to the use of different back-support exoskeletons during a repetitive lifting task. Fourteen women and thirteen men performed a dynamic stoop lifting task involving full flexion/extension of the trunk in the sagittal plane. This task was repeated for 5 min with a 10 kg load to handle. Four conditions were tested: with a passive exoskeleton (P-EXO), with two active exoskeletons (A-EXO1 and A-EXO2), as well as without exoskeleton (FREE). The oxygen consumption rate and cardiac costs were measured continuously. Results showed a significantly lower (p < 0.05) oxygen consumption rate for all exoskeletons as compared to FREE (12.6 ± 2.2 ml/kg/min). The values were also significantly lower (p < 0.001) for A-EXO1 (9.1 ± 1.8 ml/kg/min) compared to A-EXO2 (11.0 ± 1.8 ml/kg/min) and P-EXO (11.8 ± 2.4 ml/kg/min). Compared to FREE (59.7 ± 12.9 bpm), the cardiac cost was significantly reduced (p < 0.001) only for A-EXO1 (45.1 ± 11.5 bpm). Several factors can explain these differences on the cardiorespiratory parameters observed between exoskeletons: the technology used (passive vs active), the torque provided by the assistive device, the weight of the system, but also the level of anthropomorphism (related to the number of joints used by the exoskeleton). Our results also highlighted the lack of interaction between the exoskeleton and sex. Thereby, the three back-support exoskeletons tested appeared to reduce the overall physical workload associated with a repetitive lifting task both for men and women.
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Affiliation(s)
- M Schwartz
- Working Life Department, French National Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1 Rue du Morvan, 54500, Vandœuvre-Les-Nancy, France.
- Université de Lorraine, DevAH, 54000, Nancy, France.
| | - K Desbrosses
- Working Life Department, French National Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1 Rue du Morvan, 54500, Vandœuvre-Les-Nancy, France
| | - J Theurel
- Working Life Department, French National Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), 1 Rue du Morvan, 54500, Vandœuvre-Les-Nancy, France
| | - G Mornieux
- Université de Lorraine, DevAH, 54000, Nancy, France
- Faculty of Sport Sciences, Université de Lorraine, Nancy, France
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Abstract
ZusammenfassungDie Behandlung von chronischen Schmerzen kann langwierig sein. Erste Ansätze zur Nutzung von Placeboeffekten bei der Behandlung von chronischen Schmerzen zeigen erfolgversprechende Ergebnisse und können dazu beitragen, die z. T. frustranen Therapieoptionen zu verbessern. Daher sollten Placeboeffekte zur verbesserten Behandlung genutzt werden. Im derzeitigen Modell zur Entstehung von Placeboeffekten spielt die Erwartung eine zentrale Rolle. Eine positive oder negative Erwartung wird durch psychologische und biologische „State“- und „Trait“-Faktoren der Patient:innen sowie die früheren Lernerfahrungen, die der:die Patient:in mitbringt, beeinflusst. Aus diesem Modell ergeben sich Implikationen für die klinische Praxis: Positive Erwartungen sollten unterstützt werden, wobei unrealistische Erwartungen wiederum den Placeboeffekt reduzieren. Negative Erwartungen sollten kritisch diskutiert werden. Es sollte im interdisziplinären Team eine gemeinsame Botschaft an die Patient:innen vermittelt werden. Open-Label-Placebos können als Intervention genutzt werden, um die Selbstwirksamkeit zu steigern.
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Bruckner H, Hirschfeld A, DeJager R, Bassali F, Gurell D, Nghiem V, Dusowitz E, Distenfeld S, Schwartz M, Book A. Blood Tests Predict Safe Survival of Elderly with Resistant GI Cancers. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00427-6] [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: 11/30/2022]
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Godfrey E, Thayer E, Schwartz M, Aitken M. 40: Determining past contraceptive use among women with CF: Does survey administration method matter? J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Halawani AM, Tohyama S, Hung PSP, Behan B, Bernstein M, Kalia S, Zadeh G, Cusimano M, Schwartz M, Gentili F, Mikulis DJ, Laperriere NJ, Hodaie M. Correlation between Cranial Nerve Microstructural Characteristics and Vestibular Schwannoma Tumor Volume. AJNR Am J Neuroradiol 2021; 42:1853-1858. [PMID: 34615646 DOI: 10.3174/ajnr.a7257] [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] [Received: 08/07/2020] [Accepted: 05/28/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Vestibular schwannomas are common cerebellopontine angle tumors arising from the vestibulocochlear nerve and can result in cranial nerve dysfunction. Conventional MR imaging does not provide information that could correlate with cranial nerve compression symptoms of hearing loss or imbalance. We used multitensor tractography to evaluate the relationship between the WM microstructural properties of cranial nerves and tumor volume in a cohort of patients with vestibular schwannomas. MATERIALS AND METHODS A retrospective study was performed in 258 patients with vestibular schwannomas treated at the Gamma Knife clinic at Toronto Western Hospital between 2014 and 2018. 3T MR images were analyzed in 160 surgically naïve patients with unilateral vestibular schwannomas. Multitensor tractography was used to extract DTI-derived metrics (fractional anisotropy and radial, axial, and mean diffusivities of the bilateral facial and vestibulocochlear nerves [cranial nerves VII/VIII]). ROIs were placed in the transition between cisternal and intracanalicular segments, and images were analyzed using the eXtended Streamline Tractography reconstruction method. Diffusion metrics were correlated with 3D tumor volume derived from the Gamma Knife clinic. RESULTS DTI analyses revealed significantly higher fractional anisotropy values and a reduction in axial diffusivity, radial diffusivity, and mean diffusivity (all P < .001) within the affected cranial nerves VII and VIII compared with unaffected side. All specific diffusivities (axial, radial, and mean diffusivity) demonstrated an inverse correlation with tumor volume (axial, radial, and mean diffusivity, P < .01). CONCLUSIONS Multitensor tractography allows the quantification of cranial nerve VII and VIII WM microstructural alterations in patients with vestibular schwannomas. Our findings support the hypothesis that tumor volume may cause microstructural alterations of the affected cranial nerves VII and VIII. This type of advanced imaging may represent a possible avenue to correlate diffusivities with cranial nerve function.
