1
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Sundararajan P, Moser J, Williams L, Chiang T, Riordan C, Metzger M, Zhang-Plasket F, Wang F, Collins J, Williams J. Driving Spray Drying towards Better Yield: Tackling a Problem That Sticks Around. Pharmaceutics 2023; 15:2137. [PMID: 37631351 PMCID: PMC10459734 DOI: 10.3390/pharmaceutics15082137] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/05/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Powder deposition and accumulation on walls of spray drying chamber has been known to impact spray drying processes, resulting in lower yield, frequent shutdowns, and downtimes. Critical factors that impact the extent and rate of wall deposition have been studied extensively in the chemical and food industry. In this paper, we present an atypical process yield issue wherein acceptable yield is obtained during the first batch of spray drying but undergoes significant yield loss in consecutive batches. Through understanding the interplay of the process, material properties, and equipment, we identify key mechanisms that are playing a role in causing the process yield issue. These mechanisms include surface roughness of the inner wall of the spray dryer, variation in gas flow due to the introduction of process analytical technology, start-up and shutdown operating parameters that expose the wall deposited powder from the prior batch to temperatures close to the onset of glass transition temperature and cause depression of its glass transition temperature. These factors result in more wall accumulation and impact the yield in subsequent batches. By correcting for most of these factors, the yield reduction issue was mitigated, and processing efficiency was improved.
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Affiliation(s)
| | - Justin Moser
- Merck & Co., Inc., West Point, PA 19486, USA; (J.M.); (T.C.); (C.R.); (F.Z.-P.)
| | - Lisa Williams
- MSD, Ballydine, E91 V091 Clonmel, Ireland; (L.W.); (J.C.); (J.W.)
| | - Tiffany Chiang
- Merck & Co., Inc., West Point, PA 19486, USA; (J.M.); (T.C.); (C.R.); (F.Z.-P.)
| | - Colin Riordan
- Merck & Co., Inc., West Point, PA 19486, USA; (J.M.); (T.C.); (C.R.); (F.Z.-P.)
| | | | - Fan Zhang-Plasket
- Merck & Co., Inc., West Point, PA 19486, USA; (J.M.); (T.C.); (C.R.); (F.Z.-P.)
| | - Fang Wang
- Merck & Co., Inc., Rahway, NJ 07065, USA; (M.M.); (F.W.)
| | - John Collins
- MSD, Ballydine, E91 V091 Clonmel, Ireland; (L.W.); (J.C.); (J.W.)
| | - Joseph Williams
- MSD, Ballydine, E91 V091 Clonmel, Ireland; (L.W.); (J.C.); (J.W.)
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2
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OoNorasak K, Sims J, Lancaster D, Metzger M, Savalia R, Gooden C, Alvayero K, Wright A, Counsil M, Hamilton A, Samples M, Stephenson T. Student-Powered Food Waste Reduction, Hunger Relief, and Community Enrichment Efforts for Marginalized Women, Families, and Older Adults through Three Pillars of Sustainability. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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3
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Levassort H, Pépin M, Boucquemont J, Lambert O, Alencar De Pinho N, Turinici M, Helmer C, Metzger M, Teillet L, Frimat L, Combe C, Fouque D, Laville M, Ayav C, Jacquelinet C. Evolution du profil cognitive des patients ayant une maladie rénale chronique : étude longitudinale de la cohorte CKD REIN. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.158] [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: 10/14/2022]
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4
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Hurley S, Tantuccio A, Escotet-Espinoza MS, Flamm M, Metzger M. Development and Use of a Residence Time Distribution (RTD) Model Control Strategy for a Continuous Manufacturing Drug Product Pharmaceutical Process. Pharmaceutics 2022; 14:pharmaceutics14020355. [PMID: 35214087 PMCID: PMC8874656 DOI: 10.3390/pharmaceutics14020355] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023] Open
Abstract
Residence-time-distribution (RTD)-based models are key to understanding the mixing dynamics of continuous manufacturing systems. Such models can allow for material traceability throughout the process and can provide the ability for removal of non-conforming material from the finished product. These models have been implemented in continuous pharmaceutical manufacturing mainly for monitoring purposes, not as an integral part of the control strategy and in-process specifications. This paper discusses the steps taken to develop an RTD model design space and how the model was statistically incorporated into the product’s control strategy. To develop the model, experiments were conducted at a range of blender impeller speeds and total system mass flow rates. RTD parameters were optimized for each condition tested using a tank-in-series-type model with a delay. Using the experimental RTD parameters, an equation was derived relating the mean residence time to the operating conditions (i.e., blender impeller speed and mass flow rate). The RTD parameters were used in combination with real-time upstream process data to predict downstream API concentration, where these predictions allowed validation across the entire operating range of the process by comparison to measured tablet assay. The standard in-process control limits for the product were statistically tightened using the validation acceptance criteria. Ultimately, this model and strategy were accepted by regulatory authorities.
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Affiliation(s)
- Samantha Hurley
- Pharmaceutical Commercialization Technology, Merck & Co., Inc., West Point, PA 19486, USA; (A.T.); (M.M.)
- Correspondence:
| | - Anthony Tantuccio
- Pharmaceutical Commercialization Technology, Merck & Co., Inc., West Point, PA 19486, USA; (A.T.); (M.M.)
| | | | - Matthew Flamm
- Applied Mathematics and Modeling, Merck & Co., Inc., West Point, PA 19486, USA;
| | - Matthew Metzger
- Pharmaceutical Commercialization Technology, Merck & Co., Inc., West Point, PA 19486, USA; (A.T.); (M.M.)
