1
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Hill ME, Martin A, DeMauro SB. Reading to the Preterm Infant: Parent Perspectives on Barriers and Facilitators. Acad Pediatr 2023; 23:148-154. [PMID: 36055450 DOI: 10.1016/j.acap.2022.08.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe parent-reported barriers and facilitators to reading to preterm-born infants, both in the neonatal intensive care unit (NICU) and at home. We hypothesized that families of preterm infants face unique barriers previously not described in the literature, and that understanding barriers from the parent perspective will uncover strategies for improving the NICU environment and cognitive home environment and allow refinement of current reading programs. METHODS We performed a qualitative study of parents of 0 to 12 month corrected age infants presenting to neonatal follow-up clinic. Infants were born <33 weeks gestational age or with birth weight ≤1500 grams. Parents completed a semistructured interview about reading practices. Answers to open-ended questions were coded to highlight key themes. RESULTS We reached thematic saturation after interviewing 23 parents of 28 infants. Parent-generated items about barriers and facilitators to reading in the NICU and at home were each coded into 4 themes. Competing responsibilities and believing that reading was developmentally inappropriate were 2 shared themes for barriers to reading in both the NICU and home environment. Support people and understanding developmental impact were 2 shared themes for facilitators to reading in both the NICU and home environment. CONCLUSIONS This qualitative work elucidates new targets for novel programs intended to support cognitive development of high-risk preterm infants. Addressing the unique, parent-reported barriers that we have identified and supporting adoption of the facilitators could increase word exposure for preterm infants, starting in the NICU and continuing at home.
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Affiliation(s)
- Morgan E Hill
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA
| | - Ashley Martin
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA
| | - Sara B DeMauro
- Division of Neonatology, Department of Pediatrics (ME Hill, A Martin, SB DeMauro), Children's Hospital of Philadelphia - Roberts Center for Pediatric Research, Philadelphia, PA; Division of Neonatology, Department of Pediatrics (SB DeMauro), University of Pennsylvania Perelman School of Medicine.
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2
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Hill ME, Ledyard RF, Wildenhain P, Taha D, Dori Y, Burris HH. Hypereosinophilia in NICU patients with a neonatal lymphatic flow disorder. J Perinatol 2022; 42:1538-1539. [PMID: 35859185 DOI: 10.1038/s41372-022-01460-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Morgan E Hill
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Rachel F Ledyard
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Paul Wildenhain
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dalal Taha
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Yoav Dori
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Heather H Burris
- Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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3
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Abstract
Digital recording and video review of delivery room resuscitations is a proven useful tool to evaluate neonatal resuscitation program (NRP) technical and non-technical skills. It is also valuable for research, quality improvement, and individual and group learning. Digital recording and video review programs are growing in number, and planning and implementation of digital recording requires careful thought. Consideration of technology requirements, policy implementation, and stakeholder involvement is essential to implement a successful digital recording and video review program. Video review can then be applied for individual and team-based learning. An approach to sustainability and on-going quality review of the program are key components critical to success.