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Affiliation(s)
- A M Halawani
- From the Division of Brain Imaging, and Behaviour-Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Department of Medical Imaging (A.M.H., D.J.M.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology (A.M.H., D.J.M.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - S Tohyama
- From the Division of Brain Imaging, and Behaviour-Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - P S-P Hung
- From the Division of Brain Imaging, and Behaviour-Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Institute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - B Behan
- Ontario Brain Institute (B.B.), Toronto, Ontario, Canada
| | - M Bernstein
- Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - S Kalia
- Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - G Zadeh
- Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,The Arthur and Sonia Labatt Brain Tumor Research Centre (G.Z.), Hospital for Sick Children, Toronto, Ontario, Canada
| | - M Cusimano
- Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery (M.C.), Saint Michael's Hospital, Toronto, Ontario, Canada
| | - M Schwartz
- Division of Neurosurgery (M.S.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - F Gentili
- Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - D J Mikulis
- From the Division of Brain Imaging, and Behaviour-Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Department of Medical Imaging (A.M.H., D.J.M.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neuroradiology (A.M.H., D.J.M.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - N J Laperriere
- Department of Radiation Oncology (N.J.L.), University of Toronto, Toronto, Ontario, Canada.,Division of Radiation Oncology (N.J.L.), Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - M Hodaie
- From the Division of Brain Imaging, and Behaviour-Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada .,Institute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Schwartz M, Likhite S, Meyer K. Onasemnogene abeparvovec-xioi: a gene replacement strategy for the treatment of infants diagnosed with spinal muscular atrophy. Drugs Today (Barc) 2021; 57:387-399. [PMID: 34151905 DOI: 10.1358/dot.2021.57.6.3264117] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/21/2022]
Abstract
In May of 2019, the adeno-associated virus (AAV)-based gene therapy onasemnogene abeparvovec-xioi (Zolgensma) became the second Food and Drug Administration (FDA)-approved gene therapy with designated use for infants diagnosed with spinal muscular atrophy (SMA). The decision came nearly 10 years after results of the first preclinical models were initially reported. While the journey was an arduous one, the approval was an indication of the remarkable success of the first in-human clinical trials. According to the traditional classification system of autosomal recessive SMA, of which there are multiple types with phenotypic variability, SMA type 1 is the most common and most severe and represents 45% of the SMA patient population. Children with SMA type 1 cannot lift their heads without assistance and do not live past their second birthday. With Zolgensma, the first treated children with SMA type 1 have reached 5 years of age and some of them achieved the ability to sit unassisted or even walk. In this article, we review the work that led to FDA approval with emphasis on the development of preclinical and clinical studies.
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Affiliation(s)
- M Schwartz
- Biomedical Sciences Graduate School, The Ohio State University, Columbus, Ohio, USA.,Nationwide Children's Hospital, Columbus, Ohio, USA
| | - S Likhite
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | - K Meyer
- Biomedical Sciences Graduate School, The Ohio State University, Columbus, Ohio, USA.,Nationwide Children's Hospital, Columbus, Ohio, USA. .,College of Medicine, Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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Patel B, Rivers CR, Koutroumpakis F, Ahsan M, Dueker J, Hashash J, Johnston E, Barrie A, Harrison J, Schwartz M, Babichenko D, Tang G, Binion D. 414 Treatment of refractory cutaneous Crohn’s disease with ustekinumab. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.437] [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: 11/30/2022]
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Patel B, Rivers CR, Koutroumpakis F, Ahsan M, Dueker J, Hashash J, Johnston E, Barrie A, Harrison J, Schwartz M, Babichenko D, Tang G, Binion D. 262 Association of dermatologic manifestations of IBD with natural history and biomarkers of severity. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Huo M, Shultz D, Laperriere N, Hodaie M, Cusimano M, Gentili F, Payne D, Berlin A, Schwartz M, Millar B, Zadeh G, Coolens C, Tsang D. PO-0855: Radiation-induced meningiomas: outcomes following stereotactic radiosurgery. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00872-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
In the past few decades, research on pain and placebo analgesia has gained importance both scientifically and clinically. In this article, the current findings and focus of research as well as the significance of placebo research for assessing the effectiveness of pain medication are illustrated. The underlying mechanisms of placebo analgesia not only have implications for theoretical models but also offer clinically relevant guidelines for everyday interventions in pain treatment. However, many placebo phenomena are not fully understood and have to be investigated further in order to exploit the full potential of placebo effects. Interindividual differences and their inclusion in treatment will play a major role in this aspect.