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5
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Stahl EC, Gopez AR, Tsuchida CA, Fan VB, Moehle EA, Witkowsky LB, Hamilton JR, Lin-Shiao E, McElroy M, McDevitt SL, Ciling A, Tsui CK, Pestal K, Gildea HK, Keller A, Sylvain IA, Williams C, Hirsh A, Ehrenberg AJ, Kantor R, Metzger M, Nelson KL, Urnov FD, Ringeisen BR, Giannikopoulos P, Doudna JA. LuNER: Multiplexed SARS-CoV-2 detection in clinical swab and wastewater samples. PLoS One 2021; 16:e0258263. [PMID: 34758033 PMCID: PMC8580221 DOI: 10.1371/journal.pone.0258263] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/22/2021] [Indexed: 01/03/2023] Open
Abstract
Clinical and surveillance testing for the SARS-CoV-2 virus relies overwhelmingly on RT-qPCR-based diagnostics, yet several popular assays require 2-3 separate reactions or rely on detection of a single viral target, which adds significant time, cost, and risk of false-negative results. Furthermore, multiplexed RT-qPCR tests that detect at least two SARS-CoV-2 genes in a single reaction are typically not affordable for large scale clinical surveillance or adaptable to multiple PCR machines and plate layouts. We developed a RT-qPCR assay using the Luna Probe Universal One-Step RT-qPCR master mix with publicly available primers and probes to detect SARS-CoV-2 N gene, E gene, and human RNase P (LuNER) to address these shortcomings and meet the testing demands of a university campus and the local community. This cost-effective test is compatible with BioRad or Applied Biosystems qPCR machines, in 96 and 384-well formats, with or without sample pooling, and has a detection sensitivity suitable for both clinical reporting and wastewater surveillance efforts.
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Affiliation(s)
- Elizabeth C. Stahl
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Allan R. Gopez
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Connor A. Tsuchida
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Vinson B. Fan
- University of California, Berkeley, Berkeley, CA, United States of America
| | - Erica A. Moehle
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Lea B. Witkowsky
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Jennifer R. Hamilton
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Enrique Lin-Shiao
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Matthew McElroy
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Shana L. McDevitt
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Alison Ciling
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - C. Kimberly Tsui
- University of California, Berkeley, Berkeley, CA, United States of America
| | - Kathleen Pestal
- University of California, Berkeley, Berkeley, CA, United States of America
| | - Holly K. Gildea
- University of California, Berkeley, Berkeley, CA, United States of America
| | - Amanda Keller
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Iman A. Sylvain
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Clara Williams
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Ariana Hirsh
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | | | - Rose Kantor
- University of California, Berkeley, Berkeley, CA, United States of America
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, United States of America
| | - Matthew Metzger
- University of California, Berkeley, Berkeley, CA, United States of America
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, United States of America
| | - Kara L. Nelson
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, United States of America
| | - Fyodor D. Urnov
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Bradley R. Ringeisen
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Petros Giannikopoulos
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
| | - Jennifer A. Doudna
- University of California, Berkeley, Berkeley, CA, United States of America
- Innovative Genomics Institute, University of California Berkeley, Berkeley, CA, United States of America
- Howard Hughes Medical Institute, University of California, Berkeley, CA, United States of America
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6
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Faucon AL, Metzger M, Gauci C, Houillier P, Banchard A, Haymann J, Flamant M, Stengel B, Froissart M. Valeurs de références du débit de filtration glomérulaire par sexe chez le sujet sain de 18 à 90 ans. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.284] [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: 10/20/2022]
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7
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Loggetto P, Ritter J, Lam C, Marx K, Metzger M. Equity as a consideration in National Cancer Control Plans from the American continent: a comparative content analysis. The Lancet Global Health 2021. [DOI: 10.1016/s2214-109x(21)00116-9] [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] Open
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8
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Faucon AL, Leffondré K, Flamant M, Metzger M, Boffa JJ, Haymann JP, Houillier P, Thervet E, Vrtovsnik F, Proust-Lima C, Stengel B, Vidal-Petiot E, Geri G. Trajectory of extracellular fluid volume over time and subsequent risks of end-stage kidney disease and mortality in chronic kidney disease: a prospective cohort study. J Intern Med 2021; 289:193-205. [PMID: 32654192 DOI: 10.1111/joim.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Extracellular fluid volume (ECF) is independently associated with chronic kidney disease (CKD) progression and mortality in patients with CKD, but the prognostic value of the trajectory of ECF over time beyond that of baseline value is unknown. OBJECTIVES To characterize ECF trajectory and evaluate its association with the risks of end-stage kidney disease (ESKD) and mortality. METHODS From the prospective tricentric NephroTest cohort, we included 1588 patients with baseline measured glomerular filtration rate (mGFR) ≥15 mL min-1 /1.73 m2 and ECF measurement. ECF and GFR were measured repeatedly using the distribution volume and clearance of 51 Cr-EDTA, respectively. ESKD and mortality were traced through record linkage with the national registries. Adjusted shared random-effect joint models were used to analyse the association between the trajectory of ECF over time and the two competing outcomes. RESULTS Patients were mean age 58.7 years, 66.7% men, mean mGFR of 43.6 ± 18.6 mL min-1 /1.73 m2 and mean ECF of 16.1 ± 3.6 L. Over a median follow-up of 5.3 [IQR: 3.0;7.4] years, ECF increased by 136 [95%CI 106;167] mL per year on average, whilst diuretic prescription and 24-hour urinary sodium excretion remained stable. ESKD occurred in 324 (20.4%) patients, and 185 (11.6%) patients died before ESKD. A higher current value of ECF was associated with increased hazards of ESKD (adjusted hazard ratio [aHR]: 1.12 [95%CI 1.06;1.18]; P < 0.001 per 1 L increase in ECF), and death before ESKD (aHR: 1.10 [95%CI 1.04;1.17]; P = 0.002). CONCLUSIONS The current value of ECF was associated with the risks of ESKD and mortality, independent of multiple potential confounders, including kidney function decline. This highlights the need for a close monitoring and adjustment of treatment to avoid fluid overload in CKD patients.
