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Backley S, Bergh E, Garnett J, Li R, Maroufy V, Jain R, Fletcher S, Tsao K, Austin M, Johnson A, Papanna R. Fetal cardiovascular changes during open and fetoscopic in-utero spina bifida closure. Ultrasound Obstet Gynecol 2024. [PMID: 38207160 DOI: 10.1002/uog.27579] [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] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/30/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Laparotomy-assisted fetoscopic closure of spina bifida utilizing heated-humidified carbon dioxide gas has been associated with less maternal morbidity than open in-utero spina bifida closure. Fetal cardiovascular changes during these surgical interventions are not well defined. Our objective was to compare fetal bradycardia (defined as fetal heart rate (FHR)<110 bpm over 10 minutes) and changes in umbilical artery Doppler parameters throughout open in-utero closure with those observed during laparotomy-assisted fetoscopic closure. METHODS We conducted a prospective cohort study of 22 open and 46 fetoscopic consecutive in-utero closures between 2019 and 2023. Both cohorts had similar preoperative counseling and clinical management. FHR and umbilical artery velocimetry were systematically obtained during preoperative assessment, every 5 minutes during the intraoperative period, and in the postoperative assessment. FHR, pulsatility indexes and end-diastolic flows were segmented into hourly periods during surgery, and the lowest values were averaged for analysis. Umbilical vein maximum velocities were measured in the fetoscopic cohort. Each fetal heart rate recording time point was correlated to maternal parameters, including heart rate, systolic and diastolic blood pressures. RESULTS Fetal bradycardia occurred in 4/22 cases (18.2%) of open in-utero closure and in 21/46 cases (45.7%) of fetoscopic closure. FHR gradually decreased in both cohorts after general anesthesia and decreased further during surgery. FHR were significantly lower after two hours of surgery in the fetoscopic closure than in the open in-utero closure group. In addition, the FHR (BPM) change in the final stages of the fetal surgery from the baseline FHR was significantly lower in the fetoscopic cohort (-32.3 (-35.7, -29.1)) compared to the open cohort (-23.5 (-28.1, -18.8)) (p=0.002). Abnormal end-diastolic flow (defined as absent or reversed end-diastolic flow) in the umbilical artery Doppler velocity occurred in 3/22 (13.6%) of the open closure cohort and in 23/46 (50%) of the fetoscopic closure cohort (p=0.004). There were no differences in umbilical artery end-diastolic flow and pulsatility index between closure techniques during the various stages of assessment. CONCLUSIONS We observed a decrease in the FHR and abnormalities in umbilical artery Doppler parameters in both open in-utero and fetoscopic closure groups. Fetal bradycardia was more prominent during fetoscopic closure following heated-humidified carbon dioxide insufflation, but the FHR recovered after cessation of the heated-humidified carbon dioxide. Changes in FHR and umbilical artery Doppler parameters during in-utero spina bifida closure were observed to be transient, no cases required emergency delivery and no fetoscopic closure were converted to open closure. These observations should inform algorithms for perioperative management of fetal bradycardia associated with in-utero spina bifida closure. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Backley
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - E Bergh
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - J Garnett
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Li
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, Texas, USA
| | - V Maroufy
- Department of Biostatistics and Data Science, UTHealth School of Public Health, Houston, Texas, USA
| | - R Jain
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Division of Pediatric Anesthesia, Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - S Fletcher
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Division of Pediatric Neurosurgery, Departments of Pediatric Surgery and Neurosurgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - K Tsao
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Austin
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
- Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Johnson
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
| | - R Papanna
- Division of Fetal Intervention, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
- The Fetal Center at Children's Memorial Hermann Hospital, Houston, TX, USA
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Lai K, O'Brien PC, Dreosti MV, Burke M, Batchelor N, Austin M, Fox T, Hoy L. Implementation of a Systematic, Digital Oncology Workflow for Patient Distress Screening in a National, Multi-Site Radiotherapy Outpatient Setting. Int J Radiat Oncol Biol Phys 2023; 117:e402-e403. [PMID: 37785343 DOI: 10.1016/j.ijrobp.2023.06.1538] [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) Distress screening is recommended as standard of care in oncology to improve the quality of personalized care for patients, however previously reported barriers have led to poor uptake and reporting of clinician follow up and interventions. Our purpose was to improve the quality of personalized care for patients with high patient participation rate (>50%), clinical and nurse workflow compliance rate (>70%) and create structured data for practice improvement. To achieve this purpose, an in-house systematic digital screen and templated well-being plan (WBP) workflow was implemented across 33 outpatient Radiation Oncology sites in a multi-institutional center. MATERIALS/METHODS An in-house digital version of the NCCN Distress Thermometer and Problem Checklist (DT) was built in the integrated web-based portal for patients to complete at home or in a clinic setting. A digital workflow was co-designed with clinicians with automatic integration of the DT PDF document into the Electronic Medical Record (EMR), assigned for doctor review. Nurses subsequently recorded screening actions in the WBP. An extensive engagement, education and support program was completed nationally with phased implementation after an initial pilot at 3 sites. Staff and patient feedback were documented and presented with the collated data for review. RESULTS The program was successfully implemented at 33 centers across Australia in the multi-site organization between March and October 2022. A total of 7788 distress screening forms were submitted with an uptake rate of 78% at baseline and 53% at end of treatment (EOT). DT document approval rates by doctors varied (41%-98%), and WBP was completed for 48-100% of patients, with variations of rates and use noted between states and individuals for both. Referrals were recorded in the WBP for 3% of patients, however, as up to 52% of documentation was not in a WBP (for some states), true referral numbers require further manual analysis. Pairwise analysis of screening scores between time points saw 42% of scores reduced, 34% increased and 24% with no change. Analysis of a subset of patients with increased or no change in score showed 57% had some change in categories of distress, 22% had complete change and 10% had no change. CONCLUSION With an increasing global focus on improving patient centered care, implementation of a systematic digital workflow for distress screening and supportive care was achieved resulting in patient identified stressors being addressed as standard of care. Key barriers reported, include confidence discussing screening results with patients and manual workflows at EOT. The provision of a rich data set can also highlight opportunities for clinical practice improvement, cohort-based focus, clinical quality indicators, benchmarking and reporting.
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Affiliation(s)
- K Lai
- GenesisCare, Adelaide, SA, Australia
| | - P C O'Brien
- Calvary Mater Newcastle Hospital, Newcastle, Australia; GenesisCare, Sydney, NSW, Australia
| | - M V Dreosti
- Genesis Cancer Care SA, Adelaide, SA, Australia
| | - M Burke
- GenesisCare, Sydney, NSW, Australia
| | | | - M Austin
- GenesisCare, Brisbane, Australia
| | - T Fox
- GenesisCare USA, Fort Myers, FL
| | - L Hoy
- GenesisCare, Melbourne, Australia
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Sukhavasi A, Ahmad D, Austin M, Rame JE, Entwistle JW, Massey HT, Tchantchaleishvili V. Utility of Recipient Cardiothoracic Ratio in Predicting Delayed Chest Closure after Heart Transplantation. Thorac Cardiovasc Surg 2023. [PMID: 36652964 DOI: 10.1055/a-2015-1507] [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: 01/20/2023]
Abstract
BACKGROUND Predicted cardiac mass (PCM) has been well validated for size matching donor hearts to heart transplantation recipients. We hypothesized that cardiothoracic ratio (CTR) could be reflective of recipient-specific limits of oversizing, and sought to determine the utility of donor to recipient PCM ratio (PCMR) and CTR in predicting delayed chest closure after heart transplantation. METHODS A retrospective review of prospectively collected data on 38 consecutive heart transplantations performed at our institution from 2017 to 2020 was performed. Donor and recipient PCM were estimated using Multi-Ethnic Study of Atherosclerosis predictive models. Receiver operating characteristic analysis was performed to determine the discriminatory power of the ratio of PCMR to CTR in predicting delayed sternal closure. RESULTS Of the 38 patients, 71.1% (27/38) were male and the median age at transplantation was 58 (interquartile range [IQR]: 47-62) years. Ischemic cardiomyopathy was present in 31.6% of recipients (12/38). Median recipient CTR was 0.63 [IQR: 0.59-0.66]. Median donor to recipient PCMR was 1.07 [IQR: 0.96-1.19], which indicated 7% oversizing. Thirteen out of 38 (34.2%) underwent delayed sternal closure. Primary graft dysfunction occurred in 15.8% (6/38). PCMR/CTR showed good discriminatory power in predicting delayed sternal closure [area under the curve: 80.4% (65.3-95.6%)]. PCMR/CTR cut-off of 1.7 offered the best trade-off between the sensitivity (69.6%) and specificity (91.7%). CONCLUSION CTR could be helpful in guiding the recipient-specific extent of oversizing donor hearts. Maintaining the ratio of PCMR to CTR below 1.7 could avoid excessive oversizing of the donor heart.
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Affiliation(s)
- Amrita Sukhavasi
- Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Danial Ahmad
- Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Melissa Austin
- Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - J Eduardo Rame
- Division of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - John W Entwistle
- Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Howard T Massey
- Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Brown S, Austin M. CHARACTERIZATION OF COMMERCIAL DOG ALLERGEN EXTRACTS, INCLUDING NEW ULTRAFILTERED DOG EXTRACT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.566] [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: 11/11/2022]
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Yu G, Zhu Y, Austin M, Chen Y, Cao J, Diallo A, Kramer G, Li Z, Li X, Liu X, Nazikian R, Zheng Y, Luhmann NC. Diagnosing the pedestal magnetic field and magnetohydrodynamics radial structure with pedestal-scrape of layer electron cyclotron emission radiation inversion in H-mode plasma (invited). Rev Sci Instrum 2022; 93:103528. [PMID: 36319341 DOI: 10.1063/5.0099348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Forward modeling is used to interpret inversion patterns of the pedestal-Scrape of Layer (SOL) Electron Cyclotron Emission (ECE) in DIII-D H-mode experiments. The modeling not only significantly improves the ECE data interpretation quality but also leads to the potential measurements of (1) the magnetic field strength |B| at the separatrix, (2) the pedestal |B| evolution during an inter-Edge Localized Mode (ELM) period, and (3) the pedestal Magnetohydrodynamics (MHD) radial structure. The ECE shine-through effect leads to three types of pedestal-SOL radiation inversions that are discussed in this paper. The first type of inversion is the non-monotonic Te,rad profile with respect to the major radius. Using the ECE frequency at the minimum Te,rad, the inversion can be applied to measure the magnetic field |B| at the separatrix and calibrate the mapping of the ECE channels with respect to the separatrix. The second type of inversion refers to the opposite phase between the radiation fluctuations δTe,rad at the pedestal and SOL. This δTe,rad phase inversion is sensitive to density and temperature fluctuations at the pedestal foot and, thus, can be used to qualitatively measure the MHD radial structure. The third type of inversion appears when the pedestal and SOL Te,rad evolve in an opposite trend, which can be used to infer the pedestal |B| field change during an inter-ELM period. The bandwidth effect on measuring δTe,rad due to pedestal MHD is also investigated in the radiation modeling.