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Affiliation(s)
- R Klinger
- Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - M Schwartz
- Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - U Bingel
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Deutschland
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Asada Y, Turner L, Schwartz M, Chriqui JF. "Bridging, brokering, and buffering": a theoretical exploration of school leaders' engagement with local school wellness policy implementation. Implement Sci Commun 2020; 1:44. [PMID: 32885201 PMCID: PMC7427866 DOI: 10.1186/s43058-020-00029-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 03/25/2020] [Indexed: 11/26/2022] Open
Abstract
Background The Healthy, Hunger-Free Kids Act of 2010 (P.L. 111-296) prompted the expansion of federal requirements for local school wellness policies, which aim to improve health promoting practices across school districts in the USA. This qualitative study examined how school district superintendents—as key school leaders who are often listed as the district accountability figure for wellness policies applicable to kindergarten through 12th grade—engaged with wellness policy implementation. The inquiry was guided by evidence-informed implementation and leadership frameworks, including the Consolidated Framework for Implementation Research (CFIR) and “bridging, buffering, and brokering” strategies from education leadership theory. Methods We conducted focus groups and interviews with superintendents (n = 39) from 23 states. Interviews were recorded and professionally transcribed; transcripts were team-coded in Atlas.ti v8 using an iteratively revised coding guide that was informed by CFIR, pilot testing, and during weekly analyst meetings. Principles of constant comparative analysis were employed to develop themes. Results Most superintendents’ reported positive perspectives and personal motivations to engage with wellness policy implementation. Within the CFIR process domain, superintendents demonstrated adaptive leadership traits and employed a combination of “bridging, buffering, and brokering” strategies to lead implementation activities. Rather than focus on personal traits, an emphasis on specific strategies highlights actions that may be applied. Conclusions The findings offer practical strategies to support superintendents with implementation, as well as a formative contribution to the dearth of theoretical frameworks in school wellness literature, particularly by advancing the specific understanding of leadership roles within a broader implementation framework. The application of education theory allowed for a deeper inquiry into the potential ways that leaders’ strategies and engagement influences implementation more broadly.
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Affiliation(s)
- Y Asada
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W Roosevelt Rd, M/C 275, Chicago, IL 60608 USA
| | - L Turner
- College of Education, Boise State University, 1910 University Drive, Boise, Idaho 83725 USA
| | - M Schwartz
- UConn Rudd Center for Food Policy and Obesity University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT 06103 USA
| | - J F Chriqui
- Institute for Health Research and Policy, School of Public Health, University of Illinois at Chicago, 1747 W Roosevelt Rd, M/C 275, Chicago, IL 60608 USA
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Wells AU, Flaherty KR, Brown KK, Inoue Y, Devaraj A, Richeldi L, Moua T, Crestani B, Wuyts WA, Stowasser S, Quaresma M, Goeldner RG, Schlenker-Herceg R, Kolb M, Aburto M, Acosta O, Andrews C, Antin-Ozerkis D, Arce G, Arias M, Avdeev S, Barczyk A, Bascom R, Bazdyrev E, Beirne P, Belloli E, Bergna M, Bergot E, Bhatt N, Blaas S, Bondue B, Bonella F, Britt E, Buch K, Burk J, Cai H, Cantin A, Castillo Villegas D, Cazaux A, Cerri S, Chaaban S, Chaudhuri N, Cottin V, Crestani B, Criner G, Dahlqvist C, Danoff S, Dematte D'Amico J, Dilling D, Elias P, Ettinger N, Falk J, Fernández Pérez E, Gamez-Dubuis A, Giessel G, Gifford A, Glassberg M, Glazer C, Golden J, Gómez Carrera L, Guiot J, Hallowell R, Hayashi H, Hetzel J, Hirani N, Homik L, Hope-Gill B, Hotchkin D, Ichikado K, Ilkovich M, Inoue Y, Izumi S, Jassem E, Jones L, Jouneau S, Kaner R, Kang J, Kawamura T, Kessler R, Kim Y, Kishi K, Kitamura H, Kolb M, Kondoh Y, Kono C, Koschel D, Kreuter M, Kulkarni T, Kus J, Lebargy F, León Jiménez A, Luo Q, Mageto Y, Maher T, Makino S, Marchand-Adam S, Marquette C, Martinez R, Martínez M, Maturana Rozas R, Miyazaki Y, Moiseev S, Molina-Molina M, Morrison L, Morrow L, Moua T, Nambiar A, Nishioka Y, Nunes H, Okamoto M, Oldham J, Otaola M, Padilla M, Park J, Patel N, Pesci A, Piotrowski W, Pitts L, Poonyagariyagorn H, Prasse A, Quadrelli S, Randerath W, Refini R, Reynaud-Gaubert M, Riviere F, Rodríguez Portal J, Rosas I, Rossman M, Safdar Z, Saito T, Sakamoto N, Salinas Fénero M, Sauleda J, Schmidt S, Scholand M, Schwartz M, Shapera S, Shlobin O, Sigal B, Silva Orellana A, Skowasch D, Song J, Stieglitz S, Stone H, Strek M, Suda T, Sugiura H, Takahashi H, Takaya H, Takeuchi T, Thavarajah K, Tolle L, Tomassetti S, Tomii K, Valenzuela C, Vancheri C, Varone F, Veeraraghavan S, Villar A, Weigt S, Wemeau L, Wuyts W, Xu Z, Yakusevich V, Yamada Y, Yamauchi H, Ziora D. Nintedanib in patients with progressive fibrosing interstitial lung diseases-subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet Respir Med 2020; 8:453-460. [PMID: 32145830 DOI: 10.1016/s2213-2600(20)30036-9] [Citation(s) in RCA: 263] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis. METHODS The INBUILD trial was a randomised, double-blind, placebo-controlled, parallel group trial done at 153 sites in 15 countries. Participants had an investigator-diagnosed fibrosing ILD other than IPF, with chest imaging features of fibrosis of more than 10% extent on high resolution CT (HRCT), forced