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Affiliation(s)
- A-L Faucon
- From the, Centre de recherche en Epidémiologie et Santé des Populations, INSERM UMR 1018, Renal and Cardiovascular Epidemiology, Université Paris-Saclay, Paris, France
| | - K Leffondré
- INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, ISPED, Bordeaux, France
| | - M Flamant
- Department of Physiology, AP-HP, Hôpital Bichat and INSERM U1149, Paris, France.,Université de Paris, Paris, France
| | - M Metzger
- From the, Centre de recherche en Epidémiologie et Santé des Populations, INSERM UMR 1018, Renal and Cardiovascular Epidemiology, Université Paris-Saclay, Paris, France
| | - J-J Boffa
- Department of Nephrology, AP-HP, Hôpital Tenon, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - J-P Haymann
- Université Pierre et Marie Curie, Paris, France.,Department of Physiology, AP-HP, Hôpital Tenon, Paris, France
| | - P Houillier
- Université de Paris, Paris, France.,Department of Physiology, AP-HP, INSERM U1138, Centre de Recherche des Cordeliers, Hôpital Européen Georges Pompidou and Centre de Recherche des Cordeliers, Paris, France
| | - E Thervet
- Université de Paris, Paris, France.,Department of Nephrology, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - F Vrtovsnik
- Université de Paris, Paris, France.,Department of Nephrology, AP-HP, Hôpital Bichat, Paris, France
| | - C Proust-Lima
- INSERM, Bordeaux Population Health Research Center, UMR 1219, Univ. Bordeaux, ISPED, Bordeaux, France
| | - B Stengel
- From the, Centre de recherche en Epidémiologie et Santé des Populations, INSERM UMR 1018, Renal and Cardiovascular Epidemiology, Université Paris-Saclay, Paris, France
| | - E Vidal-Petiot
- Department of Physiology, AP-HP, Hôpital Bichat and INSERM U1149, Paris, France.,Université de Paris, Paris, France
| | - G Geri
- From the, Centre de recherche en Epidémiologie et Santé des Populations, INSERM UMR 1018, Renal and Cardiovascular Epidemiology, Université Paris-Saclay, Paris, France.,Medical Intensive Care Unit, AP-HP, Hôpital Ambroise Paré, Boulogne-Billancourt, France.,Université Paris-Saclay, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
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9
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Liu H, Meyer R, Flamm M, Wareham L, Metzger M, Tantuccio A, Yoon S. Optimization of Critical Quality Attributes in Tablet Film Coating and Design Space Determination Using Pilot-Scale Experimental Data. AAPS PharmSciTech 2021; 22:17. [PMID: 33389197 DOI: 10.1208/s12249-020-01884-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022] Open
Abstract
In this study, the novel high-speed tablet film coating process in the continuous manufacturing was investigated. The influence of key process variables (inlet air flow rate, inlet air temperature, and suspension spray rate) were investigated using a Box-Behnken experimental design method. Statistical regression models were developed to predict the outlet air temperature and relative humidity, the coating efficiency, the tablet moisture content, and coating uniformity. The effects of the three key process variables were comprehensively investigated based on mathematical analysis, contour plots, and interaction plots. The results indicate that all the process responses are affected by changing the inlet air flow rate, temperature, and suspension spray rate. A design space (DS) in terms of failure probability was determined based on specifications for tablet moisture content (< 3.5%) and coating uniformity (tablet weight standard deviation < 4 mg for tablet weight of 200 mg) using Monte Carlo simulations. Independent experiments were carried out and successfully validated the robustness and accuracy of the determined DS for the investigated tablet film coating process. All the data were generated using an industrial pilot-scale novel high-speed tablet coating unit from a continuous manufacturing line. The work facilitates the quality by design implementation of continuous pharmaceutical manufacturing.
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10
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Boehling P, Jacevic D, Detobel F, Holman J, Wareham L, Metzger M, Khinast JG. Validating a Numerical Simulation of the ConsiGma(R) Coater. AAPS PharmSciTech 2020; 22:10. [PMID: 33244725 PMCID: PMC7691303 DOI: 10.1208/s12249-020-01841-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022] Open
Abstract
Continuous manufacturing is increasingly used in the pharmaceutical industry, as it promises to deliver better product quality while simultaneously increasing production flexibility. GEA developed a semi-continuous tablet coater which can be integrated into a continuous tableting line, accelerating the switch from traditional batch production to the continuous mode of operation. The latter offers certain advantages over batch production, e.g., operational flexibility, increased process/product quality, and decreased cost. However, process understanding is the key element for process control. In this regard, computational tools can improve the fundamental understanding and process performance, especially those related to new processes, such as continuous tablet coating where process mechanics remain unclear. The discrete element method (DEM) and computational fluid dynamics (CFD) are two methods that allow transition from empirical process design to a mechanistic understanding of the individual process units. The developed coupling model allows to track the heat, mass, and momentum exchange between the tablet and fluid phase. The goal of this work was to develop and validate a high-fidelity CFD-DEM simulation model of the tablet coating process in the GEA ConsiGma® coater. After the model development, simulation results for the tablet movement, coating quality, and heat and mass transfer during the coating process were validated and compared to the experimental outcomes. The experimental and simulation results agreed well on all accounts measured, indicating that the model can be used in further studies to investigate the operating space of the continuous tablet coating process.
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11
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Metzger M, YODER J, Blackhall L, Abdel-Rahman E, Balogun R. SAT-312 NEPHROLOGY AND PALLIATIVE CARE COLLABORATION IN THE CARE OF PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE: RESULTS OF A CLINICIAN SURVEY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Wagner S, Merkling T, Metzger M, Bankir L, Laville M, Frimat L, Combe C, Jacquelinet C, Fouque D, Bénédicte S, Massy Z. SAT-095 URINE OSMOLARITY AND CHRONIC KIDNEY DISEASE PROGRESSION IN THE CKD-REIN COHORT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Westerhausen M, Metzger M, Blendinger F, Levermann A, Fleischer M, Hofmann B, Bucher V. Characterization of Biostable Atomic Layer Deposited (ALD) Multilayer Passivation Coatings for Active Implants .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:3927-3930. [PMID: 31946731 DOI: 10.1109/embc.2019.8856574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The next generation of flexible, electrically active implants, such as brain implants or retina chips require a flexible, biostable as well as biocompatible passivation, ensuring a degradation-free usage for long time periods on the order of several years. Until today, these passivations are prepared mostly by polyimides or parylene, both of which are water vapor permeable to a certain degree. To remedy this deficiency, Atomic Layer Deposited (ALD) thin films are characterized regarding their electrical passivating features under conditions of accelerated aging, such as elevated temperatures in a liquid environment. The initial electrical passivation by various ALD deposited multilayers, combining alternating thin Al2O3 and TiO2 layers is the goal of this research as well as the stability of these layers under induced degradation. Such layers, in combination with a parylene passivation, would ensure a water vapor impermeable and biocompatible coating.