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Affiliation(s)
- Morgan E Hill
- Division of Neonatology, Perinatal Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Sofia R Aliaga
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth E Foglia
- Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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4
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Flynn RS, Hill ME, Rood JE, Parga JJ. Abnormal Eye Movements and Poor Feeding in an Infant. Clin Pediatr (Phila) 2020; 59:532-535. [PMID: 31971002 DOI: 10.1177/0009922819901013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rachel S Flynn
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Morgan E Hill
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Julia E Rood
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joanna J Parga
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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5
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Spencer JR, Stern SA, Moore JM, Weaver HA, Singer KN, Olkin CB, Verbiscer AJ, McKinnon WB, Parker JW, Beyer RA, Keane JT, Lauer TR, Porter SB, White OL, Buratti BJ, El-Maarry MR, Lisse CM, Parker AH, Throop HB, Robbins SJ, Umurhan OM, Binzel RP, Britt DT, Buie MW, Cheng AF, Cruikshank DP, Elliott HA, Gladstone GR, Grundy WM, Hill ME, Horanyi M, Jennings DE, Kavelaars JJ, Linscott IR, McComas DJ, McNutt RL, Protopapa S, Reuter DC, Schenk PM, Showalter MR, Young LA, Zangari AM, Abedin AY, Beddingfield CB, Benecchi SD, Bernardoni E, Bierson CJ, Borncamp D, Bray VJ, Chaikin AL, Dhingra RD, Fuentes C, Fuse T, Gay PL, Gwyn SDJ, Hamilton DP, Hofgartner JD, Holman MJ, Howard AD, Howett CJA, Karoji H, Kaufmann DE, Kinczyk M, May BH, Mountain M, Pätzold M, Petit JM, Piquette MR, Reid IN, Reitsema HJ, Runyon KD, Sheppard SS, Stansberry JA, Stryk T, Tanga P, Tholen DJ, Trilling DE, Wasserman LH. The geology and geophysics of Kuiper Belt object (486958) Arrokoth. Science 2020; 367:science.aay3999. [PMID: 32054694 DOI: 10.1126/science.aay3999] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 01/27/2020] [Indexed: 11/02/2022]
Abstract
The Cold Classical Kuiper Belt, a class of small bodies in undisturbed orbits beyond Neptune, is composed of primitive objects preserving information about Solar System formation. In January 2019, the New Horizons spacecraft flew past one of these objects, the 36-kilometer-long contact binary (486958) Arrokoth (provisional designation 2014 MU69). Images from the flyby show that Arrokoth has no detectable rings, and no satellites (larger than 180 meters in diameter) within a radius of 8000 kilometers. Arrokoth has a lightly cratered, smooth surface with complex geological features, unlike those on previously visited Solar System bodies. The density of impact craters indicates the surface dates from the formation of the Solar System. The two lobes of the contact binary have closely aligned poles and equators, constraining their accretion mechanism.
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Affiliation(s)
- J R Spencer
- Southwest Research Institute, Boulder, CO 80302, USA.
| | - S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J M Moore
- NASA Ames Research Center, Moffett Field, CA 94035-1000, USA
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K N Singer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A J Verbiscer
- Department of Astronomy, University of Virginia, Charlottesville, VA 22904, USA
| | - W B McKinnon
- Department of Earth and Planetary Sciences and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - J Wm Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - R A Beyer
- SETI Institute, Mountain View, CA 94043, USA.,NASA Ames Research Center, Moffett Field, CA 94035-1000, USA
| | - J T Keane
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - T R Lauer
- National Science Foundation's National Optical Infrared Astronomy Research Laboratory, Tucson, AZ 26732, USA
| | - S B Porter
- Southwest Research Institute, Boulder, CO 80302, USA
| | - O L White
- SETI Institute, Mountain View, CA 94043, USA.,NASA Ames Research Center, Moffett Field, CA 94035-1000, USA
| | - B J Buratti
- Jet Propulsion Laboratory, California Institute of Technology Pasadena, CA 91109, USA
| | - M R El-Maarry
- Department of Earth and Planetary Sciences, Birkbeck, University of London, London WC1E 7HX, UK.,University College London, Gower St, Bloomsbury, London WC1E 6BT, UK
| | - C M Lisse
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A H Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H B Throop
- Independent Consultant, Washington, D.C., USA
| | - S J Robbins
- Southwest Research Institute, Boulder, CO 80302, USA
| | - O M Umurhan
- NASA Ames Research Center, Moffett Field, CA 94035-1000, USA
| | - R P Binzel
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - D T Britt
- Department of Physics, University of Central Florida, Orlando, FL 32816, USA
| | - M W Buie
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A F Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D P Cruikshank
- NASA Ames Research Center, Moffett Field, CA 94035-1000, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - W M Grundy
- Lowell Observatory, Flagstaff, AZ 86001, USA.,Department of Astronomy and Planetary Science, Northern Arizona University, Flagstaff, AZ, 86011, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Horanyi