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Affiliation(s)
- G Yu
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - Y Zhu
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - M Austin
- Institute for Fusion Studies, University of Texas, Austin, Texas 78712, USA
| | - Y Chen
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - J Cao
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - A Diallo
- Princeton Plasma Physics Lab, Princeton, New Jersey 08540, USA
| | - G Kramer
- Princeton Plasma Physics Lab, Princeton, New Jersey 08540, USA
| | - Z Li
- Oak Ridge Associated Universities, Oak Ridge, Tennessee 37831, USA
| | - X Li
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - X Liu
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - R Nazikian
- General Atomic, San Diego, California 92121, USA
| | - Y Zheng
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
| | - N C Luhmann
- Department of Electrical and Computer Engineering, University of California, Davis, California 95616, USA
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Fiona B, Fowler JW, Varney JL, Austin M, Jayasundera C, Bench BJ, Coon CN. PSXI-11 Oxidation Analysis on Chicken Meat Meals Composition, Aromatics, and Palatability: A Novel Aromatic Palatability Trial Utilizing Labrador Retrievers, Hercules Enose Ufgc, Spme, and Broad Spectrum Gcms. J Anim Sci 2022. [DOI: 10.1093/jas/skac247.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Even the highest quality ingredients undergo oxidative stresses during manufacturing processes, increasing the nutrition delivery challenges facing large-scale feed manufacturing. In this study we investigate the impact of increasing peroxide values (PV) in the chemical composition in rendered chicken meal (CM) and chicken by-product meal (CB). To determine canine acceptance, working Labrador Retrievers (20 male; 20 female) were used in a preliminary novel aromatic palatability test as well as a traditional two-pan palatability test. PV sample levels ranged from < 10-200 (CB or CM Sample identification: 1.~ < 10, 2.~20-50, 3.~50-100, 4.~100-200). Results indicate that dogs preferred reduced peroxide values in both aromatic (p= < 0.05) and traditional 2-pan palatability trials (p= < 0.05). Preference testing results correlated with extensive physical and chemical data obtained using a Heracles Electronic Nose ultra-fast gas chromatography (UFGC), solid-phase micro-extraction (SPME), and gas chromatography-mass spectrometry (GC-MS). The broad-spectrum analysis utilized solid-phase micro-extraction (SPME) and gas chromatography-mass spectrometry (GC-MS) to identify 177 nonpolar compounds, 340 polar compounds, and 457 volatile compounds. The overall composition did not vary; however, individual compounds had strong linear correlations with peroxide value. In chicken by-product meal samples, 38 compounds were linearly correlated; in chicken meals, 27 compounds were identified (r2>0.90). These data: 1) introduces novel quality control markers for further research and showcases the potential for greater accuracy by developing product specific markers; 2) confirms that the chemical differentiation between peroxide values went beyond lipid oxidation and highlighted multiple compounds of interest for further study; and 3) emphasizes greater levels of peroxide in pet foods have unfavorable palatability. This research was funded by the Fats and Protein Research Foundation.
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Affiliation(s)
| | | | | | | | | | - B J Bench
- Tyson Foods Ingredient Solutions Group
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Majeed A, Ruane B, Shusted CS, Austin M, Mirzozoda K, Pimpinelli M, Vojnika J, Ward L, Sundaram B, Lakhani P, Kane G, Lev Y, Barta JA. Frequency of Statin Prescription Among Individuals with Coronary Artery Calcifications Detected Through Lung Cancer Screening. Am J Med Qual 2022; 37:388-395. [PMID: 35302536 DOI: 10.1097/jmq.0000000000000053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Individuals eligible for lung cancer screening (LCS) are at risk for atherosclerotic cardiovascular disease (ASCVD) due to smoking history. Coronary artery calcifications (CAC), a common incidental finding on low-dose CT (LDCT) for LCS, is a predictor of cardiovascular events. Despite findings of high ASCVD risk and CAC, a substantial proportion of LCS patients are not prescribed primary preventive statin therapy for ASCVD. We assessed the frequency of statin prescription in LCS patients with moderate levels of CAC. Among 259 individuals with moderate CAC, 95% had ASCVD risk ≥ 7.5%. Despite this, 27% of patients were statin-free prior to LDCT and 21.2% remained statin-free after LDCT showing moderate CAC. Illustratively, while a substantial proportion of LCS patients are statin-eligible, many lack a statin prescription, even after findings of CAC burden. CAC reporting should be standardized, and interdisciplinary communication should be optimized to ensure that LCS patients are placed on appropriate preventive therapy.
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Affiliation(s)
- Amry Majeed
- Sidney Kimmel Medical College at Thomas Jefferson University
| | - Brooke Ruane
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University
| | - Christine S Shusted
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University
| | - Melissa Austin
- Sidney Kimmel Medical College at Thomas Jefferson University
| | - Khulkar Mirzozoda
- Department of Medicine, Division of Internal Medicine, Thomas Jefferson University
| | | | - Jetmir Vojnika
- Department of Medicine, Division of Internal Medicine, Thomas Jefferson University
| | - Lawrence Ward
- Department of Medicine, Division of Internal Medicine, Thomas Jefferson University
| | | | - Paras Lakhani
- Department of Radiology, Thomas Jefferson University
| | - Gregory Kane
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University
| | - Yair Lev
- Division of Cardiology, Thomas Jefferson University
| | - Julie A Barta
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University
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Heydt Q, Xintaropoulou C, Clear A, Austin M, Pislariu I, Miraki-Moud F, Cutillas P, Korfi K, Calaminici M, Cawthorn W, Suchacki K, Nagano A, Gribben JG, Smith M, Cavenagh JD, Oakervee H, Castleton A, Taussig D, Peck B, Wilczynska A, McNaughton L, Bonnet D, Mardakheh F, Patel B. Adipocytes disrupt the translational programme of acute lymphoblastic leukaemia to favour tumour survival and persistence. Nat Commun 2021; 12:5507. [PMID: 34535653 PMCID: PMC8448863 DOI: 10.1038/s41467-021-25540-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 08/17/2021] [Indexed: 11/09/2022] Open
Abstract
The specific niche adaptations that facilitate primary disease and Acute Lymphoblastic Leukaemia (ALL) survival after induction chemotherapy remain unclear. Here, we show that Bone Marrow (BM) adipocytes dynamically evolve during ALL pathogenesis and therapy, transitioning from cellular depletion in the primary leukaemia niche to a fully reconstituted state upon remission induction. Functionally, adipocyte niches elicit a fate switch in ALL cells towards slow-proliferation and cellular quiescence, highlighting the critical contribution of the adipocyte dynamic to disease establishment and chemotherapy resistance. Mechanistically, adipocyte niche interaction targets posttranscriptional networks and suppresses protein biosynthesis in ALL cells. Treatment with general control nonderepressible 2 inhibitor (GCN2ib) alleviates adipocyte-mediated translational repression and rescues ALL cell quiescence thereby significantly reducing the cytoprotective effect of adipocytes against chemotherapy and other extrinsic stressors. These data establish how adipocyte driven restrictions of the ALL proteome benefit ALL tumours, preventing their elimination, and suggest ways to manipulate adipocyte-mediated ALL resistance.
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Affiliation(s)
- Q Heydt
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - C Xintaropoulou
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - A Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - M Austin
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - I Pislariu
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - F Miraki-Moud
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - P Cutillas
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - K Korfi
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - M Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - W Cawthorn
- BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh, Scotland, UK
| | - K Suchacki
- BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh, Scotland, UK
| | - A Nagano
- Centre for Molecular Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - J G Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - M Smith
- Department of Haemato-Oncology, St Bartholomew's Hospital, West Smithfield, London, UK
| | - J D Cavenagh
- Department of Haemato-Oncology, St Bartholomew's Hospital, West Smithfield, London, UK
| | - H Oakervee
- Department of Haemato-Oncology, St Bartholomew's Hospital, West Smithfield, London, UK
| | - A Castleton
- Christie NHS Foundation Trust, Manchester, UK
| | - D Taussig
- Haemato-oncology Unit, The Royal Marsden Hospital, Sutton, UK
| | - B Peck
- Centre for Tumour Biology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - A Wilczynska
- CRUK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - L McNaughton
- Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, UK
| | - D Bonnet
- Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, London, UK
| | - F Mardakheh
- Centre for Molecular Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK
| | - B Patel
- Centre for Haemato-Oncology, Barts Cancer Institute, John Vane Science Centre, Charterhouse Square, Queen Mary University of London, London, UK.
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Black-Schaffer WS, Robboy SJ, Gross DJ, Crawford JM, Johnson K, Austin M, Karcher DS, Johnson RL, Powell SZ, Sanfrancesco J, Cohen MB. Evidence-Based Alignment of Pathology Residency With Practice II: Findings and Implications. Acad Pathol 2021; 8:23742895211002816. [PMID: 33889716 PMCID: PMC8040604 DOI: 10.1177/23742895211002816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/15/2021] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
This article presents findings from a 4-year series of surveys of new-in-practice pathologists, and a survey of physician employers of new pathologists, assessing how pathology graduate medical education prepares its graduates for practice. Using the methodology described in our previous study, we develop evidence for the importance of residency training for various practice areas, comparing findings over different practice settings, sizes, and lengths of time in practice. The principal findings are (1) while new-in-practice pathologists and their employers report residency generally prepared them well for practice, some areas—billing and coding, laboratory management, molecular pathology, and pathology informatics—consistently were identified as being important in practice but inadequately prepared for in residency; (2) other areas—autopsy pathology, and subspecialized apheresis and blood donor center blood banking services—consistently were identified as relatively unimportant in practice and excessively prepared for in residency; (3) the notion of a single comprehensive model for categorical training in residency is challenged by the disparity between broad general practice in some settings and narrower subspecialty practice in others; and (4) the need for preparation in some areas evolves during practice, raising questions about the appropriate mode and circumstance for training in these areas. The implications of these findings range from rebalancing the emphasis among practice areas in residency, to reconsidering the structure of graduate medical education in pathology to meet present and evolving future practice needs.