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14
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Galbraith S, Park S, Huang Z, Liu H, Meyer R, Metzger M, Flamm M, Hurley S, Yoon S. Linking process variables to residence time distribution in a hybrid flowsheet model for continuous direct compression. Chem Eng Res Des 2020. [DOI: 10.1016/j.cherd.2019.10.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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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15
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Wagner S, Merkling T, Metzger M, Bankir L, Fouque D, Laville M, Frimat L, Combe C, Massy Z, Stengel B. Consommation d’eau pure et progression vers l’insuffisance rénale terminale. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.026] [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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16
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Prezelin-Reydit M, Combe C, Harambat J, Massy Z, Metzger M, Lange C, Lambert O, Stengel B, Leffondré K. Hyperuricémie et progression de la maladie rénale chronique : données longitudinales de la cohorte CKD-REIN. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.027] [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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17
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Flerlage J, Mauz-Körholz C, Kelly K, McCarten K, Punnett A, Kaste S, Dieckmann K, Marks L, Seelisch J, Drachtman R, Lewis J, Beishuzen A, Kluge R, Kurch L, Stroevesandt D, Metzger M. INCLUSION OF A PEDIATRIC PERSPECTIVE INTO RECOMMENDATIONS FOR THE INITIAL EVALUATION AND STAGING OF HODGKIN LYMPHOMA: A CALL TO ACTION FROM THE INTERNATIONAL SEARCH WORKING GROUP. Hematol Oncol 2019. [DOI: 10.1002/hon.24_2629] [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: 11/10/2022]
Affiliation(s)
- J. Flerlage
- Oncology; St. Jude Children's Research Hospital; Memphis United States
| | - C. Mauz-Körholz
- Pediatric Hematology and Oncology; Martin-Luther-University; Giessen Germany
| | - K. Kelly
- Hematology/Oncology; Roswell Park Comprehensive Cancer Center; Buffalo United States
| | - K. McCarten
- Diagnostic Imaging; 13Rhode Island Hospital/Warren Alpert Medical School at Brown University; Providence United States
| | - A. Punnett
- Pediatrics; Sickkids Hospital; Toronto Ontario Canada
| | - S. Kaste
- Oncology; St. Jude Children's Research Hospital; Memphis United States
| | - K. Dieckmann
- Radiotherapy; Medizinische Universität Wien; Vienna Austria
| | - L. Marks
- Pediatric Hematology/Oncology; Stanford; Palo Alto United States
| | - J. Seelisch
- Hematology/Oncology; Children's Hospital, London Health Sciences Centre; London Ontario Canada
| | - R. Drachtman
- Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - J. Lewis
- Hematology/Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | | | - R. Kluge
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - L. Kurch
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | | | - M. Metzger
- Oncology; St. Jude Children's Research Hospital; Memphis United States
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Metzger M, Mauz-Körholz C, Flerlage J, Bartelt J, Billett A, Choi J, Ehrhardt M, Georgi T, Hasenclever D, Wang F, Zhang H, Kaste S, Kluge R, Körholz D, Kurch L, Link M, Stoevesandt D, Hudson M, Krasin M. SAFETY AND RESPONSE AFTER 2 CYCLES OF BRENTUXIMAB VEDOTIN SUBSTITUTING VINCRISTINE IN THE OEPA/COPDAC REGIMEN FOR HIGH RISK PEDIATRIC HODGKIN LYMPHOMA (HL). Hematol Oncol 2019. [DOI: 10.1002/hon.25_2629] [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: 11/07/2022]
Affiliation(s)
- M. Metzger
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - C. Mauz-Körholz
- Pediatric Hematology Oncology; Justus Liebig Universität; Giessen Germany
| | - J. Flerlage
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - J. Bartelt
- Clinic of Radiology; Martin Luther University; Halle (Saale) Germany
| | - A. Billett
- Blood Disorders Center; Dana-Farber/Boston Children's Hospital; Boston United States
| | - J.K. Choi
- Pathology; St Jude Children's Research Hospital; Memphis United States
| | - M. Ehrhardt
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - T. Georgi
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - D. Hasenclever
- Institut for Medical Informatics; University of Leipzig; Leipzig Germany
| | - F. Wang
- Biostatistics; St Jude Children's Research Hospital; Memphis United States
| | - H. Zhang
- Biostatistics; St Jude Children's Research Hospital; Memphis United States
| | - S.C. Kaste
- Diagnostic Imaging; St Jude Children's Research Hospital; Memphis United States
| | - R. Kluge
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - D. Körholz
- Pediatric Hematology Oncology; Justus Liebig Universität; Giessen Germany
| | - L. Kurch
- Nuclear Medicine; University of Leipzig; Leipzig Germany
| | - M. Link
- Pediatric Hematology Oncology; Stanford University Medical Center; Palo Alto United States
| | - D. Stoevesandt
- Clinic of Radiology; Martin Luther University; Halle (Saale) Germany
| | - M.M. Hudson
- Oncology; St Jude Children's Research Hospital; Memphis United States
| | - M. Krasin
- Radiation Oncology; St Jude Children's Research Hospital; Memphis United States
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Voss P, Poxleitner P, Metzger M, Schmelzeisen R, Schlager S, Füßinger M. Accuracy of CAD-CAM manufactured implants and DCIA transplants. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.460] [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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Faucon AL, Flamant M, Metzger M, Boffa J, Houillier P, Thervet E, Vrtovsnik F, Stengel B, Vidal-Petiot E, Geri G. Valeur pronostique du volume extracellulaire au cours de la maladie rénale chronique. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.077] [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: 10/28/2022]
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Balkau B, Metzger M, Andreelli F, Frimat L, Speyer E, Combe C, Laville M, Jacquelinet C, Briançon S, Ayav C, Massy Z, Pisoni RL, Stengel B, Fouque D. Impact of sex and glucose-lowering treatments on hypoglycaemic symptoms in people with type 2 diabetes and chronic kidney disease. The French Chronic Kidney Disease - Renal Epidemiology and Information Network (CKD-REIN) Study. Diabetes Metab 2018; 45:175-183. [PMID: 29706470 DOI: 10.1016/j.diabet.2018.03.007] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/27/2018] [Accepted: 03/27/2018] [Indexed: 12/15/2022]
Abstract
AIM To describe current practices of glucose-lowering treatments in people with diabetes and chronic kidney disease (CKD), the associated glucose control and hypoglycaemic symptoms, with an emphasis on sex differences. METHODS Among the 3033 patients with CKD stages 3-5 recruited into the French CKD-REIN study, 645 men and 288 women had type 2 diabetes and were treated by glucose-lowering drugs. RESULTS Overall, 31% were treated only with insulin, 28% with combinations of insulin and another drug, 42% with non-insulin glucose-lowering drugs. In CKD stage 3, 40% of patients used metformin, 12% at stages 4&5, similar for men and women; in CKD stage 3, 53% used insulin, similar for men and women, but at stages 4&5, 59% of men and 77% of women used insulin. Patients were reasonably well controlled, with a median HbA1c of 7.1% (54mmol/mol) in men, 7.4% (57mmol/mol) in women (P=0.0003). Hypoglycaemic symptoms were reported by 40% of men and 59% of women; they were not associated with the estimated glomerular filtration rate, nor with albuminuria or with HbA1c in multivariable analyses, but they were more frequent in people treated with insulin, particularly with fast-acting and pre-mixed insulins. CONCLUSION Glucose-lowering treatment, HbA1c and hypoglycaemic symptoms were sex dependent. Metformin use was similar in men and women, but unexpectedly low in CKD stage 3; its use could be encouraged rather than resorting to insulin. Hypoglycaemic symptoms were frequent and need to be more closely monitored, with appropriate patient-education, especially in women.