vital capacity (FVC) of 45% or more predicted, and diffusing capacity of the lung for carbon monoxide (DLco) of at least 30% and less than 80% predicted. Participants fulfilled protocol-defined criteria for ILD progression in the 24 months before screening, despite management considered appropriate in clinical practice for the individual ILD. Participants were randomly assigned 1:1 by means of a pseudo-random number generator to receive nintedanib 150 mg twice daily or placebo for at least 52 weeks. Participants, investigators, and other personnel involved in the trial and analysis were masked to treatment assignment until after database lock. In this subgroup analysis, we assessed the rate of decline in FVC (mL/year) over 52 weeks in patients who received at least one dose of nintedanib or placebo in five prespecified subgroups based on the ILD diagnoses documented by the investigators: hypersensitivity pneumonitis, autoimmune ILDs, idiopathic non-specific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILDs. The trial has been completed and is registered with ClinicalTrials.gov, number NCT02999178. FINDINGS Participants were recruited between Feb 23, 2017, and April 27, 2018. Of 663 participants who received at least one dose of nintedanib or placebo, 173 (26%) had chronic hypersensitivity pneumonitis, 170 (26%) an autoimmune ILD, 125 (19%) idiopathic non-specific interstitial pneumonia, 114 (17%) unclassifiable idiopathic interstitial pneumonia, and 81 (12%) other ILDs. The effect of nintedanib versus placebo on reducing the rate of FVC decline (mL/year) was consistent across the five subgroups by ILD diagnosis in the overall population (hypersensitivity pneumonitis 73·1 [95% CI -8·6 to 154·8]; autoimmune ILDs 104·0 [21·1 to 186·9]; idiopathic non-specific interstitial pneumonia 141·6 [46·0 to 237·2]; unclassifiable idiopathic interstitial pneumonia 68·3 [-31·4 to 168·1]; and other ILDs 197·1 [77·6 to 316·7]; p=0·41 for treatment by subgroup by time interaction). Adverse events reported in the subgroups were consistent with those reported in the overall population. INTERPRETATION The INBUILD trial was not designed or powered to provide evidence for a benefit of nintedanib in specific diagnostic subgroups. However, its results suggest that nintedanib reduces the rate of ILD progression, as measured by FVC decline, in patients who have a chronic fibrosing ILD and progressive phenotype, irrespective of the underlying ILD diagnosis. FUNDING Boehringer Ingelheim.
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Affiliation(s)
- Athol U Wells
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Kevin R Flaherty
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kevin K Brown
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka, Japan
| | - Anand Devaraj
- Department of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK
| | - Luca Richeldi
- Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Teng Moua
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bruno Crestani
- Université de Paris, Inserm U1152, APHP, Hôpital Bichat, Centre de reference constitutif pour les maladies pulmonaires rares, Paris, France
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Manuel Quaresma
- Boehringer Ingelheim International, Ingelheim am Rhein, Germany
| | | | | | - Martin Kolb
- McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
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Dharmapuri S, Özbek U, Lin JY, Schwartz M, Branch A, Ang C. Predictive value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) In hepatocellular carcinoma (HCC) patients treated with nivolumab (N). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.071] [Citation(s) in RCA: 2] [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] [Indexed: 11/14/2022] Open
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Singh S, Nuyts S, Doline R, Satti S, Schwartz M, Thatcher S, Chen Y, Katz S, Garg M, Wagemans J, Specenier P, Wittekindt C, Lee L, Reifler J, Sonis S, Emanuel M, Cilli F, Joslyn A, Wade J. Severe oral mucositis (SOM) mitigation by genetically modified lactococcus lactis bacteria (LLB) producing human trefoil factor 1 (hTFF1; AG013) in patients being treated with concomitant chemoradiation (CRT) for oral and oropharyngeal cancers (OCOPC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dharmapuri S, Özbek U, Lin JY, Schwartz M, Branch A, Ang C. Outcomes of hepatocellular carcinoma (HCC) patients treated with nivolumab: The Mount Sinai Hospital experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Buckstein M, Kim E, Facciuto M, Sung M, Taouli B, Schwartz M, Rosenzweig K. Phase II Trial Using Combination of TACE and SBRT for Unresectable Single Large HCC: Interim Report. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Smith W, McGee H, Schwartz M, Sung M, Rosenzweig K, Buckstein M. The Safety of Nivolumab in Combination with Prior or Concurrent Radiation Therapy Among Patients with Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Smith W, Law A, Hulkower M, McGee H, Schwartz M, Taouli B, Sung M, Buckstein M. The Effect of Radiation Therapy on the Objective Response and Outcomes with Nivolumab for Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berrevoet F, Doerhoff C, Muysoms F, Hopson S, Muzi MG, Nienhuijs S, Kullman E, Tollens T, Schwartz M, Leblanc K, Velanovich V, Jørgensen LN. Open ventral hernia repair with a composite ventral patch - final results of a multicenter prospective study. BMC Surg 2019; 19:93. [PMID: 31311545 PMCID: PMC6633695 DOI: 10.1186/s12893-019-0555-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/03/2019] [Indexed: 01/08/2023] Open
Abstract