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - D E Jennings
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - J J Kavelaars
- National Research Council of Canada, Victoria, BC V9E 2E7, Canada
| | - I R Linscott
- Independent Consultant, Mountain View, CA 94043, USA
| | - D J McComas
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S Protopapa
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D C Reuter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - P M Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | | | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A M Zangari
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A Y Abedin
- National Research Council of Canada, Victoria, BC V9E 2E7, Canada
| | | | - S D Benecchi
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - E Bernardoni
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - C J Bierson
- Earth and Planetary Science Department, University of California, Santa Cruz, CA 95064, USA
| | - D Borncamp
- Decipher Technology Studios, Alexandria, VA 22314, USA
| | - V J Bray
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - A L Chaikin
- Independent Science Writer, Arlington, VT 05250, USA
| | | | - C Fuentes
- Universidad de Chile, Centro de Astrofísica y Tecnologías Afines, Santiago, Chile
| | - T Fuse
- Kashima Space Technology Center, National Institute of Information and Communications Technology, Kashima, Ibaraki 314-8501, Japan
| | - P L Gay
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - S D J Gwyn
- National Research Council of Canada, Victoria, BC V9E 2E7, Canada
| | - D P Hamilton
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - J D Hofgartner
- Jet Propulsion Laboratory, California Institute of Technology Pasadena, CA 91109, USA
| | - M J Holman
- Center for Astrophysics, Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138, USA
| | - A D Howard
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904, USA
| | - C J A Howett
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H Karoji
- National Institutes of Natural Sciences, Tokyo, Japan
| | - D E Kaufmann
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M Kinczyk
- Marine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - B H May
- Independent Collaborator, Windlesham GU20 6YW, UK
| | - M Mountain
- Association of Universities for Research in Astronomy, Washington, DC 20004, USA
| | - M Pätzold
- Rheinisches Institut für Umweltforschung an der Universität zu Köln, Cologne 50931, Germany
| | - J M Petit
- Institut Univers, Temps-fréquence, Interfaces, Nanostructures, Atmosphère et environnement, Molécules, Unité Mixte de Recherche, Centre National de la Recherche Scientifique, Universite Bourgogne Franche Comte, F-25000 Besancon, France
| | - M R Piquette
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - I N Reid
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | | | - K D Runyon
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S S Sheppard
- Department of Terrestrial Magnetism, Carnegie Institution for Science, Washington, DC 20015, USA
| | - J A Stansberry
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - T Stryk
- Roane State Community College, Oak Ridge, TN 37830, USA
| | - P Tanga
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Laboratoire Lagrange/ Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7293, 06304 Nice Cedex 4, France
| | - D J Tholen
- Institute for Astronomy, University of Hawaii, Honolulu, HI 96822, USA
| | - D E Trilling
- Department of Astronomy and Planetary Science, Northern Arizona University, Flagstaff, AZ, 86011, USA
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6
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Grundy WM, Bird MK, Britt DT, Cook JC, Cruikshank DP, Howett CJA, Krijt S, Linscott IR, Olkin CB, Parker AH, Protopapa S, Ruaud M, Umurhan OM, Young LA, Dalle Ore CM, Kavelaars JJ, Keane JT, Pendleton YJ, Porter SB, Scipioni F, Spencer JR, Stern SA, Verbiscer AJ, Weaver HA, Binzel RP, Buie MW, Buratti BJ, Cheng A, Earle AM, Elliott HA, Gabasova L, Gladstone GR, Hill ME, Horanyi M, Jennings DE, Lunsford AW, McComas DJ, McKinnon WB, McNutt RL, Moore JM, Parker JW, Quirico E, Reuter DC, Schenk PM, Schmitt B, Showalter MR, Singer KN, Weigle GE, Zangari AM. Color, composition, and thermal environment of Kuiper Belt object (486958) Arrokoth. Science 2020; 367:science.aay3705. [PMID: 32054693 DOI: 10.1126/science.aay3705] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/22/2020] [Indexed: 11/02/2022]
Abstract
The outer Solar System object (486958) Arrokoth (provisional designation 2014 MU69) has been largely undisturbed since its formation. We studied its surface composition using data collected by the New Horizons spacecraft. Methanol ice is present along with organic material, which may have formed through irradiation of simple molecules. Water ice was not detected. This composition indicates hydrogenation of carbon monoxide-rich ice and/or energetic processing of methane condensed on water ice grains in the cold, outer edge of the early Solar System. There are only small regional variations in color and spectra across the surface, which suggests that Arrokoth formed from a homogeneous or well-mixed reservoir of solids. Microwave thermal emission from the winter night side is consistent with a mean brightness temperature of 29 ± 5 kelvin.