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Affiliation(s)
- B Balkau
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France
| | - M Metzger
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France
| | - F Andreelli
- Diabetology, CHU Pitié-Salpétrière, APHP, Paris, France
| | - L Frimat
- Lorraine Univ, Paris-Descartes Univ, Apemac, EA 4360, Nancy, France; Nephrology Department, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - E Speyer
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France
| | - C Combe
- Service de Néphrologie Transplantation Dialyse Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; Inserm, U1026, Univ Bordeaux Segalen, Bordeaux, France
| | - M Laville
- Department of Nephrology, Centre Hospitalier Lyon Sud, Univ Lyon, UCBL, Carmen, Pierre-Bénite, France
| | - C Jacquelinet
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France; Agence de la Biomédecine, Saint-Denis, France
| | - S Briançon
- Inserm CIC-1433, CHRU Nancy, Clinical Epidemiology, Vandoeuvre-lès-Nancy, France
| | - C Ayav
- Inserm CIC-1433, CHRU Nancy, Clinical Epidemiology, Vandoeuvre-lès-Nancy, France
| | - Z Massy
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France; Nephrology Department, CHU Ambroise Paré, Boulogne, France
| | - R L Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - B Stengel
- CESP Centre for Research in Epidemiology and Population Health, Univ Paris-Saclay, Univ Paris Sud, UVSQ, UMRS 1018, Villejuif, France.
| | - D Fouque
- Department of Nephrology, Centre Hospitalier Lyon Sud, Univ Lyon, UCBL, Carmen, Pierre-Bénite, France
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Baleeiro RB, Schweinlin M, Rietscher R, Diedrich A, Czaplewska JA, Metzger M, Lehr CM, Scherlieb R, Hanefeld A, Gottschaldt M, Walden P. Nanoparticle-Based Mucosal Vaccines Targeting Tumor-Associated Antigens to Human Dendritic Cells. J Biomed Nanotechnol 2018; 12:1527-43. [PMID: 29337492 DOI: 10.1166/jbn.2016.2267] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The induction of effective T cell-mediated immune responses is the main objective of vaccination against cancer. T cell responses are initiated by dendritic cells (DCs) as the most potent antigen-presenting cells. Designing vaccines for efficient delivery of tumor antigens to these cells in immunogenic fashion is, therefore, a major task in tumor immunology. In this human-based in vitro study we investigated the suitability of different polymeric nanoparticles (NPs) for delivering the tumor-associated antigen Her2/neu to DCs for induction of T cell responses by mucosal vaccination. The natural polymer chitosan and novel functionalized PLGA-based polymers were used for NP production. All NPs were efficiently taken up by DCs. Her2/neu delivered by NPs was more efficiently processed and presented by DCs than the soluble protein and induced more vigorous CD4+ and CD8+ T cell proliferation, and cytotoxic T cells. Testing the suitability of this platform for mucosal vaccination, NPs were applied to the apical side of an intestinal epithelium model and found to be efficiently transported across the epithelial layer to become available to basolateral DCs. Thus, chitosan and PLGA-based NPs are efficient carriers for delivery of antigens to DCs for induction of T cell-based immunity, and suitable for mucosal vaccine formulations.
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Abstract
ZusammenfassungEine indirekte Beurteilung der Mikroarchitektur (MA) ist in der täglichen Praxis anhand des TBS (Trabecular Bone Score) näherungsweise möglich. Das Ziel der OsteoLaus-Kohorte besteht darin, klinische Risikofaktoren und Informationen aus der DXA (Knochenmineraldichte [BMD], TBS und Wirbelkörperfrakturerkennung [VFA]) zu kombinieren, um Frauen mit hohem Frakturrisiko leichter zu erkennen. Wir nahmen 631 Frauen im mittleren Alter von 67,4 ± 6,7 J. und mit einem BMI von 26,1 ± 4,6 auf. Es bestand eine schwache Korrelation zwischen BMD und Zentrums-gematchtem TBS (r2 = 0,16). Die Prävalenz von Wirbelfrakturen (VFx) Grad 2/3, größeren osteoporotischen (OP) Frakturen und allen OP-Frakturen betrug 8,4 %, 17,0 % bzw. 26,0 %. Alters- und BMI-adjustierte OR (nach abnehmender SD) lagen bei 1,8 (1,2–2,5), 1,6 (1,2–2,1) bzw. 1,3 (1,1–1,6) für BMD und 2,0 (1,4–3,0), 1,9 (1,4–2,5) bzw. 1,4 (1,1–1,7) für TBS. Die TBS OR (nach abnehmender SD), adjustiert nach Alter, BMI und Wirbelsäulen-BMD, für VFx Grad 2/3, größere und alle OP-Frakturen betrugen 1,7 (1,1–2,7), 1,6 (1,2–2,2) bzw. 1,3 (1,0–1,7). Nur 35 bis 44 % der Frauen mit OP-Frakturen hatten eine BMD <−2,5 SD oder einen TBS < 1.200. Durch Kombination eines BMD < −2,5 SD oder TBS < 1,200 werden 54 bis 60 % der Frauen mit OP-Fraktur erkannt. Somit können wir anhand von VFA, BMD und TBS aus einem einfachen und strahlenarmen Röntgenverfahren, der DXA, Zusatzinformationen gewinnen, die für den Patienten im Praxisalltag von Nutzen sind.