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Affiliation(s)
- W Stephen Black-Schaffer
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - David J Gross
- College of American Pathologists, Washington, DC, USA
| | - James M Crawford
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | - Melissa Austin
- Uniformed Services, University of the Health Sciences, Bethesda, MD, USA
| | - Donald S Karcher
- George Washington University Medical Center, Washington, DC, USA
| | | | - Suzanne Z Powell
- Weill Cornell Medical College Houston, TX, USA.,Houston Methodist Hospital, Houston, TX, USA
| | | | - Michael B Cohen
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Wilczynski JA, Decaro MV, Marhefka GD, Thoma BN, Varghese S, Tchantchaleishvili V, Austin M, Danelich IM. Very High-Dose Furosemide Continuous Infusions: A Case Series. J Card Fail 2020; 26:794-797. [PMID: 32505817 DOI: 10.1016/j.cardfail.2020.05.022] [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: 11/04/2019] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is paucity of data evaluating the efficacy and safety of very high-dose furosemide continuous infusions (≥40 mg/h) for volume removal. This infusion is a novel strategy of loop diuretic administration that may add valuable data to current literature. METHODS AND RESULTS This was a retrospective chart review. Patients were eligible for inclusion if prescribed a very high-dose furosemide infusion (defined as ≥40 mg/h, up to 240 mg/h) from April 1, 2017, to January 1, 2019, at Thomas Jefferson University Hospital. Data collected included the change in cumulative urine output, net urine output, incidence of acute kidney injury, occurrences of hypotension, electrolyte abnormalities, body weight, and ototoxicity. Twenty-two patients were included in this analysis. The median change in 24-hour urine output from before to after very high-dose continuous furosemide infusion increased from 1193 mL at 24 hours before infusion initiation to 3518 mL at 24 hours after infusion initiation (P < .01). Serum creatinine increased 24 hours after infusion initiation but decreased within 48 hours. There were no electrolyte abnormalities. Out of 22 patients, only 2 had an occurrence of hypotension. No patients were reported to have ototoxicity. CONCLUSIONS Very high-dose furosemide continuous infusions provide a significant increase in diuresis without worsening renal function, disturbing electrolytes, or increasing the risk of ototoxicity. Further studies are necessary to examine the efficacy and safety of this novel strategy.
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Affiliation(s)
- Jessica A Wilczynski
- Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
| | - Matthew V Decaro
- Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Gregary D Marhefka
- Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Brandi N Thoma
- Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Susan Varghese
- Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | | | - Melissa Austin
- Sydney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Ilya M Danelich
- Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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11
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Saeui CT, Cho KC, Dharmarha V, Nairn AV, Galizzi M, Shah SR, Gowda P, Park M, Austin M, Clarke A, Cai E, Buettner MJ, Ariss R, Moremen KW, Zhang H, Yarema KJ. Cell Line-, Protein-, and Sialoglycosite-Specific Control of Flux-Based Sialylation in Human Breast Cells: Implications for Cancer Progression. Front Chem 2020; 8:13. [PMID: 32117864 PMCID: PMC7013041 DOI: 10.3389/fchem.2020.00013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Abstract
Sialylation, a post-translational modification that impacts the structure, activity, and longevity of glycoproteins has been thought to be controlled primarily by the expression of sialyltransferases (STs). In this report we explore the complementary impact of metabolic flux on sialylation using a glycoengineering approach. Specifically, we treated three human breast cell lines (MCF10A, T-47D, and MDA-MB-231) with 1,3,4-O-Bu3ManNAc, a "high flux" metabolic precursor for the sialic acid biosynthetic pathway. We then analyzed N-glycan sialylation using solid phase extraction of glycopeptides (SPEG) mass spectrometry-based proteomics under conditions that selectively captured sialic acid-containing glycopeptides, referred to as "sialoglycosites." Gene ontology (GO) analysis showed that flux-based changes to sialylation were broadly distributed across classes of proteins in 1,3,4-O-Bu3ManNAc-treated cells. Only three categories of proteins, however, were "highly responsive" to flux (defined as two or more sialylation changes of 10-fold or greater). Two of these categories were cell signaling and cell adhesion, which reflect well-known roles of sialic acid in oncogenesis. A third category-protein folding chaperones-was unexpected because little precedent exists for the role of glycosylation in the activity of these proteins. The highly flux-responsive proteins were all linked to cancer but sometimes as tumor suppressors, other times as proto-oncogenes, or sometimes both depending on sialylation status. A notable aspect of our analysis of metabolically glycoengineered breast cells was decreased sialylation of a subset of glycosites, which was unexpected because of the increased intracellular levels of sialometabolite "building blocks" in the 1,3,4-O-Bu3ManNAc-treated cells. Sites of decreased sialylation were minor in the MCF10A (<25% of all glycosites) and T-47D (<15%) cells but dominated in the MDA-MB-231 line (~60%) suggesting that excess sialic acid could be detrimental in advanced cancer and cancer cells can evolve mechanisms to guard against hypersialylation. In summary, flux-driven changes to sialylation offer an intriguing and novel mechanism to switch between context-dependent pro- or anti-cancer activities of the several oncoproteins identified in this study. These findings illustrate how metabolic glycoengineering can uncover novel roles of sialic acid in oncogenesis.
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Affiliation(s)
- Christopher T Saeui
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Kyung-Cho Cho
- Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Vrinda Dharmarha
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Alison V Nairn
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA, United States
| | - Melina Galizzi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA, United States
| | - Sagar R Shah
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Prateek Gowda
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Marian Park
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Melissa Austin
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Amelia Clarke
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Edward Cai
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Matthew J Buettner
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Ryan Ariss
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States
| | - Kelley W Moremen
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA, United States
| | - Hui Zhang
- Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kevin J Yarema
- Department of Biomedical Engineering, Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, MD, United States.,Department of Chemical and Biomolecular Engineering, Whiting School of Engineering, The Johns Hopkins University, Baltimore, MD, United States.,Department of Oncology, The Johns Hopkins School of Medicine, Baltimore, MD, United States
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12
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Lanctôt KL, Lindsay MP, Smith EE, Sahlas DJ, Foley N, Gubitz G, Austin M, Ball K, Bhogal S, Blake T, Herrmann N, Hogan D, Khan A, Longman S, King A, Leonard C, Shoniker T, Taylor T, Teed M, de Jong A, Mountain A, Casaubon LK, Dowlatshahi D, Swartz RH. Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue following Stroke, 6th edition update 2019. Int J Stroke 2019; 15:668-688. [PMID: 31221036 DOI: 10.1177/1747493019847334] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [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: 01/14/2023]
Abstract
The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Mood, Cognition and Fatigue following Stroke is a comprehensive set of evidence-based guidelines addressing three important issues that can negatively impact the lives of people who have had a stroke. These include post-stroke depression and anxiety, vascular cognitive impairment, and post-stroke fatigue. Following stroke, approximately 20% to 50% of all persons may be affected by at least one of these conditions. There may also be overlap between conditions, particularly fatigue and depression. If not recognized and treated in a timely matter, these conditions can lead to worse long-term outcomes. The theme of this edition of the CSBPR is Partnerships and Collaborations, which stresses the importance of integration and coordination across the healthcare system to ensure timely and seamless care to optimize recovery and outcomes. Accordingly, these recommendations place strong emphasis on the importance of timely screening and assessments, and timely and adequate initiation of treatment across care settings. Ideally, when screening is suggestive of a mood or cognition issue, patients and families should be referred for in-depth assessment by healthcare providers with expertise in these areas. As the complexity of patients treated for stroke increases, continuity of care and strong communication among healthcare professionals, and between members of the healthcare team and the patient and their family is an even bigger imperative, as stressed throughout the recommendations, as they are critical elements to ensure smooth transitions from acute care to active rehabilitation and reintegration into their community.
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Affiliation(s)
- Krista L Lanctôt
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
| | | | - Eric E Smith
- Calgary Stroke Program, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta
| | - Demetrios J Sahlas
- Division of Neurology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | - Gord Gubitz
- Queen Elizabeth II Health Sciences Centre, Halifax, Canada.,Department of Medicine (Neurology), Dalhousie University, Halifax, Canada.,Canadian Stroke Consortium, Ontario, Canada
| | - Melissa Austin
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | - Treena Blake
- GF Strong Rehabilitation Centre, Vancouver, Canada
| | - Nathan Herrmann
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
| | - David Hogan
- University of Calgary Cumming School of Medicine, Calgary, Canada
| | - Aisha Khan
- Montreal University Health Center, Montreal, Canada
| | - Stewart Longman
- Calgary Stroke Program, Alberta Health Services, Calgary, Canada
| | - Andrea King
- Nova Scotia Health Authority, Halifax, Canada
| | - Carol Leonard
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Canada
| | | | - Trudy Taylor
- Carewest Dr. Vernon Fanning Centre, Calgary, Canada
| | - Moira Teed
- Heart and Stroke Foundation of Canada, Toronto, Canada
| | | | - Anita Mountain
- Dalhousie University Division of Physical Medicine and Rehabilitation, Halifax, Canada.,Nova Scotia Rehabilitation Centre Site, Halifax, Canada
| | - Leanne K Casaubon
- University of Toronto Faculty of Medicine, Toronto, Canada.,Canadian Stroke Consortium, Ontario, Canada.,Toronto Western Hospital, University Health Network, Toronto, Canada
| | | | - Richard H Swartz
- Sunnybrook Research Institute, Toronto, Canada.,University of Toronto Faculty of Medicine, Toronto, Canada
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13
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Harris A, Austin M, Blake T, Bird M. Perceived benefits and barriers to yoga participation after stroke: A focus group approach. Complement Ther Clin Pract 2019; 34:153-156. [DOI: 10.1016/j.ctcp.2018.11.015] [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] [Received: 06/19/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
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14
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Affiliation(s)
- M. Austin
- Polytechnic of Central London, Photographic Technology Research Group, 18–22 Riding House Street, London W1P 7PD, England
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15
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Black-Schaffer WS, Gross DJ, Crawford JM, Robboy SJ, Johnson K, Cohen MB, Austin M, Sanfrancesco J, Karcher DS, Powell SZ, Johnson RL. Evidence-Based Alignment of Pathology Residency With Practice: Methodology and General Consideration of Results. Acad Pathol 2018; 5:2374289518790501. [PMID: 30151423 PMCID: PMC6104218 DOI: 10.1177/2374289518790501] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/24/2018] [Accepted: 06/19/2018] [Indexed: 11/26/2022] Open
Abstract
Few medical specialties engage in ongoing, organized data collection to assess how graduate medical education in their disciplines align with practice. Pathology educators, the American Board of Pathology, and major pathology organizations undertook an evidence-based, empirical assessment of what all pathologists need to learn in categorical residency. Two challenges were known when we commenced and we encountered 2 others during the project; all were ultimately satisfactorily addressed. Initial challenges were (1) ensuring broad representation of the new-in-practice pathologist experience and (2) adjusting for the effect on this experience of subspecialty fellowship(s) occurring between residency and practice. Additional challenges were (3) needing to assess and quantify degree and extent of subspecialization in different practice settings and (4) measuring changing practice responsibilities with increasing time in practice. We instituted annual surveys of pathologists who are relatively new (<10 years) in practice and a survey of physician employers of new pathologists. The purpose of these surveys was to inform (1) the American Board of Pathology certification process, which needs to assess the most critical knowledge, judgment, and skills required by newly practicing pathologists, and (2) pathology graduate medical education training requirements, which need to be both efficient and effective in graduating competent practitioners. This article presents a survey methodology to evaluate alignment of graduate medical education training with the skills needed for new-in-practice physicians, illustrates an easily interpreted graphical format for assessing survey data, and provides high-level results showing consistency of findings between similar populations of respondents, and between new-in-practice physicians and physician-employers.