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Affiliation(s)
- W M Grundy
- Lowell Observatory, Flagstaff, AZ 86001, USA. .,Department of Astronomy and Planetary Science, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - M K Bird
- Argelander-Institut für Astronomie, University of Bonn, D-53121 Bonn, Germany.,Rheinisches Institut für Umweltforschung, Universität zu Köln, 50931 Cologne, Germany
| | - D T Britt
- University of Central Florida, Orlando, FL 32816, USA
| | - J C Cook
- Pinhead Institute, Telluride, CO 81435, USA
| | | | - C J A Howett
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Krijt
- Steward Observatory, University of Arizona, Tucson, AZ 85719, USA
| | | | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A H Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Protopapa
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M Ruaud
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - O M Umurhan
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C M Dalle Ore
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - J J Kavelaars
- National Research Council, Victoria, BC V9E 2E7, Canada.,Department of Physics and Astronomy, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - J T Keane
- California Institute of Technology, Pasadena, CA 91125, USA
| | - Y J Pendleton
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - S B Porter
- Southwest Research Institute, Boulder, CO 80302, USA
| | - F Scipioni
- NASA Ames Research Center, Moffett Field, CA 94035, USA.,Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - J R Spencer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A J Verbiscer
- University of Virginia, Charlottesville, VA 22904, USA
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R P Binzel
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - M W Buie
- Southwest Research Institute, Boulder, CO 80302, USA
| | - B J Buratti
- NASA Jet Propulsion Laboratory, La Cañada Flintridge, CA 91011, USA
| | - A Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A M Earle
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - L Gabasova
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Horanyi
- University of Colorado, Boulder, CO 80309, USA
| | - D E Jennings
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - A W Lunsford
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D J McComas
- Princeton University, Princeton, NJ 08544, USA
| | | | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J M Moore
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - J W Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E Quirico
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - D C Reuter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - P M Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | - B Schmitt
- Institut de Planétologie et d'Astrophysique de Grenoble, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Grenoble, France
| | - M R Showalter
- Carl Sagan Center, SETI Institute, Mountain View, CA 94043, USA
| | - K N Singer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - G E Weigle
- Big Head Endian LLC, Leawood, KS 67019, USA
| | - A M Zangari
- Southwest Research Institute, Boulder, CO 80302, USA
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7
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McComas DJ, Christian ER, Cohen CMS, Cummings AC, Davis AJ, Desai MI, Giacalone J, Hill ME, Joyce CJ, Krimigis SM, Labrador AW, Leske RA, Malandraki O, Matthaeus WH, McNutt RL, Mewaldt RA, Mitchell DG, Posner A, Rankin JS, Roelof EC, Schwadron NA, Stone EC, Szalay JR, Wiedenbeck ME, Bale SD, Kasper JC, Case AW, Korreck KE, MacDowall RJ, Pulupa M, Stevens ML, Rouillard AP. Probing the energetic particle environment near the Sun. Nature 2019; 576:223-227. [PMID: 31802005 PMCID: PMC6908744 DOI: 10.1038/s41586-019-1811-1] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022]
Abstract
NASA's Parker Solar Probe mission1 recently plunged through the inner heliosphere of the Sun to its perihelia, about 24 million kilometres from the Sun. Previous studies farther from the Sun (performed mostly at a distance of 1 astronomical unit) indicate that solar energetic particles are accelerated from a few kiloelectronvolts up to near-relativistic energies via at least two processes: 'impulsive' events, which are usually associated with magnetic reconnection in solar flares and are typically enriched in electrons, helium-3 and heavier ions2, and 'gradual' events3,4, which are typically associated with large coronal-mass-ejection-driven shocks and compressions moving through the corona and inner solar wind and are the dominant source of protons with energies between 1 and 10 megaelectronvolts. However, some events show aspects of both processes and the electron-proton ratio is not bimodally distributed, as would be expected if there were only two possible processes5. These processes have been very difficult to resolve from prior observations, owing to the various transport effects that affect the energetic particle population en route to more distant spacecraft6. Here we report observations of the near-Sun energetic particle radiation environment over the first two orbits of the probe. We find a variety of energetic particle events accelerated both locally and remotely including by corotating interaction regions, impulsive events driven by acceleration near the Sun, and an event related to a coronal mass ejection. We provide direct observations of the energetic particle radiation environment in the region just above the corona of the Sun and directly explore the physics of particle acceleration and transport.