Background This study assessed clinical outcomes, including safety and recurrence, from the two-year follow-up of patients who underwent open ventral primary hernia repair with the use of the Parietex™ Composite Ventral Patch (PCO-VP). Methods A prospective single-arm, multicenter study of 126 patients undergoing open ventral hernia repair for umbilical and epigastric hernias with the PCO-VP was performed. Results One hundred twenty-six subjects (110 with umbilical hernia and 16 with epigastric hernia) with a mean hernia diameter of 1.8 cm (0.4–4.0) were treated with PCO-VP. One hundred subjects completed the two-year study. Cumulative hernia recurrence was 3.0% (3/101; 95%CI: 0.0–6.3%) within 24 months. Median Numeric Rating Scale pain scores improved from 2 [0–10] at baseline to 0 [0–3] at 1 month (P < 0.001) and remained low at 24 months 0 [0–6] (P < 0.001). 99% (102/103) of the patients were satisfied with their repair at 24 months postoperative. Conclusions The use of PCO-VP to repair primary umbilical and epigastric defects yielded a low recurrence rate, low postoperative and chronic pain, and high satisfaction ratings, confirming that PCO-VP is effective for small ventral hernia repair in the two-year term after implantation. Trial registration The study was registered publically at clinicaltrials.gov (NCT01848184 registered May 7, 2013).
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Affiliation(s)
- F Berrevoet
- Department of General and Hepatopancreatobiliary Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - C Doerhoff
- Surgicare of Missouri, Jefferson City, MO, USA
| | - F Muysoms
- Department of Surgery AZ Maria Middelares, Ghent, Belgium
| | - S Hopson
- Bon Secours Hernia Center, Mary Immaculate Hospital, Newport News, VA, USA
| | - M G Muzi
- University Hospital Tor Vergata, Rome, Italy
| | - S Nienhuijs
- Department of Surgery, Catharina Hospital, Eindhoven, Netherlands
| | - E Kullman
- HELSA Specialist Center, Linköping, Sweden
| | - T Tollens
- Imelda Hospital -General Surgery Imelda Hospital, Bonheiden, Belgium
| | - M Schwartz
- Monmouth Medical Center, Long Branch, NJ, USA
| | - K Leblanc
- Our Lady of Lakes Regional Medical Center, Baton Rouge, LA, USA
| | - V Velanovich
- Division of General Surgery, University of South Florida, Tampa General Hospital, Tampa, FL, USA
| | - L N Jørgensen
- Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Kertser A, Baruch K, Deczkowska A, Weiner A, Croese T, Kenigsbuch M, Cooper I, Tsoory M, Ben-Hamo S, Amit I, Schwartz M. Corticosteroid signaling at the brain-immune interface impedes coping with severe psychological stress. Sci Adv 2019; 5:eaav4111. [PMID: 31149632 PMCID: PMC6541460 DOI: 10.1126/sciadv.aav4111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 04/22/2019] [Indexed: 05/22/2023]
Abstract
The immune system supports brain plasticity and homeostasis, yet it is prone to changes following psychological stress. Thus, it remains unclear whether and how stress-induced immune alterations contribute to the development of mental pathologies. Here, we show that following severe stress in mice, leukocyte trafficking through the choroid plexus (CP), a compartment that mediates physiological immune-brain communication, is impaired. Blocking glucocorticoid receptor signaling, either systemically or locally through its genetic knockdown at the CP, facilitated the recruitment of Gata3- and Foxp3-expressing T cells to the brain and attenuated post-traumatic behavioral deficits. These findings functionally link post-traumatic stress behavior with elevated stress-related corticosteroid signaling at the brain-immune interface and suggest a novel therapeutic target to attenuate the consequences of severe psychological stress.
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Affiliation(s)
- A. Kertser
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - K. Baruch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - A. Deczkowska
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - A. Weiner
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - T. Croese
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - M. Kenigsbuch
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - I. Cooper
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
| | - M. Tsoory
- Department of Veterinary Resources, Weizmann Institute of Science, Rehovot, Israel
| | - S. Ben-Hamo
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - I. Amit
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - M. Schwartz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
- Corresponding author.
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Abstract
Modern quantum technology currently experiences extensive advances in applicability in communications, cryptography, computing, metrology and lithography. Harnessing this technology platform for chem/bio sensing scenarios is an appealing opportunity enabling ultra-sensitive detection schemes. This is further facilliated by the progress in fabrication, miniaturization and integration of visible and infrared quantum photonics. Especially, the combination of efficient single-photon sources together with waveguiding/sensing structures, serving as active optical transducer, as well as advanced detector materials is promising integrated quantum photonic chem/bio sensors. Besides the intrinsic molecular selectivity and non-destructive character of visible and infrared light based sensing schemes, chem/bio sensors taking advantage of non-classical light sources promise sensitivities beyond the standard quantum limit. In the present review, recent achievements towards on-chip chem/bio quantum photonic sensing platforms based on N00N states are discussed along with appropriate recognition chemistries, facilitating the detection of relevant (bio)analytes at ultra-trace concentration levels. After evaluating recent developments in this field, a perspective for a potentially promising sensor testbed is discussed for reaching integrated quantum sensing with two fiber-coupled GaAs chips together with semiconductor quantum dots serving as single-photon sources.