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Affiliation(s)
- W Stephen Black-Schaffer
- MGH Pathology Service, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David J Gross
- Policy Roundtable, College of American Pathologists, Washington, DC, USA
| | - James M Crawford
- Department of Pathology and Laboratory Medicine, Hofstra Northwell School of Medicine, Lake Success, NY, USA
| | - Stanley J Robboy
- Pathology Department, Duke University Medical Center, Durham, NC, USA
| | - Kristen Johnson
- CAP Learning, College of American Pathologists, Northfield, IL, USA
| | - Michael B Cohen
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Melissa Austin
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Donald S Karcher
- The George Washington University Medical Center, Washington, DC, USA
| | - Suzanne Z Powell
- Weill Cornell Medical College and Texas A&M University, Houston, TX, USA
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16
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Bramble J, Steidinger S, Hamasu C, Austin M. Clinical Medical Librarian Licensure: Pros versus Cons. Med Ref Serv Q 2018; 37:306-311. [PMID: 30239301 DOI: 10.1080/02763869.2018.1477719] [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] [Indexed: 06/08/2023]
Abstract
In hospitals and clinics, anyone who "touches" a patient has a license authorizing them to do so-from the phlebotomist to the cardiologist, from the genetic counselor to the social worker, and so on, except for the clinical medical librarian. This column discusses the intent versus the realities of occupational licensure for clinical medical librarians and provides recommendations for next steps.
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Affiliation(s)
- John Bramble
- a National Network of Libraries of Medicine MidContinental Region, University of Utah , Salt Lake City , Utah , USA
| | - Shawn Steidinger
- b Primary Children's Hospital, Intermountain Healthcare , Salt Lake City , Utah , USA
| | - Claire Hamasu
- a National Network of Libraries of Medicine MidContinental Region, University of Utah , Salt Lake City , Utah , USA
| | - Melissa Austin
- c Emporia State University , Emporia , Kansas , USA
- d Salt Lake Community College , Taylorsville , Utah , USA
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17
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Saeui CT, Nairn AV, Galizzi M, Douville C, Gowda P, Park M, Dharmarha V, Shah SR, Clarke A, Austin M, Moremen KW, Yarema KJ. Integration of genetic and metabolic features related to sialic acid metabolism distinguishes human breast cell subtypes. PLoS One 2018; 13:e0195812. [PMID: 29847599 PMCID: PMC5976204 DOI: 10.1371/journal.pone.0195812] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 02/08/2018] [Accepted: 03/29/2018] [Indexed: 11/18/2022] Open
Abstract
In this report we use 'high-flux' tributanoyl-modified N-acetylmannosamine (ManNAc) analogs with natural N-acetyl as well as non-natural azido- and alkyne N-acyl groups (specifically, 1,3,4-O-Bu3ManNAc, 1,3,4-O-Bu3ManNAz, and 1,3,4-O-Bu3ManNAl respectively) to probe intracellular sialic acid metabolism in the near-normal MCF10A human breast cell line in comparison with earlier stage T-47D and more advanced stage MDA-MB-231 breast cancer lines. An integrated view of sialic acid metabolism was gained by measuring intracellular sialic acid production in tandem with transcriptional profiling of genes linked to sialic acid metabolism. The transcriptional profiling showed several differences between the three lines in the absence of ManNAc analog supplementation that helps explain the different sialoglycan profiles naturally associated with cancer. Only minor changes in mRNA transcript levels occurred upon exposure to the compounds confirming that metabolic flux alone can be a key determinant of sialoglycoconjugate display in breast cancer cells; this result complements the well-established role of genetic control (e.g., the transcription of STs) of sialylation abnormalities ubiquitously associated with cancer. A notable result was that the different cell lines produced significantly different levels of sialic acid upon exogenous ManNAc supplementation, indicating that feedback inhibition of UDP-GlcNAc 2-epimerase/ManNAc kinase (GNE)-generally regarded as the 'gatekeeper' enzyme for titering flux into sialic acid biosynthesis-is not the only regulatory mechanism that limits production of this sugar. A notable aspect of our metabolic glycoengineering approach is its ability to discriminate cell subtype based on intracellular metabolism by illuminating otherwise hidden cell type-specific features. We believe that this strategy combined with multi-dimensional analysis of sialic acid metabolism will ultimately provide novel insights into breast cancer subtypes and provide a foundation for new methods of diagnosis.
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Affiliation(s)
- Christopher T. Saeui
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Alison V. Nairn
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, United States of America
| | - Melina Galizzi
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, United States of America
| | - Christopher Douville
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Prateek Gowda
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Marian Park
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Vrinda Dharmarha
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Sagar R. Shah
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Amelia Clarke
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Melissa Austin
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Kelley W. Moremen
- Complex Carbohydrate Research Center, University of Georgia, Athens, Georgia, United States of America
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, Georgia, United States of America
| | - Kevin J. Yarema
- Department of Biomedical Engineering and the Translational Tissue Engineering Center, The Johns Hopkins University, Baltimore, Maryland, United States of America
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18
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Cecchini GG, Jones ACL, Fuentes-Garcia M, Adams DJ, Austin M, Membreno E, Mills AP. Detector for positronium temperature measurements by two-photon angular correlation. Rev Sci Instrum 2018; 89:053106. [PMID: 29864868 DOI: 10.1063/1.5017724] [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: 06/08/2023]
Abstract
We report on the design and characterization of a modular γ-ray detector assembly developed for accurate and efficient detection of coincident 511 keV back-to-back γ-rays following electron-positron annihilation. Each modular detector consists of 16 narrow lutetium yttrium oxyorthosilicate scintillators coupled to a multi-anode Hamamatsu H12700B photomultiplier tube. We discuss the operation and optimization of 511 keV γ-ray detection resulting from testing various scintillators and detector arrangements concluding with an estimate of the coincident 511 keV detection efficiency for the intended experiment and a preliminary test representing one-quarter of the completed array.
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Affiliation(s)
- G G Cecchini
- Department of Physics and Astronomy, University of California, Riverside, California 92521, USA
| | - A C L Jones
- Department of Physics and Astronomy, University of California, Riverside, California 92521, USA
| | - M Fuentes-Garcia
- Department of Physics and Astronomy, University of California, Riverside, California 92521, USA
| | - D J Adams
- College of Natural and Agricultural Sciences Machine Shop, University of California, Riverside, California 92521, USA
| | - M Austin
- Department of Physics, Marquette University, Milwaukee, Wisconsin 53233, USA
| | - E Membreno
- Department of Physics and Astronomy, University of California, Riverside, California 92521, USA
| | - A P Mills
- Department of Physics and Astronomy, University of California, Riverside, California 92521, USA
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19
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Moser FG, Watterson CT, Weiss S, Austin M, Mirocha J, Prasad R, Wang J. High Signal Intensity in the Dentate Nucleus and Globus Pallidus on Unenhanced T1-Weighted MR Images: Comparison between Gadobutrol and Linear Gadolinium-Based Contrast Agents. AJNR Am J Neuroradiol 2018; 39:421-426. [PMID: 29419400 DOI: 10.3174/ajnr.a5538] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/15/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In view of the recent observations that gadolinium deposits in brain tissue after intravenous injection, our aim of this study was to compare signal changes in the globus pallidus and dentate nucleus on unenhanced T1-weighted MR images in patients receiving serial doses of gadobutrol, a macrocyclic gadolinium-based contrast agent, with those seen in patients receiving linear gadolinium-based contrast agents. MATERIALS AND METHODS This was a retrospective analysis of on-site patients with brain tumors. Fifty-nine patients received only gadobutrol, and 60 patients received only linear gadolinium-based contrast agents. Linear gadolinium-based contrast agents included gadoversetamide, gadobenate dimeglumine, and gadodiamide. T1 signal intensity in the globus pallidus, dentate nucleus, and pons was measured on the precontrast portions of patients' first and seventh brain MRIs. Ratios of signal intensity comparing the globus pallidus with the pons (globus pallidus/pons) and dentate nucleus with the pons (dentate nucleus/pons) were calculated. Changes in the above signal intensity ratios were compared within the gadobutrol and linear agent groups, as well as between groups. RESULTS The dentate nucleus/pons signal ratio increased in the linear gadolinium-based contrast agent group (t = 4.215, P < .001), while no significant increase was seen in the gadobutrol group (t = -1.422, P = .08). The globus pallidus/pons ratios followed similarly, with an increase in the linear gadolinium-based contrast agent group (t = 2.931, P < .0001) and no significant change in those receiving gadobutrol (t = 0.684, P = .25). CONCLUSIONS Successive doses of gadobutrol do not result in T1 shortening compared with changes seen in linear gadolinium-based contrast agents.