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Affiliation(s)
- D J McComas
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA.
| | | | - C M S Cohen
- California Institute of Technology, Pasadena, CA, USA
| | - A C Cummings
- California Institute of Technology, Pasadena, CA, USA
| | - A J Davis
- California Institute of Technology, Pasadena, CA, USA
| | - M I Desai
- Southwest Research Institute, San Antonio, TX, USA
- University of Texas at San Antonio, San Antonio, TX, USA
| | | | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - C J Joyce
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - S M Krimigis
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - A W Labrador
- California Institute of Technology, Pasadena, CA, USA
| | - R A Leske
- California Institute of Technology, Pasadena, CA, USA
| | - O Malandraki
- National Observatory of Athens, IAASARS, Athens, Greece
| | | | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - R A Mewaldt
- California Institute of Technology, Pasadena, CA, USA
| | - D G Mitchell
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | | | - J S Rankin
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - E C Roelof
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - N A Schwadron
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
- University of New Hampshire, Durham, NH, USA
| | - E C Stone
- California Institute of Technology, Pasadena, CA, USA
| | - J R Szalay
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - M E Wiedenbeck
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - S D Bale
- University of California at Berkeley, Berkeley, CA, USA
- The Blackett Laboratory, Imperial College London, London, UK
| | - J C Kasper
- University of Michigan, Ann Arbor, MI, USA
| | - A W Case
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | - K E Korreck
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
| | | | - M Pulupa
- University of California at Berkeley, Berkeley, CA, USA
| | - M L Stevens
- Smithsonian Astrophysical Observatory, Cambridge, MA, USA
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8
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Stern SA, Weaver HA, Spencer JR, Olkin CB, Gladstone GR, Grundy WM, Moore JM, Cruikshank DP, Elliott HA, McKinnon WB, Parker JW, Verbiscer AJ, Young LA, Aguilar DA, Albers JM, Andert T, Andrews JP, Bagenal F, Banks ME, Bauer BA, Bauman JA, Bechtold KE, Beddingfield CB, Behrooz N, Beisser KB, Benecchi SD, Bernardoni E, Beyer RA, Bhaskaran S, Bierson CJ, Binzel RP, Birath EM, Bird MK, Boone DR, Bowman AF, Bray VJ, Britt DT, Brown LE, Buckley MR, Buie MW, Buratti BJ, Burke LM, Bushman SS, Carcich B, Chaikin AL, Chavez CL, Cheng AF, Colwell EJ, Conard SJ, Conner MP, Conrad CA, Cook JC, Cooper SB, Custodio OS, Dalle Ore CM, Deboy CC, Dharmavaram P, Dhingra RD, Dunn GF, Earle AM, Egan AF, Eisig J, El-Maarry MR, Engelbrecht C, Enke BL, Ercol CJ, Fattig ED, Ferrell CL, Finley TJ, Firer J, Fischetti J, Folkner WM, Fosbury MN, Fountain GH, Freeze JM, Gabasova L, Glaze LS, Green JL, Griffith GA, Guo Y, Hahn M, Hals DW, Hamilton DP, Hamilton SA, Hanley JJ, Harch A, Harmon KA, Hart HM, Hayes J, Hersman CB, Hill ME, Hill TA, Hofgartner JD, Holdridge ME, Horányi M, Hosadurga A, Howard AD, Howett CJA, Jaskulek SE, Jennings DE, Jensen JR, Jones MR, Kang HK, Katz DJ, Kaufmann DE, Kavelaars JJ, Keane JT, Keleher GP, Kinczyk M, Kochte MC, Kollmann P, Krimigis SM, Kruizinga GL, Kusnierkiewicz DY, Lahr MS, Lauer TR, Lawrence GB, Lee JE, Lessac-Chenen EJ, Linscott IR, Lisse CM, Lunsford AW, Mages DM, Mallder VA, Martin NP, May BH, McComas DJ, McNutt RL, Mehoke DS, Mehoke TS, Nelson DS, Nguyen HD, Núñez JI, Ocampo AC, Owen WM, Oxton GK, Parker AH, Pätzold M, Pelgrift JY, Pelletier FJ, Pineau JP, Piquette MR, Porter SB, Protopapa S, Quirico E, Redfern JA, Regiec AL, Reitsema HJ, Reuter DC, Richardson DC, Riedel JE, Ritterbush MA, Robbins SJ, Rodgers DJ, Rogers GD, Rose DM, Rosendall PE, Runyon KD, Ryschkewitsch MG, Saina MM, Salinas MJ, Schenk PM, Scherrer JR, Schlei WR, Schmitt B, Schultz DJ, Schurr DC, Scipioni F, Sepan RL, Shelton RG, Showalter MR, Simon M, Singer KN, Stahlheber EW, Stanbridge DR, Stansberry JA, Steffl AJ, Strobel DF, Stothoff MM, Stryk T, Stuart JR, Summers ME, Tapley MB, Taylor A, Taylor HW, Tedford RM, Throop HB, Turner LS, Umurhan OM, Van Eck J, Velez D, Versteeg MH, Vincent MA, Webbert RW, Weidner SE, Weigle GE, Wendel JR, White OL, Whittenburg KE, Williams BG, Williams KE, Williams SP, Winters HL, Zangari AM, Zurbuchen TH. Initial results from the New Horizons exploration of 2014 MU 69, a small Kuiper Belt object. Science 2019; 364:364/6441/eaaw9771. [PMID: 31097641 DOI: 10.1126/science.aaw9771] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/16/2019] [Indexed: 11/02/2022]
Abstract
The Kuiper Belt is a distant region of the outer Solar System. On 1 January 2019, the New Horizons spacecraft flew close to (486958) 2014 MU69, a cold classical Kuiper Belt object approximately 30 kilometers in diameter. Such objects have never been substantially heated by the Sun and are therefore well preserved since their formation. We describe initial results from these encounter observations. MU69 is a bilobed contact binary with a flattened shape, discrete geological units, and noticeable albedo heterogeneity. However, there is little surface color or compositional heterogeneity. No evidence for satellites, rings or other dust structures, a gas coma, or solar wind interactions was detected. MU69's origin appears consistent with pebble cloud collapse followed by a low-velocity merger of its two lobes.