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Affiliation(s)
- J Haas
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany.
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Abstract
In order to study the course of optic nerve degeneration and devise possible ways to achieve neuroprotection, a well-controlled, animal model of partial crush injury of the optic nerve was used. Following the controlled partial crush injury of the rat optic nerve, quantitative morphological and electrophysiological measurements were made of primary and secondary neuronal losses. The neuroprotective effects of NMDA-receptor antagonists and α2-adrenoreceptor agonists were also studied. The results suggested that the ongoing progression of the optic nerve degeneration in glaucoma might be a consequence of the toxic extracellular environment produced by neurons that degenerate as a result of the primary cause of the disease (such as increased IOP).
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Affiliation(s)
- M Schwartz
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
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Abstract
SummaryFibrinolysis and the last stage of clotting were examined in 20 healthy infants on days 1-4 after birth. Plasminogen was constantly at half its normal level: 1.2-1.4 u/ml. The euglobulin lysis was increased only on day 1 in 50% of the cases. The mean values on days 1 and 4 showed a statistically significant difference: 0.45 ± 0.20 and 0.14 ± 0.05 (t = 2.1 p < 0.05). Fibrinogen was low or low normal at birth (mean values: 230 ± 57 mg%) but increased significantly in the next days reaching a mean of 293 ± 41 mg% on day 4 (t = 3.6 ρ < 0.001). Factor XIII was normal in all cases. Increased fibrinolysis in day 1 is probably due to a high level of activator at birth and the low plasminogen and fibrinogen are probably a consequence of the physiological „immaturity” of the liver.
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Quinn B, Kim N, Romano K, Hill C, Ladbury C, Schwartz M, Showalter T, Fisher C, Fields E. Dose/Fractionation Regimens of Vaginal Cylinder Brachytherapy Correlate With Increased Radiation Toxicity and Vaginal Stenosis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Quinn B, Kim N, Ladbury C, Schwartz M, Hill C, Romano K, Showalter T, Fisher C, Fields E. Prolonged Regimens of Vaginal Cylinder Brachytherapy Correlate With Increased Recurrence and Decreased Overall Survival. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schwartz M, Schwartz E, Moskalewicz M. Putting it all together: How disordered temporality is core to the phenomenology and neurobiology of mania. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Disturbances of temporality in mania, underemphasized in present-day accounts, are nonetheless core to understanding both the phenomenology and the neurobiology of the disorder:– phenomenology: already in 1954, Binswanger had articulated that persons with mania live almost exclusively in the present and hardly at all into the future. Especially in the larger scheme of things, their future is already here. There is no “advancing, developing or maturing,” anticipations have already been achieved, and all that I strive for is basically present if you will just get out of my way! A half century ago, Binswanger summed up the consequence of manic temporality: the manic self, not living into the future, “is not… an existential self.” This presentation will further describe phenomenological characteristics of such a self in mania;– findings from contemporary neuroscience correlate remarkably well with the above phenomenology, importantly clarifying present and future therapeutic interventions. Of critical importance in mania, clocks in our brains afford receptor sites for the lithium ion. Once bound to the receptor, lithium potently inhibits the circadian rhythm regulator glycogen synthase kinase 3 (GSK3) and profoundly alters the biological cascade that it initiates. In this presentation, by taking a close look, step-by-step, we will clarify how lithium disrupts mania rhythm dysregulation and restores a more “normalized” temporality. The consequence is no less than the return of the existential self. We will also briefly glance, in this presentation, at the window that lithium cellular efficacy offers for treatment options “after lithium.”Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Jaber J, Verissimo J, Mendonça J, Schwartz M, Leite S, Humel S, Moravia A, Raposo T, Garrido M, Halabi E, Hollanda A, Reys B. Dual Diagnosis and Treatment: The Experience of a Multiprofessional Team in Mental Health. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IntroductionThe work was developed with the people hospitalized in the period of 1 year in a psychiatric clinic in Rio de Janeiro city, Brazil. 175 patients who presented dual diagnosis were evaluated.ObjectivesThe research aims to know the distribution of the most frequent psychiatric diagnosis associated with the disorders for the use of psychoactive substances. The work also has as objective to assess the treatment of patients carrying these disorders so that there is a better efficiency of the individual treatment plan.MethodsThe work consisted of the evaluation of all patients who were admitted to the clinic in the period of 1 year, using the ICD-10 for the diagnosis of dual pathologies. All the patients were assessed by the multiprofessional team, composed by general practicioner, psychiatrist, psychologist, pharmaceutic, therapist in chemical dependence, family therapist and physiotherapist. The patients were treated with the use of psychopharms, cognitive behavioral psychotherapy, 12-step program, art therapy and moderate physical activity. Family members of all patients were also interviewed.ResultsIn the evaluation conducted by the team, it was found the following distribution of the most frequent diagnosis associated to disorder for the use of psychoactive substances: depression (26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-schizophrenic psychosis (12.6%), schizophrenia (9.1%), and other diagnosis (6.8%).ConclusionsThe formulation of the dual diagnosis provided a better approach of the patients on the part of the team, promoting the strengthening of the therapeutic bond and causing positive impact on the evolution of these disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Davis B, Schwartz M, Duchemin D, Carl Barrett J, Post G. Validation of a Multiplexed Gene Signature Assay for Diagnosis of Canine Cancers from Formalin-Fixed Paraffin-Embedded Tissues. J Vet Intern Med 2017; 31:854-863. [PMID: 28370296 PMCID: PMC5435129 DOI: 10.1111/jvim.14686] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 01/05/2017] [Accepted: 02/07/2017] [Indexed: 01/09/2023] Open