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Małecki A, Skipor-Lahuta J, Toborek M, Abbott NJ, Antonetti DA, Su EJ, Lawrence DA, Atış M, Akcan U, Yılmaz CU, Orhan N, Düzgün P, Ceylan UD, Arıcan N, Karahüseyinoğlu S, Şahin GN, Ahıshalı B, Kaya M, Aydin S, Klopstein A, Engelhardt B, Baumann J, Tsao CC, Huang SF, Ogunshola O, Boytsova EB, Morgun AV, Khilazheva ED, Pozhilenkova EA, Gorina YV, Martynova GP, Salmina AB, Bueno D, Garcia-Fernàndez J, Castro V, Skowronska M, Toborek M, Chupel MU, Minuzzi LG, Filaire E, Teixeira AM, Corsi M, Versele R, Fuso A, Sevin E, Di Lorenzo C, Businaro R, Fenart L, Gosselet F, Candela P, Deli MA, Delaney C, O’Keefe E, Farrell M, Doyle S, Campbell M, Drewes LR, Appelt-Menzel A, Cubukova A, Metzger M, Fischer R, Francisco DMF, Bruggmann R, Fries A, Blecharz KG, Wagner J, Winkler L, Schneider U, Vajkoczy P, Furuse M, Gabbert L, Dilling C, Sisario D, Soukhoroukov V, Burek M, Guérit S, Fidan E, Devraj K, Czupalla CJ, Macas J, Thom S, Plate KH, Gerhardt H, Liebner S, Harazin A, Bocsik A, Váradi J, Fenyvesi F, Tubak V, Vecsernyés M, Helms HC, Waagepetersen HS, Nielsen CU, Brodin B, Hoyk Z, Tóth ME, Lénárt N, Dukay B, Kittel Á, Vígh J, Veszelka S, Walter F, Zvara Á, Puskás L, Sántha M, Engelhardt S, Ogunshola OO, Huber A, Reitner A, Osmen S, Hahn K, Bounzina N, Gerhartl A, Schönegger A, Steinkellner H, Laccone F, Neuhaus W, Hudson N, Celkova L, Iltzsche A, Drndarski S, Begley DJ, Janiurek MM, Kucharz K, Christoffersen C, Nielsen LB, Lauritzen M, Johnson RH, Kho DT, O’Carroll SJ, Angel CE, Graham ES, Pereira J, Karali CS, Cheng V, Zarghami N, Soto MS, Couch Y, Anthony DC, Sibson NR, Kealy J, Keep RF, Routhe LJ, Xiang J, Ye H, Hua Y, Moos T, Xi G, Kristensen M, Bach A, Strømgaard K, Kutuzov N, Lopes-Pinheiro MA, Lim J, Kamermans A, van Horssen J, Unger WW, Fontijn R, de Vries HE, Majerova P, Garruto RM, Marchetti L, Francisco D, Gruber I, Lyck R, Mészáros M, Porkoláb G, Kiss L, Pilbat AM, Török Z, Bozsó Z, Fülöp L, Michalicova A, Galba J, Mihaljevic S, Novak M, Kovac A, Morofuji Y, Fujimoto T, Watanabe D, Nakagawa S, Ujifuku K, Horie N, Izumo T, Anda T, Matsuo T, Niu F, Buch S, Nyúl-Tóth Á, Kozma M, Nagyőszi P, Nagy K, Fazakas C, Haskó J, Molnár K, Farkas AE, Galajda P, Wilhelm I, Krizbai IA, Kelly E, Wallace E, Greene C, Hughes S, Kealy J, Doyle N, Humphries MM, Grant GA, Friedman A, Veksler R, Molloy MG, Meaney JF, Pender N, Doherty CP, Park M, Liskiewicz A, Przybyla M, Kasprowska-Liśkiewicz D, Nowacka-Chmielewska M, Malecki A, Pombero A, Garcia-Lopez R, Martinez-Morga M, Martinez S, Prager O, Solomon-Kamintsky L, Schoknecht K, Bar-Klein G, Milikovsky D, Vazana U, Rosenbach D, Kovács R, Friedman A, Radak Z, Rodríguez-Lorenzo S, Bruggmann R, Kooij G, de Vries HE, Oxana SG, Denis B, Elena V, Anna A, Alla S, Vladimir S, Andrey M, Nataliya M, Elena K, Elizaveta B, Alexander S, Nikita N, Alla B, Yirong Y, Arkady A, Artem G, Mariya U, Anastasia S, Madina B, Artem S, Alexander K, Esmat SA, Valery P, Artem T, Jürgen K, de Abreu MS, Calpena AC, Espina M, García ML, Romero IA, Male D, Storck S, Hartz A, Pahnke J, Surma CU, Surma M, Giżejewski Z, Zieliński H, Szczepkowska A, Kowalewska M, Krawczynska A, Herman AP, Skipor J, Kachappilly N, Veenstra M, Rivera RL, Williams DW, Morgello S, Berman JW, Wyneken U, Batiz LF, Temizyürek A, Khodadust R, Küçük M, Gürses C, Emik S, Zielińska M, Obara-Michlewska M, Milewski K, Skonieczna E, Fręśko I, Neuwelt EA, Maria ARS, Bras AR, Lipka D, Valkai S, Kincses A, Dér A, Deli MA. Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers. Fluids Barriers CNS 2017. [PMCID: PMC5667590 DOI: 10.1186/s12987-017-0071-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Villain C, Metzger M, Combe C, Fouque D, Frimat L, Jacquelinet C, Laville M, Robinson B, Stengel B, Massy Z. Prévalence de la maladie cardiovasculaire athéromateuse et non athéromateuse chez les patients malades rénaux chroniques : impact du vieillissement. Nephrol Ther 2017. [DOI: 10.1016/j.nephro.2017.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Faivre JC, Adam V, Block V, Metzger M, Salleron J, Dauchy S. Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer. Support Care Cancer 2017; 25:3425-3435. [PMID: 28597252 DOI: 10.1007/s00520-017-3762-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 05/22/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. METHODS The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. RESULTS We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. CONCLUSION The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.