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Affiliation(s)
- S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA.
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J R Spencer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - W M Grundy
- Lowell Observatory, Flagstaff, AZ 86001, USA
| | - J M Moore
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA
| | - D P Cruikshank
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78238, USA.,Department of Physics and Astronomy, University of Texas, San Antonio, TX 78249, USA
| | - W B McKinnon
- Department of Earth and Planetary Sciences and McDonnell Center for the Space Sciences, Washington University, St. Louis, MO 63130, USA
| | - J Wm Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A J Verbiscer
- Department of Astronomy, University of Virginia, Charlottesville, VA 22904, USA
| | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D A Aguilar
- Independent consultant, Carbondale, CO 81623, USA
| | - J M Albers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T Andert
- Universität der Bundeswehr München, Neubiberg 85577, Germany
| | - J P Andrews
- Southwest Research Institute, Boulder, CO 80302, USA
| | - F Bagenal
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - M E Banks
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - B A Bauer
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - K E Bechtold
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C B Beddingfield
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - N Behrooz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K B Beisser
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S D Benecchi
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - E Bernardoni
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - R A Beyer
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - S Bhaskaran
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - C J Bierson
- Earth and Planetary Science Department, University of California, Santa Cruz, CA 95064, USA
| | - R P Binzel
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - E M Birath
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M K Bird
- Argelander-Institut für Astronomie, University of Bonn, Bonn D-53121, Germany.,Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | - D R Boone
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - A F Bowman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - V J Bray
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - D T Britt
- Department of Physics, University of Central Florida, Orlando, FL 32816, USA
| | - L E Brown
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R Buckley
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M W Buie
- Southwest Research Institute, Boulder, CO 80302, USA
| | - B J Buratti
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - L M Burke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S S Bushman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B Carcich
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA.,Cornell University, Ithaca, NY 14853, USA
| | - A L Chaikin
- Independent science writer, Arlington, VT 05250, USA
| | - C L Chavez
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - A F Cheng
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - E J Colwell
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S J Conard
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M P Conner
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C A Conrad
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J C Cook
- Pinhead Institute, Telluride, CO 81435, USA
| | - S B Cooper
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - O S Custodio
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C M Dalle Ore
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - C C Deboy
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - P Dharmavaram
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - G F Dunn
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A M Earle
- Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - A F Egan
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J Eisig
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R El-Maarry
- Department of Earth and Planetary Sciences, Birkbeck, University of London, London WC1E 7HX, UK
| | - C Engelbrecht
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B L Enke
- Southwest Research Institute, Boulder, CO 80302, USA
| | - C J Ercol
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - E D Fattig
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - C L Ferrell
- Southwest Research Institute, Boulder, CO 80302, USA
| | - T J Finley
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J Firer
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - W M Folkner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M N Fosbury
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G H Fountain
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J M Freeze
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - L Gabasova
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - L S Glaze
- NASA Headquarters, Washington, DC 20546, USA
| | - J L Green
- NASA Headquarters, Washington, DC 20546, USA
| | - G A Griffith
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - Y Guo
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Hahn
- Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | - D W Hals