Abstract
Background Use of molecular‐based diagnostics for companion animals is impeded by availability of technology platforms, tissue acquisition requirements, and species‐specific reagents. Hypothesis/Objectives To validate a quantitative nuclease protection assay (qNPA) to simultaneously measure RNA expression of multiple genes in archived formalin‐fixed paraffin‐embedded (FFPE) tumors from dogs. Animals All tumor biopsy samples were collected retrospectively from surgical biopsies and in the care of veterinarians. Methods Retrospective case series. A qNPA 96‐well ArrayPlate was built using 30 canine‐specific genes, 5 housekeeping genes, positive and negative controls with qualified gene‐specific oligonucleotides. Pearson's correlation, coefficient of variation (CV), and multivariate analysis were used to determine analytical performance using 40 FFPE dog tumors. Once validated, 70 FFPE dog tumors were analyzed for differences in gene expression using hierarchical clustering and analysis of variance of log transformed data. Immunohistochemistry (IHC) was performed to correlate gene expression and protein expression in a subset of tumors. Results The assay was linear with decreasing sample input (R2 = 0.978), reproducible within and between 96‐well plates (r = 0.988 and 0.95, respectively) and between different laboratories (CV = 0.96). Hierarchical cluster analysis showed grouping of tumors by histogenesis and oncogenes. Significant differences were found between BCl2, E2F transcription factor 1, MDM2, COX‐2, MET proto‐oncogene receptor kinase, and other biologically relevant gene expression in tumor subtypes. Immunohistochemistry confirmed protein expression. Conclusions and Clinical Implications Because this technology works reliably on FFPE specimens, it can help expedite the broad introduction of multiplexed genomic information for improved diagnostics and discovery of new targets for therapies in veterinary oncology.
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Affiliation(s)
| | | | - D Duchemin
- Innogenics Inc, Harvard, MA.,Veterinary Cancer Center, Norwalk, CT
| | | | - G Post
- Innogenics Inc, Harvard, MA.,Veterinary Cancer Center, Norwalk, CT
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Scales DB, Schwartz M. 385 Neonatal pig supplement effects on mortality. J Anim Sci 2017. [DOI: 10.2527/asasmw.2017.385] [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: 11/13/2022] Open
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Titano J, Biederman D, Korff R, Schwartz M, Facciuto M, Gunasekaran G, Florman S, Tabori N, Patel R, Nowakowski F, Fischman A, Lookstein R, Kim E. Radioembolization vs. chemoembolization for unresectable solitary hepatocellular carcinoma ≤3 cm. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
Despite fluoride’s (F) well-documented ability to prevent caries, the effects of F concentrations on enamel and dentin apatite crystals are unknown. The present study examined the hypothesis that tooth F concentration and tooth crystallite size correlate. One hundred human unerupted third molars were studied—53 from Fortaleza-Brazil (F water 0.7 ppm), 23 from Toronto (1.0 ppm), and 24 from Montreal (0.2 ppm). F concentration was analyzed by Neutron Activation Analysis and apatite crystal size by powder x-ray diffraction. A positive correlation between dentin F concentration and enamel crystallite length and width was found. Enamel crystallite length was significantly greater in teeth from Fortaleza than in teeth from Toronto (p = 0.011) and Montreal (p = 0.003). Enamel crystallite widths were significantly greater in Fortaleza teeth compared with those from Toronto (p = 0.020) and Montreal (p < 0.001). No difference in the dentin crystallite size was seen in the 3 regions. Thus, tooth F concentration and crystallite size correlate.
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Affiliation(s)
- A Vieira
- Faculty of Dentistry, University of Toronto, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, ON, Canada
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Abstract
Fluoride (F) has been a useful instrument in caries prevention. However, only limted data exist on the effect of its long-term use on dentin mineralization patterns and microhardness. The objective of this study was to evaluate the influence of tooth F concentration ([F]) and dental fluorosis (DF) severity on dentin microhardness and mineralization. We collected 137 teeth in Montreal and Toronto, Canada, and Fortaleza, Brazil, where optimum or suboptimum levels of water F were 0.2 ppm, 1 ppm, and 0.7 ppm, respectively. Teeth were analyzed for DF severity, dentin [F], enamel [F], dentin microhardness, and dentin mineralization. Dentin [F] correlated with DF severity; enamel [F] correlated with dentin microhardness and dentin mineralization; DF severity correlated with dentin microhardness. Genetic factors ( e.g., DF severity) and environmental factors ( e.g., tooth [F]) influenced the mechanical properties (microhardness) of the teeth, while only the environmental factors influenced their material properties ( e.g., mineralization). Fortaleza teeth were harder and less mineralized and presented higher dentin [F] values. Montreal teeth presented lower levels of DF when compared with both Toronto and Fortaleza teeth.