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Affiliation(s)
- J C Faivre
- Academic Department of Radiation Therapy and Brachytherapy, Lorraine Institute of Cancerology - Alexis-Vautrin CLCC [Centre de lutte contre le cancer - Cancer Center] - Unicancer, 6 avenue de Bourgogne - CS 30 519, F-54511, Vandoeuvre-lès-Nancy cedex, France.
| | - V Adam
- Supportive Care in Cancer Department, Institut de Cancérologie de Lorraine, F-54500, Vandœuvre-lès-Nancy, France
| | - V Block
- French Association for Supportive Care in Cancer, 20 rue leblanc, F-7515, Paris, France
| | - M Metzger
- Institut de Cancérologie de Lorraine, Medical Library, F-54500, Vandœuvre-lès-Nancy, France
| | - J Salleron
- Biostatistics and Epidemiology Department, Institut de Cancérologie de Lorraine, F-54500, Vandœuvre-lès-Nancy, France
| | - S Dauchy
- Gustave Roussy, Département de Soins de Support, Université Paris-Saclay, F-94805, Villejuif, France.,ES3, EA1610, Université Paris-Sud, Paris, France
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Voss P, Mici E, Füßinger M, Metzger M, Bittermann G, Schmelzeisen R. Cook-Swartz Doppler Probe for evaluation of perfusion of microvascular flaps. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.663] [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: 10/19/2022]
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Padlina I, Gonzalez-Rodriguez E, Hans D, Metzger M, Stoll D, Aubry-Rozier B, Lamy O. The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort. Osteoporos Int 2017; 28:909-915. [PMID: 27900426 DOI: 10.1007/s00198-016-3829-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED We evaluated the influence of degenerative disease and fractured vertebra on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS) in 1500 women aged 50-80 years. TBS was not affected by a degenerative disease. While BMD increases after 62.5 years, TBS continues to decline. TBS should play a leading role in lumbar spine evaluation. INTRODUCTION After menopause, lumbar spine (LS) BMD and TBS values decrease. Degenerative disease (DD) increases with age and affect LS BMD. The aim of this study was to measure changes in LS BMD and TBS in women 50 to 80 years old, taking into account the impact of fractured vertebrae and DD. METHODS LS BMD, TBS, and vertebral fracture assessment were evaluated in the OsteoLaus cohort (1500 women, 50-80 years old). The exams were analyzed following ISCD guidelines to identify vertebrae with fractures or DD (Vex). RESULTS 1443 women were enrolled: mean age 66.7 ± 11.7 years, BMI 25.7 ± 4.4. LS BMD and TBS were weakly correlated (r2 = 0.16). The correlation (Vex excluded) between age and BMD was +0.03, between age and TBS -0.34. According to age group, LS BMD was 1.2 to 3.2% higher before excluding Vex (p < 0.001). TBS had an insignificant change of <1% after excluding Vex. LS BMD (Vex) decreased by 4.6% between 52.5 and 62.5 years, and increased by 2.6% between 62.5 and 77.5 years. TBS (Vex excluded) values decreased steadily with age with an overall loss of 8.99% between 52.5 and 77.5 years. Spine TBS, femoral neck, and total hip BMD gradually decreased with age, reaching one SD between the oldest and youngest group. CONCLUSIONS TBS is not affected by DD. While BMD increases after 62.5 years, TBS continues to decline. For lumbar spine evaluation, in view of its independence from DD, TBS should play a leading role in the diagnosis in complement to BMD.
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Affiliation(s)
- I Padlina
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - E Gonzalez-Rodriguez
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - D Hans
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - M Metzger
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - D Stoll
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - B Aubry-Rozier
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - O Lamy
- Center of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
- Service of Internal Medicine, Lausanne University Hospital, 1011, Lausanne, Switzerland.
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Metzger M. Multi-Modal Energy System Design for Germany and Europe. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650430] [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: 11/05/2022]
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Tabibzadeh N, Metzger M, Letavernier E, Boffa JJ, Flamant M, Vrtovsnik F, Thervet E, Houillier P, Stengel B, Haymann JP. Osmolalité urinaire à jeun : un marqueur de progression de la maladie rénale chronique. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.341] [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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Mraihi H, Lamy O, Metzger M, Soares S, Aubry-Rozier B, Stoll D, Hans D. THU0460 What Is The Best Lumbar Spine Vertebrae Combination To Predict Major Osteoporotic Fracture? The Osteolaus Cohort Study:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5265] [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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Scicolone JV, Metzger M, Koynov S, Anderson K, Takhistov P, Glasser BJ, Muzzio FJ. Effect of liquid addition on the bulk and flow properties of fine and coarse glass beads. AIChE J 2015. [DOI: 10.1002/aic.15004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James V. Scicolone
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Matthew Metzger
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Sara Koynov
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Kellie Anderson
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Paul Takhistov
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Benjamin J. Glasser
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
| | - Fernando J. Muzzio
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey; Piscataway NJ 08854
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Metzger M. New technologies and modern planning strategies in CMF trauma cases. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kaboré J, Metzger M, Helmer C, Massy Z, Stengel B. Pronostic de l’effet combiné de l’hypertension artérielle apparemment résistante au traitement et de la maladie rénale chronique chez le sujet âgé. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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35
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Alencar De Pinho N, Coscas R, Metzger M, Massy Z, Stengel B. Fistules artério-veineuses non fonctionnelles à l’initiation de l’hémodialyse : fréquence et déterminants dans la population française. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.027] [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: 10/23/2022]
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36
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Courbebaisse M, Metzger M, Stengel B, Houillier P, Bankir L, Prié D. FGF23 et copeptine : association et valeur prédictive au cours de la maladie rénale chronique. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.225] [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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37
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Schmitt M, Metzger M, Gradl D, Davidson G, Orian-Rousseau V. CD44 functions in Wnt signaling by regulating LRP6 localization and activation. Cell Death Differ 2015; 22:677-89. [PMID: 25301071 PMCID: PMC4356338 DOI: 10.1038/cdd.2014.156] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 07/31/2014] [Accepted: 08/18/2014] [Indexed: 11/09/2022] Open
Abstract
Wnt reception at the membrane is complex and not fully understood. CD44 is a major Wnt target gene in the intestine and is essential for Wnt-induced tumor progression in colorectal cancer. Here we show that CD44 acts as a positive regulator of the Wnt receptor complex. Downregulation of CD44 expression decreases, whereas CD44 overexpression increases Wnt activity in a concentration-dependent manner. Epistasis experiments place CD44 function at the level of the Wnt receptor LRP6. Mechanistically, CD44 physically associates with LRP6 upon Wnt treatment and modulates LRP6 membrane localization. Moreover, CD44 regulates Wnt signaling in the developing brain of Xenopus laevis embryos as shown by a decreased expression of Wnt targets tcf-4 and en-2 in CD44 morphants.