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Affiliation(s)
- F G Moser
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - C T Watterson
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - S Weiss
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - M Austin
- Department of Radiology (M.A.), Lahey Clinic, Burlington, Massachusetts
| | - J Mirocha
- Samuel Oschin Comprehensive Cancer Institute (J.M.), Cedars Sinai Medical Center, Los Angeles, California
| | - R Prasad
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - J Wang
- Bayer Healthcare (J.W.), Whippany, New Jersey
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20
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Wallace A, Madaelil T, Austin M, Wiesner E, Jennings J. Percutaneous image-guided ablation of musculoskeletal non–small cell lung cancer metastases: pain palliation, local tumor control, and remission of oligometastatic disease. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.790] [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] Open
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21
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Roberts G, Ollert M, Aalberse R, Austin M, Custovic A, DunnGalvin A, Eigenmann PA, Fassio F, Grattan C, Hellings P, Hourihane J, Knol E, Muraro A, Papadopoulos N, Santos AF, Schnadt S, Tzeli K. A new framework for the interpretation of IgE sensitization tests. Allergy 2016; 71:1540-1551. [PMID: 27224838 DOI: 10.1111/all.12939] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 12/27/2022]
Abstract
IgE sensitization tests, such as skin prick testing and serum-specific IgE, have been used to diagnose IgE-mediated clinical allergy for many years. Their prime drawback is that they detect sensitization which is only loosely related to clinical allergy. Many patients therefore require provocation tests to make a definitive diagnosis; these are often expensive and potentially associated with severe reactions. The likelihood of clinical allergy can be semi-quantified from an IgE sensitization test results. This relationship varies though according to the patients' age, ethnicity, nature of the putative allergic reaction and coexisting clinical diseases such as eczema. The likelihood of clinical allergy can be more precisely estimated from an IgE sensitization test result, by taking into account the patient's presenting features (pretest probability). The presence of each of these patient-specific factors may mean that a patient is more or less likely to have clinical allergy with a given test result (post-test probability). We present two approaches to include pretest probabilities in the interpretation of results. These approaches are currently limited by a lack of data to allow us to derive pretest probabilities for diverse setting, regions and allergens. Also, cofactors, such as exercise, may be necessary for exposure to an allergen to result in an allergic reaction in specific IgE-positive patients. The diagnosis of IgE-mediated allergy is now being aided by the introduction of allergen component testing which may identify clinically relevant sensitization. Other approaches are in development with basophil activation testing being closest to clinical application.
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Affiliation(s)
- G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Clinical and Experimental Sciences Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - M. Ollert
- Department of Infection and Immunity; Luxembourg Institute of Health (LIH); Esch-sur-Alzette, Luxembourg and Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis; University of Southern Denmark; Odense Denmark
| | - R. Aalberse
- Department of Immunopathology; Sanquin Research; Amsterdam and Landsteiner Laboratory; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - M. Austin
- Anaphylaxis Campaign; Farnborough UK
| | - A. Custovic
- Department of Paediatrics; Imperial College London; London UK
| | - A. DunnGalvin
- Department of Paediatrics and Child Health; School of Applied Psychology; University College Cork; Cork Ireland
| | - P. A. Eigenmann
- Department of Child and Adolescent; University Hospitals of Geneva; Geneva Switzerland
| | | | - C. Grattan
- Dermatology Centre; Norfolk & Norwich University Hospital; Norwich UK
| | | | - J. Hourihane
- Paediatrics and Child Health; University College Cork; Cork Ireland
| | - E. Knol
- Departments of Immunology and Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. Muraro
- Department of Pediatrics; University of Padua; Padova Italy
| | - N. Papadopoulos
- Centre for Pediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | - A. F. Santos
- Division of Asthma, Allergy & Lung Biology; Department of Paediatric Allergy; King's College London; London UK
- MRC & Asthma UK Centre in Allergic Mechanisms of Asthma; London UK
- Immunoallergology Department; Coimbra University Hospital; Coimbra Portugal
| | - S. Schnadt
- German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)); Mönchengladbach Germany
| | - K. Tzeli
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
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Nezhad M, Eboli P, Austin M, Schlick K, Alexander M. E-025 First Reported Case of Mechanical Thrombectomy for Acute Ischemic Stroke in an Individual with a Total Artificial Heart. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.97] [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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Godfrey C, Tauscher G, Hunsberger S, Austin M, Scott L, Schouten JT, Luetkemeyer AF, Benson C, Coombs R, Swindells S. A survey of tuberculosis infection control practices at the NIH/NIAID/DAIDS-supported clinical trial sites in low and middle income countries. BMC Infect Dis 2016; 16:269. [PMID: 27287374 PMCID: PMC4901412 DOI: 10.1186/s12879-016-1579-y] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/18/2016] [Indexed: 12/01/2022] Open
Abstract
Background Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement. Methods A survey was developed that assessed IC activities in three domains: facility level measures, administrative control measures and environmental measures. An external site monitor visited each site in 2013–2014, to complete the audit. A central review committee evaluated the site-level survey and results were tabulated. Fisher’s exact test was performed to determine whether there were significant differences in practices at sites that had IC officers versus sites that did not have IC officers. Significance was assessed at p</=.05 Results Seven of thirty-three sites surveyed (22 %) had all the evaluated tuberculosis IC (TB IC) elements in place. Sixty-one percent of sites had an IC officer tasked with developing and maintaining TB IC standard operating procedures. Twenty-two (71 %) sites promptly identified and segregated individuals with TB symptoms. Thirty (93 %) sites had a separate waiting area for patients, and 26 (81 %) collected sputum within a specific well-ventilated area that was separate from the general waiting area. Sites with an IC officer were more likely to have standard operating procedures covering TB IC practices (p = 0.02) and monitor those policies (p = 0.02) and perform regular surveillance of healthcare workers (p = 0.02). The presence of an IC officer had a positive impact on performance in most of the TB IC domains surveyed including having adequate ventilation (p = 0.02) and a separate area for sputum collection (p = 0.02) Conclusions Specific and targeted support of TB IC activities in the clinical research environment is needed and is likely to have a positive and sustained impact on preventing the transmission of TB to both health care workers and vulnerable HIV-infected research participants. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1579-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine Godfrey
- Division of AIDS, National Institute of Allergy and Infectious Diseases, 5601 Fisher's Lane Room 9E49, MSC 9830, 20892-9830, Bethesda, MD, USA.
| | - Gail Tauscher
- Division of AIDS, National Institute of Allergy and Infectious Diseases, 5601 Fisher's Lane Room 9E49, MSC 9830, 20892-9830, Bethesda, MD, USA
| | - Sally Hunsberger
- Division of AIDS, National Institute of Allergy and Infectious Diseases, 5601 Fisher's Lane Room 9E49, MSC 9830, 20892-9830, Bethesda, MD, USA
| | - Melissa Austin
- Office of HIV/AIDS Network Coordination, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lesley Scott
- Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand Johannesburg South Africa, Johannesburg, South Africa
| | - Jeffrey T Schouten
- Office of HIV/AIDS Network Coordination, Seattle, WA, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Robert Coombs
- Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, WA, USA
| | - Susan Swindells
- Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Langridge T, Austin M, Zhang X, Shiue L, Duvic M, Ni X. 029 CD209 + monocyte-derived myeloid dendritic cells were increased in patients with leukemic cutaneous T-cell lymphoma after extracorporeal photopheresis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.053] [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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Racca R, Austin M, Rutenko A, Bröker K. Monitoring the gray whale sound exposure mitigation zone and estimating acoustic transmission during a 4-D seismic survey, Sakhalin Island, Russia. ENDANGER SPECIES RES 2015. [DOI: 10.3354/esr00703] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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26
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Hillier SL, Rabe LK, Beamer MA, Stoner K, Austin M, Petrina M, Crowe DS, Chaiworapongsa T, Lamont R, Ahmed A, Hassan S, Romero R. O13.1 The broad diversity of cultivable microbiota in pregnant women and the detection of novel organisms. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.147] [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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27
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DunnGalvin A, Chan CH, Crevel R, Grimshaw K, Poms R, Schnadt S, Taylor SL, Turner P, Allen KJ, Austin M, Baka A, Baumert JL, Baumgartner S, Beyer K, Bucchini L, Fernández-Rivas M, Grinter K, Houben GF, Hourihane J, Kenna F, Kruizinga AG, Lack G, Madsen CB, Clare Mills EN, Papadopoulos NG, Alldrick A, Regent L, Sherlock R, Wal JM, Roberts G. Precautionary allergen labelling: perspectives from key stakeholder groups. Allergy 2015; 70:1039-51. [PMID: 25808296 DOI: 10.1111/all.12614] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 01/22/2023]
Abstract
Precautionary allergen labelling (PAL) was introduced by the food industry to help manage and communicate the possibility of reaction from the unintended presence of allergens in foods. However, in its current form, PAL is counterproductive for consumers with food allergies. This review aims to summarize the perspectives of all the key stakeholders (including clinicians, patients, food industry and regulators), with the aim of defining common health protection and risk minimization goals. The lack of agreed reference doses has resulted in inconsistent application of PAL by the food industry and in levels of contamination that prompt withdrawal action by enforcement officers. So there is a poor relationship between the presence or absence of PAL and actual reaction risk. This has led to a loss of trust in PAL, reducing the ability of consumers with food allergies to make informed choices. The result has been reduced avoidance, reduced quality of life and increased risk-taking by consumers who often ignore PAL. All contributing stakeholders agree that PAL must reflect actual risk. PAL should be transparent and consistent with rules underpinning decision-making process being communicated clearly to all stakeholders. The use of PAL should indicate the possible, unintended presence of an allergen in a consumed portion of a food product at or above any proposed action level. This will require combined work by all stakeholders to ensure everyone understands the approach and its limitations. Consumers with food allergy then need to be educated to undertake individualized risk assessments in relation to any PAL present.