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Affiliation(s)
- A Vieira
- Faculty of Dentistry, University of Toronto
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Schwartz M, Wu C, Fridman D, Rotenberg O, Arabkhazaeli M, Scott C, Levie M. Why We Fail. Single Dose Methotrexate Failure – Comparing Patients Receiving Second Dose with Those Selected for Surgical Intervention. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.195] [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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McGee H, King M, Olson A, Kim E, Fischman A, Schwartz M, Rosenzweig K, Buckstein M. Combined External Beam Radiation Therapy and Transarterial Radioembolization for HCC with Gross Vascular Invasion. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1027] [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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Wax D, Zerillo J, Tabrizian P, Schwartz M, Hill B, Lin HM, DeMaria S. A retrospective analysis of liver resection performed without central venous pressure monitoring. Eur J Surg Oncol 2016; 42:1608-13. [DOI: 10.1016/j.ejso.2016.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 03/11/2016] [Accepted: 03/22/2016] [Indexed: 12/11/2022] Open
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39
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Durrani R, Titano J, Bishay V, Schwartz M, Facciuto M, Gunasekeran G, Tabori N, Fischman A, Patel R, Nowakowski F, Lookstein R, Kim E. Outcomes of radioembolization for unresectable hepatocellular carcinoma in patients with a model of end-stage liver disease score ≥15. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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40
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Biederman D, Titano J, Bishay V, Durrani R, Dayan E, Schwartz M, Facciuto M, Gunasekaran G, Florman S, Tabori N, Patel R, Nowakowski F, Fischman A, Lookstein R, Kim E. Radiation segmentectomy vs. microwave ablation for unresectable solitary hepatocellular carcinoma ≤3 cm: a propensity score matching study. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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41
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Marinelli B, Biederman D, Titano J, Bishay V, Tabori N, Schwartz M, Facciuto M, Gunasekaran G, Florman S, Fischman A, Patel R, Nowakowski F, Lookstein R, Kim E. Efficacy of yttrium-90 salvage therapy in the treatment of hepatocellular carcinoma unresponsive to chemoembolization. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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42
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Biederman D, Titano J, Swinburne N, Bishay V, Gunasekaran G, Schwartz M, Facciuto M, Florman S, Fischman A, Patel R, Tabori N, Nowakowski F, Lookstein R, Kim E. Radioembolization for unresectable hepatocellular carcinoma secondary to the hepatitis C virus: a analysis of survival and toxicity stratified by viral load. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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43
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Ghiassi-Nejad Z, Tarchi P, Tabrizian P, Schwartz M, Buckstein M. Patterns of Failure in Patients With Cholangiocarcinoma Following Surgical Resection Without Adjuvant Radiation. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mehta S, Schwartz M, Fridman D, Levie M, To J, Chudnoff S. Office Hysteroscopy for the Removal of a Retained Intrauterine Device. J Minim Invasive Gynecol 2015; 22:S183. [DOI: 10.1016/j.jmig.2015.08.673] [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: 11/30/2022]
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45
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Buckstein M, Facciuto M, Blacksburg S, Kim E, Fischman A, Schwartz M, Rosenzweig K. Assessment of Response Following Combination DEB-TACE and SBRT for Unresectable Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Dmytriw A, Schwartz M, Agid R. E-019 treatment of intracranial dural arteriovenous fistulas refractory to endovascular therapy with gamma knife radiosurgery. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Niederbracht H, Hargart F, Schwartz M, Koroknay E, Kessler CA, Jetter M, Michler P. Fabrication and optical characterization of large scale membrane containing InP/AlGaInP quantum dots. Nanotechnology 2015; 26:235201. [PMID: 25994204 DOI: 10.1088/0957-4484/26/23/235201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Single-photon sources with a high extraction efficiency are a prerequisite for applications in quantum communication and quantum computation schemes. One promising approach is the fabrication of a quantum dot containing membrane structure in combination with a solid immersion lens and a metal mirror. We have fabricated an 80 nm thin semiconductor membrane with incorporated InP quantum dots in an AlGaInP double hetero barrier via complete substrate removal. In addition, a gold layer was deposited on one side of the membrane acting as a mirror. The optical characterization shows in detail that the unique properties of the quantum dots are preserved in the membrane structure.
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Affiliation(s)
- H Niederbracht
- Institut fuer Halbleiteroptik und Funktionelle Grenzflaechen, University of Stuttgart, Allmandring 3, 70569 Stuttgart, Germany
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Titano J, Ward T, Pierobon E, Schwartz M, Facciuto M, Fischman A, Patel R, Tabori N, Nowakowski F, Lookstein R, Kim E. Transarterial Chemoembolization Outcomes in Downstaging Hepatocellular Carcinoma Patients beyond the Milan Criteria. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.10.038] [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] Open
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49
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Alva A, Clark M, Daignault-Newton S, Huebner T, Mehra R, Ionescu C, Schwartz M. Circulating Tumor Cells As Biomarkers During Neoadjuvant Chemotherapy in Bladder Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.67] [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: 11/13/2022] Open
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50
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Schwartz M, Florman S. Optimal liver allocation for hepatocellular carcinoma: hurry up AND wait, but which one when? Am J Transplant 2014; 14:1479-80. [PMID: 24903890 DOI: 10.1111/ajt.12773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 03/26/2014] [Accepted: 04/04/2014] [Indexed: 01/25/2023]
Affiliation(s)
- M Schwartz
- Icahn School of Medicine at Mount Sinai, Recanati/Miller Transplantation Institute, New York, NY
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