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Affiliation(s)
- M Schmitt
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Campus North, Postfach 3640, Karlsruhe 76021, Germany
| | - M Metzger
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Campus North, Postfach 3640, Karlsruhe 76021, Germany
| | - D Gradl
- Zoological Institute II, Karlsruhe Institute of Technology, Campus South, Postfach 6980, Karlsruhe 76128, Germany
| | - G Davidson
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Campus North, Postfach 3640, Karlsruhe 76021, Germany
| | - V Orian-Rousseau
- Institute of Toxicology and Genetics, Karlsruhe Institute of Technology, Campus North, Postfach 3640, Karlsruhe 76021, Germany
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Abstract
This study examined the overall psychological effects of inebriation facilitated by the naturally-occurring plant hallucinogen Salvia divinorum using a double-blind, randomized, placebo-controlled trial. Thirty healthy individuals self-administered Salvia divinorum via combustion and inhalation in a quiet, comfortable research setting. Experimental sessions, post-session interviews, and 8-week follow-up meetings were audio recorded and transcribed to provide the primary qualitative material analyzed here. Additionally, post-session responses to the Hallucinogen Rating Scale provided a quantitative groundwork for mixed-methods discussion. Qualitative data underwent thematic content analysis, being coded independently by three researchers before being collaboratively integrated to provide the final results. Three main themes and 10 subthemes of acute intoxication emerged, encompassing the qualities of the experience, perceptual alterations, and cognitive-affective shifts. The experience was described as having rapid onset and being intense and unique. Participants reported marked changes in auditory, visual, and interoceptive sensory input; losing normal awareness of themselves and their surroundings; and an assortment of delusional phenomena. Additionally, the abuse potential of Salvia divinorum was examined post hoc. These findings are discussed in light of previous research, and provide an initial framework for greater understanding of the subjective effects of Salvia divinorum, an emerging drug of abuse.
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Affiliation(s)
- Peter H Addy
- Medical Informatics, VA Connecticut Healthcare System, West Haven, CT, USA Department of Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
| | - Albert Garcia-Romeu
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Boucquemont J, Metzger M, Combe C, Stengel B, Leffondré K. Quels modèles statistiques utiliser pour étudier les facteurs de risque de progression de la maladie rénale chronique ? Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.318] [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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40
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Yuan W, Metzger M, Haymann J, Boffa J, Fouque D, Stengel B. La réduction des apports protéiques est-elle réalisable et efficace pour ralentir la progression de la MRC vers le stade terminal dans la vraie vie ? Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.322] [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: 10/24/2022]
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41
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Mulrooney D, Nunnery S, Armstrong G, Ness K, Srivastava K, Donovan D, Metzger M, Krasin M, Joshi V, Durand JB, Robison L, Hudson M, Flamm S. Coronary Artery Disease Detected by Coronary Computed Tomographic Angiography (CCTA) in Adult Survivors of Childhood Hodgkin Lymphoma. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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42
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Lewis J, Drachtman R, McCarten K, Metzger M. Definition and Significance of Osseous Involvement in Newly Diagnosed Pediatric Hodgkin Lymphoma. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Castellanos E, Peña A, Alabi S, Baez F, Gamboa J, Metzger M, De Alarcon P. A Risk Adapted, Response- Based Therapeutic Regimen Using OEPA/COPDAC for the Treatment of Children with High Risk Hodgkin Lymphoma; from the Central American y Dominican Republic Group. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371136] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Howard S, Metzger M. SIOP PODC Adapted Treatment Regimens for Hodgkin Lymphoma: A Framework for Management of Pediatric Cancer in Low- and Middle-income Countries. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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45
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McCarten K, Metzger M, Drachtman R, Voss S, Friedman D, Schwartz C, Cho S. Pleural Effusion in Intermediate Hodgkin Lymphoma COG Protocol AHOD0031-Evolution with Therapy and Association with Bulk Mediastinal Disease or Bone, Lung or Pleural Nodular Disease. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371170] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nagaishi V, Cardinali L, Zampieri T, Furigo I, Metzger M, Donato J. Possible crosstalk between leptin and prolactin during pregnancy. Neuroscience 2014; 259:71-83. [DOI: 10.1016/j.neuroscience.2013.11.050] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 10/23/2013] [Accepted: 11/22/2013] [Indexed: 11/24/2022]
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Abstract
Hop aroma compounds and digestive transformation products thereof were investigated in view of their human intestinal absorption and biotransformation processes.
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Affiliation(s)
- A. Heinlein
- Department of Chemistry and Pharmacy
- Food Chemistry
- University Erlangen-Nuremberg
- 91052 Erlangen, Germany
| | - M. Metzger
- Tissue Engineering and Regenerative Medicine
- University Wuerzburg
- 97070 Wuerzburg, Germany
| | - H. Walles
- Tissue Engineering and Regenerative Medicine
- University Wuerzburg
- 97070 Wuerzburg, Germany
| | - A. Buettner
- Department of Chemistry and Pharmacy
- Food Chemistry
- University Erlangen-Nuremberg
- 91052 Erlangen, Germany
- Fraunhofer Institute for Process Engineering and Packaging (IVV)
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Ermer M, Voss P, Bittermann G, Metzger M, Schmelzeisen R. Post operative bleeding in dentoalveolar surgery—a 6 years retrospective analysis. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.236] [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: 11/26/2022]
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49
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Bittermann G, Voss P, Henke M, Schmelzeisen R, Metzger M. Virtual reconstruction of resection margins after tumours resection for focussed radiation therapy. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.285] [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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50
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Trivin C, Metzger M, Boffa J, Vrtovsnik F, Houiller P, Haymann J, Flamant M, Stengel B, Thervet E. Hémoglobine glycquée (HbA1c), facteur indépendant de mortalité chez des patients non diabétiques présentant une maladie rénale chronique. Nephrol Ther 2013. [DOI: 10.1016/j.nephro.2013.07.144] [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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