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Affiliation(s)
- A. DunnGalvin
- Department of Paediatrics and Child Health; School of Applied Psychology; University College Cork; Cork Ireland
| | - C.-H. Chan
- Food Allergy Branch; Food Standards Agency; Bedford UK
| | - R. Crevel
- Safety and Environmental Assurance Centre; Unilever; Colworth Science Park Sharnbrook Bedford UK
| | - K. Grimshaw
- Clinical and Experimental Sciences Academic Unit; University of Southampton Faculty of Medicine; Southampton UK
| | | | - S. Schnadt
- German Allergy and Asthma Association (Deutscher Allergie- und Asthmabund (DAAB)); Mönchengladbach Germany
| | - S. L. Taylor
- Food Allergy Research & Resource Program; University of Nebraska; Lincoln NE USA
| | - P. Turner
- Section of Paediatrics (Allergy and Infectious Diseases); MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Imperial College London; London UK
| | - K. J. Allen
- Centre of Food and Allergy Research; Murdoch Children's Research Institute; Melbourne Vic. Australia
- Department of Paediatrics; Royal Children's Hospital; Melbourne Vic. Australia
| | - M. Austin
- Anaphylaxis Campaign; Farnborough UK
| | - A. Baka
- ILSI Europe; Brussels Belgium
| | - J. L. Baumert
- Food Allergy Research & Resource Program; University of Nebraska; Lincoln NE USA
| | - S. Baumgartner
- Center for Analytical Chemistry; University of Natural Resources and Life Sciences; Vienna Austria
| | - K. Beyer
- Department of Paediatric Pneumology & Immunology; Charité University Medical Centre; Berlin Germany
| | | | | | - K. Grinter
- Allergen Bureau & Nestle; Rhodes New South Wales Australia
| | | | - J. Hourihane
- Paediatrics and Child Health; University College Cork; Cork Ireland
| | - F. Kenna
- Anaphylaxis Ireland; Cork Ireland
| | | | - G. Lack
- Division of Asthma, Allergy and Lung Biology; King's College London; MRC and Asthma UK Centre in Allergic Mechanisms of Asthma; Guy's and St Thomas’ NHS Foundation Trust; London UK
| | - C. B. Madsen
- National Food Institute; Technical University of Denmark; Søborg Denmark
| | - E. N. Clare Mills
- Institute of Inflammation and Repair; Manchester Academic Health Science Centre; Manchester Institute of Biotechnology; The University of Manchester; Manchester UK
| | - N. G. Papadopoulos
- Centre for Pediatrics and Child Health; Institute of Human Development; University of Manchester; Manchester UK
- Allergy Department; 2nd Pediatric Clinic; University of Athens; Athens Greece
| | | | - L. Regent
- Anaphylaxis Campaign; Farnborough UK
| | - R. Sherlock
- Allergen Bureau & DTS Facta; Hobart Australia
| | | | - G. Roberts
- Clinical and Experimental Sciences Academic Unit; University of Southampton Faculty of Medicine; Southampton UK
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust
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Arem H, Yu K, Xiong X, Moy K, Freedman ND, Mayne ST, Albanes D, Amundadottir LT, Arslan AA, Austin M, Bamlet WR, Beane-Freeman L, Bracci P, Canzian F, Chanock SJ, Cotterchio M, Duell EJ, Gallinger S, Giles GG, Goggins M, Goodman PJ, Hartge P, Hassan M, Helzlsouer K, Henderson B, Holly EA, Hoover R, Jacobs EJ, Kamineni A, Klein A, Klein E, Kolonel LN, Li D, Malats N, Männistö S, McCullough ML, Olson SH, Orlow I, Peters U, Petersen GM, Porta M, Severi G, Shu XO, Van Den Eeden S, Visvanathan K, White E, Yu H, Zeleniuch-Jacquotte A, Zheng W, Tobias GS, Maeder D, Brotzman M, Risch H, Sampson JN, Stolzenberg-Solomon RZ. Correction: vitamin d metabolic pathway genes and pancreatic cancer risk. PLoS One 2015; 10:e0129983. [PMID: 26039095 PMCID: PMC4454722 DOI: 10.1371/journal.pone.0129983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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29
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Arem H, Yu K, Xiong X, Moy K, Freedman ND, Mayne ST, Albanes D, Arslan AA, Austin M, Bamlet WR, Beane-Freeman L, Bracci P, Canzian F, Cotterchio M, Duell EJ, Gallinger S, Giles GG, Goggins M, Goodman PJ, Hartge P, Hassan M, Helzlsouer K, Henderson B, Holly EA, Hoover R, Jacobs EJ, Kamineni A, Klein A, Klein E, Kolonel LN, Li D, Malats N, Männistö S, McCullough ML, Olson SH, Orlow I, Peters U, Petersen GM, Porta M, Severi G, Shu XO, Visvanathan K, White E, Yu H, Zeleniuch-Jacquotte A, Zheng W, Tobias GS, Maeder D, Brotzman M, Risch H, Sampson JN, Stolzenberg-Solomon RZ. Vitamin D metabolic pathway genes and pancreatic cancer risk. PLoS One 2015; 10:e0117574. [PMID: 25799011 PMCID: PMC4370655 DOI: 10.1371/journal.pone.0117574] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 07/14/2014] [Accepted: 12/28/2014] [Indexed: 12/20/2022] Open
Abstract
Evidence on the association between vitamin D status and pancreatic cancer risk is inconsistent. This inconsistency may be partially attributable to variation in vitamin D regulating genes. We selected 11 vitamin D-related genes (GC, DHCR7, CYP2R1, VDR, CYP27B1, CYP24A1, CYP27A1, RXRA, CRP2, CASR and CUBN) totaling 213 single nucleotide polymorphisms (SNPs), and examined associations with pancreatic adenocarcinoma. Our study included 3,583 pancreatic cancer cases and 7,053 controls from the genome-wide association studies of pancreatic cancer PanScans-I-III. We used the Adaptive Joint Test and the Adaptive Rank Truncated Product statistic for pathway and gene analyses, and unconditional logistic regression for SNP analyses, adjusting for age, sex, study and population stratification. We examined effect modification by circulating vitamin D concentration (≤50, >50 nmol/L) for the most significant SNPs using a subset of cohort cases (n = 713) and controls (n = 878). The vitamin D metabolic pathway was not associated with pancreatic cancer risk (p = 0.830). Of the individual genes, none were associated with pancreatic cancer risk at a significance level of p<0.05. SNPs near the VDR (rs2239186), LRP2 (rs4668123), CYP24A1 (rs2762932), GC (rs2282679), and CUBN (rs1810205) genes were the top SNPs associated with pancreatic cancer (p-values 0.008-0.037), but none were statistically significant after adjusting for multiple comparisons. Associations between these SNPs and pancreatic cancer were not modified by circulating concentrations of vitamin D. These findings do not support an association between vitamin D-related genes and pancreatic cancer risk. Future research should explore other pathways through which vitamin D status might be associated with pancreatic cancer risk.
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Affiliation(s)
- Hannah Arem
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
- * E-mail:
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Xiaoqin Xiong
- Information Management Systems, Inc., Calverton, Maryland, United States of America
| | - Kristin Moy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Susan T. Mayne
- Yale School of Public Health/Yale Cancer Center, New Haven, Connecticut, United States of America
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Alan A. Arslan
- Departments of Population Health, Obstetrics and Gynecology (Obs/Gyn) and Environmental Medicine, New York University, New York, New York, United States of America
| | - Melissa Austin
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - William R. Bamlet
- Department of Epidemiology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Laura Beane-Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Paige Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Federico Canzian
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michelle Cotterchio
- Dalla Lana School of Public Health, University of Toronto; Prevention and Cancer Control, Cancer Care Ontario Toronto, Ontario, Canada
| | - Eric J. Duell
- Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Steve Gallinger
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Graham G. Giles
- Cancer Epidemiology Centre, Cancer Council Victoria and Centre for MEGA Epidemiology, School of Population Health, the University of Melbourne, Melbourne, Australia
| | - Michael Goggins
- Departments of Oncology, Pathology and Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Phyllis J. Goodman
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, United States of America
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Manal Hassan
- Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America
| | | | - Brian Henderson
- Department of Preventative Medicine, School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Elizabeth A. Holly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Robert Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Eric J. Jacobs
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia, United States of America
| | - Aruna Kamineni
- GroupHealth Research Institute, Seattle, Washington, United States of America
| | - Alison Klein
- MD Mercy, Baltimore, Maryland, United States of America
| | - Eric Klein
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, United States of America
| | | | - Donghui Li
- Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America
| | - Núria Malats
- Molecular Pathology Program, Spanish National Cancer Research Center, Madrid, Spain
| | - Satu Männistö
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland
| | - Marjorie L. McCullough
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia, United States of America
| | - Sara H. Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Ulrike Peters
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, United States of America
| | - Gloria M. Petersen
- Department of Epidemiology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Miquel Porta
- Hospital del Mar Institute of Medical Research (IMIM), and School of Medicine, Barcelona Spain
| | - Gianluca Severi
- Cancer Epidemiology Centre, Cancer Council Victoria and Centre for MEGA Epidemiology, School of Population Health, the University of Melbourne, Melbourne, Australia
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, United States of America
| | | | - Emily White
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, United States of America
| | - Herbert Yu
- University of Hawaii Cancer Center, Manoa, Hawaii, United States of America
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health, Obstetrics and Gynecology (Obs/Gyn) and Environmental Medicine, New York University, New York, New York, United States of America
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, and Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Geoffrey S. Tobias
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Dennis Maeder
- Cancer Genomics Research Laboratory, National Cancer Institute, Division of Cancer Epidemiology and Genetics, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | | | - Harvey Risch
- Yale School of Public Health/Yale Cancer Center, New Haven, Connecticut, United States of America
| | - Joshua N. Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
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Billings C, Hurdman J, Austin M, Armstrong I, Elliot C, Condliffe R, Kiely D. P170 Heart Rate Recovery At One Minute Following Incremental Shuttle Walk Test Predicts Outcome In Pulmonary Hypertension. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.299] [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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Gama S, Austin M, Jarvis M. Sickle cell solubility test: evaluation of an in-house method. Br J Biomed Sci 2014; 71:104-7. [PMID: 25265754 DOI: 10.1080/09674845.2014.11669973] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aims to assess the performance of an in-house sickle cell solubility test (SCT) and compare it against data published on other in-house and commercial methods. Also assessed are the effects of possible interference due to haemoglobin (Hb) level, Hb F and Hb S levels, as well as lipaemia, icterus and haemolysis index. A total of 1030 patient samples were tested by the SCT and subsequently confirmed by high-performance liquid chromatography (HPLC). Seventy-five (7.3%) samples revealed a positive SCT whereas 955 (92.7%) were negative. The sensitivity and specificity of the method was 100% and it was shown to detect low levels of Hb S (12.1%). These data show that the authors' in-house SCT method has an excellent performance against other documented methods (including some commercial kits), which is probably explained by its robustness against low levels of Hb S and interfering substances such as lipaemia. The authors believe this shows that in-house tests are able to produce highly reliable results comparable to, if not better than, certain commercially available CE-marked kits.
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Genant H, Bolognese M, Mautalen C, Brown J, Recknor C, Goemaere S, Engelke K, Yang YC, Austin M, Grauer A, Libanati C. OP0291 Romosozumab Administration is Associated with Significant Improvements in Lumbar Spine and Hip Volumetric Bone Mineral Density and Content Compared with Teriparatide. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2526] [Citation(s) in RCA: 2] [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: 11/03/2022]
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Bruce J, Parker A, Donald M, Esposito M, Curatolo L, Kennedy A, Simpson K, Morton C, Cormack J, Austin M. Impact of a dedicated trauma desk in ambulance control on the identification of major trauma in Scotland. Crit Care 2014. [PMCID: PMC4068883 DOI: 10.1186/cc13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Renteria LS, Austin M, Lazaro M, Andrews MA, Lustina J, Raj JU, Ibe BO. RhoA-Rho kinase and platelet-activating factor stimulation of ovine foetal pulmonary vascular smooth muscle cell proliferation. Cell Prolif 2013; 46:563-75. [PMID: 24033386 PMCID: PMC3788060 DOI: 10.1111/cpr.12052] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 05/17/2013] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Platelet-activating factor (PAF) is produced by pulmonary vascular smooth muscle cells (PVSMC). We studied effects of Rho kinase on PAF stimulation of PVSMC proliferation in an attempt to understand the role of RhoA/Rho kinase on PAF-induced ovine foetal pulmonary vascular remodelling. Our hypothesis is that PAF acts through Rho kinase, as one of its downstream signals, to induce arterial (SMC-PA) and venous (SMC-PV) cell proliferation in the hypoxic lung environment of the foetus, in utero. MATERIALS AND METHODS Rho kinase and MAPK effects on PAF receptor (PAFR)-mediated cell population expansion, and PAFR expression, were studied by DNA synthesis, western blot analysis and immunocytochemistry. Effects of constructs T19N and G14V on PAF-induced cell proliferation were also investigated. RESULTS Hypoxia increased PVSMC proliferation and Rho kinase inhibitors, Y-27632 and Fasudil (HA-1077) as well as MAPK inhibitors PD 98059 and SB 203580 attenuated PAF stimulation of cell proliferation. RhoA T19N and G14V stimulated cell proliferation, but co-incubation with PAF did not affect proliferative effects of the constructs. PAFR protein expression was significantly downregulated in both cell types by both Y-27632 and HA-1077, with comparable profiles. Also, cells treated with Y-27632 had less PAF receptor fluorescence with significant disruption of cell morphology. CONCLUSIONS Our results show that Rho kinase non-specifically modulated PAFR-mediated responses by a translational modification of PAFR protein, and suggest that, in vivo, activation of Rho kinase by PAF may be a further pathway to sustain PAFR-mediated PVSMC proliferation.
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Affiliation(s)
- L. S. Renteria
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
| | - M. Austin
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
| | - M. Lazaro
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
| | - M. A. Andrews
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
| | - J. Lustina
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
| | - J. U. Raj
- Department of PediatricsUniversity of Illinois ChicagoChicagoIL60612USA
| | - B. O. Ibe
- Division of NeonatologyDepartment of PediatricsLos Angeles Biomedical Research Institute at Harbor‐UCLA Medical CenterTorranceCA90502USA
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Törring O, Brown J, Jensen JE, Gilchrist N, Recknor C, Roux C, Austin M, Wang A, Grauer A, Ho PR, Wagman R. OP0037 Denosumab discontinuation and associated fracture incidence: Analysis from the freedom trial. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1720] [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: 11/03/2022]
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Martins RG, Parvathaneni U, Bauman JE, Sharma AK, Raez LE, Papagikos MA, Yunus F, Kurland BF, Eaton KD, Liao JJ, Mendez E, Futran N, Wang DX, Chai X, Wallace SG, Austin M, Schmidt R, Hayes DN. Cisplatin and radiotherapy with or without erlotinib in locally advanced squamous cell carcinoma of the head and neck: a randomized phase II trial. J Clin Oncol 2013; 31:1415-21. [PMID: 23460709 DOI: 10.1200/jco.2012.46.3299] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The combination of cisplatin and radiotherapy is a standard treatment for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Cetuximab-radiotherapy is superior to radiotherapy alone in this population, validating epidermal growth factor receptor (EGFR) as a target. Erlotinib is a small-molecule inhibitor of EGFR. Adding EGFR inhibition to standard cisplatin-radiotherapy may improve efficacy. PATIENTS AND METHODS Patients with locally advanced SCCHN were randomly assigned to receive cisplatin 100 mg/m(2) on days 1, 22, and 43 combined with 70 Gy of radiotherapy (arm A) or the same chemoradiotherapy with erlotinib 150 mg per day, starting 1 week before radiotherapy and continued to its completion (arm B). The primary end point was complete response rate (CRR), evaluated by central review. The secondary end point was progression-free survival (PFS). Available tumors were tested for p16 and EGFR by fluorescent in situ hybridization. RESULTS Between December 2006 and October 2011, 204 patients were randomly assigned. Arms were well balanced for all patient characteristics including p16, with the exception of more women on arm A. Patients on arm B had more rash, but treatment arms did not differ regarding rates of other grade 3 or 4 toxicities. Arm A had a CRR of 40% and arm B had a CRR of 52% (P = .08) when evaluated by central review. With a median follow-up time of 26 months and 54 progression events, there was no difference in PFS (hazard ratio, 0.9; P = .71). CONCLUSION Erlotinib did not increase the toxicity of cisplatin and radiotherapy in patients with locally advanced HNSCC but failed to significantly increase CRR or PFS.
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Affiliation(s)
- Renato G Martins
- University of Washington, Seattle Cancer Care Alliance, 825 Eastlake Ave E MS G4-940, Seattle, WA 98109, USA.
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Austin M, Ferrell C, Reyes M. Do elevated hematocrits prolong the PT/aPTT? Clin Lab Sci 2013; 26:89-94. [PMID: 23772474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The Clinical and Laboratory Standards Institute guidelines require special processing of whole blood specimens with hematocrits greater than 55% due to the possibility of spurious prolongation of routine coagulation studies (PT, aPTT). As samples with hematocrits above 60% are rare at our institution, our study seeks to determine the effect of relative citrate excess on routine coagulation studies in samples with hematocrits of 60% to determine whether special processing is necessary. A calculated volume of 3.2% citrate was added to 1 mL aliquots of 40 whole blood samples in citrated tubes from adult patients to simulate a hematocrit of 60%. A dilutional control was created by adding an equivalent volume of saline to a separate 1 mL aliquot. Routine coagulation studies (PT, aPTT) were run on both samples on the STA Compact Analyzer in accordance with manufacturer instructions. While a paired Student's t-test demonstrated a clinically significant change in both PT and aPTT with the addition of citrate (p = 0.0002 for PT and p = 0.0234 for aPTT), clinical management would not have been altered by any observed change. More interestingly, we observed a shortening of 27/40 PTs and 23/40 aPTTs rather than the expected prolongation. Based on our data, no adjustment of citrate volume appears to be necessary in samples with hematocrits less than or equal to 60%.
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Affiliation(s)
- Melissa Austin
- Department of Pathology, University of Washington Medical Center, Seattle, WA, USA.
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Austin M, Schmidt R, Parvathaneni U, Bauman JE, Hayes DN, Papagikos MA, Eaton KD, Liao JJ, Mendez E, Kurland BF, Xiaoyu S, Wallace SG, Martins R. Expression of p16, ERCC1, and EGFR amplification as predictors of responsiveness of locally advanced squamous cell carcinomas of head and neck (SCCHN) to cisplatin, radiotherapy, and erlotinib: A phase II randomized trial. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.5515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5515 Background: This study evaluated the expression of p16 and ERCC1 and EGFR amplification as predictive and prognostic factors in a recently completed phase II randomized trial comparing cisplatin (100 mg/m2 on d 1, 22, 43) with radiotherapy (70Gy) +/- erlotinib (150 mg/d during radiotherapy) in locally advanced SCCHN. p16 (HPV surrogate) is a known prognostic factor in oropharyngeal SCCHN, and high ERCC1 expression has been correlated with resistance to cisplatin. EGFR gene copy number may be prognostic in SCCHN and alter response to erlotinib. Methods: Pretreatment formalin-fixed, paraffin-embedded tumor tissue was available for 84/204 patients. EGFR copy number was assessed using Vysis LSI DNA probes, and immunohistochemistry was performed on Leica Bond III machines using Lab Vision ERCC-1 (8F1) and CINtec p16 antibodies. All assays were performed in accordance with manufacturer instructions; all studies were reviewed by a single Pathologist (MA) who was blinded to patient outcome. Logistic regression and Cox regression models fit a treatment arm by marker interaction and tested selected linear contrasts. Results: Efficacy analysis showed no difference in complete response rate (CRR) and progression-free survival (PFS) between treatment arms. However, PFS in both arms was better than historical comparisons, with only 46 events over a median follow-up of 23 months. Positivity in p16 was associated with greater CRR (OR 3.5, p=0.03) and longer PFS (HR=0.38; p= 0.07). The CRR effect was greater for the erlotinib arm (OR 8.1, p=0.01) than for Arm A (OR 1.5, p=0.56). The ERCC1 (+) rate was 46% (39/84).ERCC1 expression above the median was not associated with worse CRR (OR 0.69; p=0.46) or PFS (HR 0.99; p=0.98). Only 4 tumors showed EGFR amplification precluding further analysis. Conclusions: p16(+) tumors had a better outcome, similar to other recent trials, and erlotinib seemed to increase the CRR among p16(+) tumors. ERCC1 expression did not predict chemoradioresistance in this study. EGFR amplification was too rare in the tested population to assess predictive or prognostic value.
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Affiliation(s)
| | | | | | | | - David N. Hayes
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | - Brenda F Kurland
- Clinical Statistics, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Shawn Xiaoyu
- Fred Hutchinson Cancer Research Center, Seattle, WA
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Wood-Baker R, Walters EH, Blizzard L, Austin M. Prehospital oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. Intern Med J 2012; 42:229-30; author reply 231. [DOI: 10.1111/j.1445-5994.2011.02655.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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Lamb JJ, Holick MF, Lerman RH, Konda VR, Minich DM, Desai A, Chen TC, Austin M, Kornberg J, Chang JL, Hsi A, Bland JS, Tripp ML. Nutritional supplementation of hop rho iso-alpha acids, berberine, vitamin D3, and vitamin K1 produces a favorable bone biomarker profile supporting healthy bone metabolism in postmenopausal women with metabolic syndrome. Nutr Res 2011; 31:347-55. [DOI: 10.1016/j.nutres.2011.03.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 03/25/2011] [Accepted: 03/29/2011] [Indexed: 12/18/2022]
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Rowan W, Austin M, Beno J, Ellis R, Feder R, Ouroua A, Patel A, Phillips P. Electron cyclotron emission diagnostic for ITER. Rev Sci Instrum 2010; 81:10D935. [PMID: 21033963 DOI: 10.1063/1.3496978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Electron temperature measurements and electron thermal transport inferences will be critical to the nonactive and deuterium phases of ITER operation and will take on added importance during the alpha heating phase. The diagnostic must meet stringent criteria on spatial coverage and spatial resolution during full field operation. During the early phases of operation, it must operate equally well at half field. The key to the diagnostic is the front end design. It consists of a quasioptical antenna and a pair of calibration sources. The radial resolution of the diagnostic is less than 0.06 m. The spatial coverage extends at least from the core to the separatrix with first harmonic O-mode being used for the core and second harmonic X-mode being used for the pedestal. The instrumentation used for the core measurement at full field can be used for detection at half field by changing the detected polarization. Intermediate fields are accessible. The electron cyclotron emission systems require in situ calibration, which is provided by a novel hot calibration source. The critical component for the hot calibration source, the emissive surface, has been successfully tested. A prototype hot calibration source has been designed, making use of extensive thermal and mechanical modeling.
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Affiliation(s)
- W Rowan
- Institute for Fusion Studies, The University of Texas at Austin, Austin, Texas 78712, USA.
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Genant HK, Engelke K, Hanley DA, Brown JP, Omizo M, Bone HG, Kivitz AJ, Fuerst T, Wang H, Austin M, Libanati C. Denosumab improves density and strength parameters as measured by QCT of the radius in postmenopausal women with low bone mineral density. Bone 2010; 47:131-9. [PMID: 20399288 DOI: 10.1016/j.bone.2010.04.594] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 03/25/2010] [Accepted: 04/09/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bone strength is determined by both cortical and trabecular bone compartments and can be evaluated radiologically through measurement of bone density and geometry. Quantitative computed tomography (QCT) separately assesses cortical and trabecular bone reliably at various sites, including the distal radius where there is a gradation of cortical and trabecular bone. We evaluated the effect of denosumab, a fully human monoclonal antibody that inhibits RANK ligand, on distal radius QCT in women with low bone mass to assess the impact of this novel therapy separately on trabecular and cortical bone. METHODS Postmenopausal women (n=332) with spine areal bone mineral density (BMD) T-scores between -1.0 and -2.5 received denosumab 60 mg or placebo every 6 months during the 24-month study. QCT measurements along the distal radius were made using a whole-body computed tomography scanner and were used to determine the percentage change from baseline in volumetric BMD; volumetric bone mineral content (BMC); cortical thickness; volume; circumference; and density-weighted polar moment of inertia (PMI), a derived index of bone strength. RESULTS Denosumab treatment significantly increased total BMD and BMC along the radius (proximal, distal, and ultradistal sections). At 24 months, the ultradistal region had the greatest percentage increase in total BMD (4.7% [95% CI, 3.6-5.7]; P<0.001) and total BMC (5.7% [95% CI, 4.8-6.6]; P<0.001) over placebo. When cortical and trabecular bone at the proximal and distal regions were separately assessed, cortical bone had significant (P<0.001) increases in BMD, BMC, and thickness, and trabecular bone had a significant increase in BMD relative to placebo (P<0.05). Bone strength, estimated by density-weighted PMI, significantly increased compared with placebo after 6 months of treatment, with the largest percentage increase occurring at 24 months in the ultradistal region (6.6% [95% CI, 5.6-7.6]; P<0.0001). CONCLUSIONS QCT measurements demonstrated that denosumab significantly increased BMD, BMC, and PMI along the radius over 24 months. Additionally, denosumab prevented the decrease in QCT-measured cortical thickness observed in the placebo group. These data extend the evidence from previous dual-energy X-ray absorptiometry studies for a positive effect of denosumab on both the cortical and trabecular bone compartments and propose a possible mechanism for the reduction in fracture risk achieved with denosumab therapy.
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Affiliation(s)
- H K Genant
- Dept. of Radiology, University of California, San Francisco, CA 94143, USA.
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Holick MF, Lamb JJ, Lerman RH, Konda VR, Darland G, Minich DM, Desai A, Chen TC, Austin M, Kornberg J, Chang JL, Hsi A, Bland JS, Tripp ML. Hop rho iso-alpha acids, berberine, vitamin D3 and vitamin K1 favorably impact biomarkers of bone turnover in postmenopausal women in a 14-week trial. J Bone Miner Metab 2010; 28:342-50. [PMID: 20024591 DOI: 10.1007/s00774-009-0141-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 10/22/2009] [Indexed: 01/24/2023]
Abstract
Osteoporosis is a major health issue facing postmenopausal women. Increased production of pro-inflammatory cytokines resulting from declining estrogen leads to increased bone resorption. Nutrition can have a positive impact on osteoporosis prevention and amelioration. The objective of this study was to investigate the impact of targeted phytochemicals and nutrients essential for bone health on bone turnover markers in healthy postmenopausal women. In this 14-week, single-blinded, 2-arm placebo-controlled pilot study, all women were instructed to consume a modified Mediterranean-style low-glycemic-load diet and to engage in limited aerobic exercise; 17 randomized to the placebo and 16 to the treatment arm (receiving 200 mg hop rho iso-alpha acids, 100 mg berberine sulfate trihydrate, 500 IU vitamin D(3) and 500 microg vitamin K(1), twice daily). Thirty-two women completed the study. Baseline nutrient intake did not differ between arms. At 14 weeks, the treatment arm exhibited an estimated 31% mean reduction (P = 0.02) in serum osteocalcin (a marker of bone turnover), whereas the placebo arm exhibited a 19% increase (P = 0.03) compared to baseline. Serum 25-hydroxyvitamin D (25(OH)D) increased by 13% (P = 0.24) in the treatment arm and decreased by 25% (P < 0.01) in the placebo arm. The between-arm differences for OC and 25(OH)D were statistically significant. Serum IGF-I was increased in both arms, but the increase was more significant in the treatment arm at 14 weeks (P < 0.01). Treatment with hop rho iso-alpha acids, berberine sulfate trihydrate, vitamin D(3) and vitamin K(1) produced a more favorable bone biomarker profile that supports a healthy bone metabolism.
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Desai A, Konda VR, Darland G, Austin M, Prabhu KS, Bland JS, Carroll BJ, Tripp ML. META060 inhibits multiple kinases in the NF-kappaB pathway and suppresses LPS--mediated inflammation in vitro and ex vivo. Inflamm Res 2009; 58:229-34. [PMID: 19169645 DOI: 10.1007/s00011-008-8162-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE We investigated whether a novel candidate META060 targeted the inflammatory signal transduction without affecting constitutive COX-2 enzymatic activity in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. We also investigated its bioavailability in humans and its anti-inflammatory effect ex vivo. METHODS We measured prostaglandin E(2), nitric oxide, TNFalpha and IL-6 by ELISA, COX-2 protein by Western blot, NF-kappaB nuclear binding by electrophoretic mobility shift assays, and NF-kappaB activation by luciferase assay. Kinase inhibitions were measured by cell-free assays. Bioavailability was tested in 4 human subjects consuming 940 mg META060. LPS-activated TNFalpha and IL-6 were measured in peripheral blood mononuclear cells (PBMC) isolated from 1 subject up to 6 hours post administration. RESULTS META060 dose-dependently inhibited prostaglandin E(2) and nitric oxide formation, COX-2 abundance, and NF-kappaB activation. In cell-free assays, META060 inhibited multiple kinases in the NF-kappaB signaling pathway, including BTK, PI3K, and GSK3. META060 was detected in the plasma of the subjects; isolated PBMC were resistant to LPS-stimulated TNFalpha and IL-6 production. CONCLUSION Without inhibiting COX-2 enzyme, META060 reduces the inflammation by inhibiting multiple kinases involved in NF-kappaB pathway, and may have potential as a safe anti-inflammatory therapeutic.
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Affiliation(s)
- A Desai
- MetaProteomics Nutrigenomics Research Center, a subsidiary of Metagenics, Inc., Gig Harbor, WA 98332, USA.
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Wickenden JA, Jin H, Johnson M, Gillings AS, Newson C, Austin M, Chell SD, Balmanno K, Pritchard CA, Cook SJ. Colorectal cancer cells with the BRAF(V600E) mutation are addicted to the ERK1/2 pathway for growth factor-independent survival and repression of BIM. Oncogene 2008; 27:7150-61. [PMID: 18806830 DOI: 10.1038/onc.2008.335] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The RAF-mitogen-activated protein kinase kinase 1/2-extracellular signal-regulated kinase 1/2 (RAF-MEK1/2-ERK1/2) pathway is activated in many human tumours and can protect cells against growth factor deprivation; however, most such studies have relied upon overexpression of RAF or MEK constructs that are not found in tumours. Here we show that expression of the endogenous BRAF(V600E) allele in mouse embryonic fibroblasts from conditional knock-in transgenic mice activates ERK1/2, represses the BH3-only protein BIM and protects cells from growth factor withdrawal. Human colorectal cancer (CRC) cell lines harbouring BRAF(V600E) are growth factor independent for the activation of ERK1/2 and survival. However, treatment with the MEK1/2 inhibitors U0126, PD184352 or the novel clinical candidate AZD6244 (ARRY-142886) overcomes growth factor independence, causing CRC cell death. BIM is de-phosphorylated and upregulated following MEK1/2 inhibition in all CRC cell lines studied and knockdown of BIM reduces cell death, indicating that repression of BIM is a major part of the ability of BRAF(V600E) to confer growth factor-independent survival. We conclude that a single endogenous BRAF(V600E) allele is sufficient to repress BIM and prevent death arising from growth factor withdrawal, and CRC cells with BRAF(V600E) mutations are addicted to the ERK1/2 pathway for repression of BIM and growth factor-independent survival.
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Affiliation(s)
- J A Wickenden
- Laboratory of Molecular Signalling, The Babraham Institute, Babraham Research Campus, Babraham, Cambridge, UK
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Coltart I, Austin M, Shawcross DL. Response to "MELD score and serum sodium in the prediction of survival of patients with cirrhosis awaiting liver transplantation". Gut 2008; 57:1024-5. [PMID: 18559393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Portal A, Austin M, Bruce M, Sizer E, Auzinger G, Heneghan M, Wendon J. A comparison of Gc globulin and neutrophil gelatinase-associated lipocalin in patients with liver disease. Crit Care 2007. [PMCID: PMC4095447 DOI: 10.1186/cc5554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Austin M, Portal A, Wendon J. What is the role of carboxyhaemoglobin in patients with liver failure? Crit Care 2007. [PMCID: PMC4095450 DOI: 10.1186/cc5557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Austin M, McMillan H, Edwards J, Hope S, Baldi M, Zhang M, Plunkett J, Meredith I. How Representative are Early Phase Study Patients? A Single Centre Experience. Heart Lung Circ 2007. [DOI: 10.1016/j.hlc.2007.06.451] [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: 11/26/2022]
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