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D P Hamilton
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - S A Hamilton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J J Hanley
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A Harch
- Cornell University, Ithaca, NY 14853, USA
| | - K A Harmon
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - H M Hart
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J Hayes
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C B Hersman
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T A Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J D Hofgartner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M E Holdridge
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Horányi
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - A Hosadurga
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A D Howard
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904, USA
| | - C J A Howett
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S E Jaskulek
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D E Jennings
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - J R Jensen
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M R Jones
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - H K Kang
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D J Katz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D E Kaufmann
- Southwest Research Institute, Boulder, CO 80302, USA
| | - J J Kavelaars
- National Research Council of Canada, Victoria, BC V9E 2E7, Canada
| | - J T Keane
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125, USA
| | - G P Keleher
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Kinczyk
- Marine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - M C Kochte
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - P Kollmann
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S M Krimigis
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G L Kruizinga
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - D Y Kusnierkiewicz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M S Lahr
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T R Lauer
- National Optical Astronomy Observatory, Tucson, AZ 26732, USA
| | - G B Lawrence
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J E Lee
- NASA Marshall Space Flight Center, Huntsville, AL 35812, USA
| | | | - I R Linscott
- Independent consultant, Mountain View, CA 94043, USA
| | - C M Lisse
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A W Lunsford
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D M Mages
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - V A Mallder
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - N P Martin
- Independent consultant, Crested Butte, CO 81224, USA
| | - B H May
- Independent collaborator, Windlesham GU20 6YW, UK
| | - D J McComas
- Southwest Research Institute, San Antonio, TX 78238, USA.,Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D S Mehoke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - T S Mehoke
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - H D Nguyen
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - J I Núñez
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A C Ocampo
- NASA Headquarters, Washington, DC 20546, USA
| | - W M Owen
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - G K Oxton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A H Parker
- Southwest Research Institute, Boulder, CO 80302, USA
| | - M Pätzold
- Rheinisches Institut für Umweltforschung, Universität zu Köln, Cologne 50931, Germany
| | | | | | - J P Pineau
- Stellar Solutions, Palo Alto, CA 94306, USA
| | - M R Piquette
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - S B Porter
- Southwest Research Institute, Boulder, CO 80302, USA
| | - S Protopapa
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E Quirico
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - J A Redfern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - A L Regiec
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - D C Reuter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - D C Richardson
- Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | - J E Riedel
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M A Ritterbush
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - S J Robbins
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D J Rodgers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - G D Rogers
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D M Rose
- Southwest Research Institute, Boulder, CO 80302, USA
| | - P E Rosendall
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K D Runyon
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M G Ryschkewitsch
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M M Saina
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - P M Schenk
- Lunar and Planetary Institute, Houston, TX 77058, USA
| | - J R Scherrer
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - W R Schlei
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - B Schmitt
- University Grenoble Alpes, Centre National de la Recherche Scientifique, Institut de Planétologie et d'Astrophysique de Grenoble, 38000 Grenoble, France
| | - D J Schultz
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D C Schurr
- NASA Headquarters, Washington, DC 20546, USA
| | - F Scipioni
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - R L Sepan
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R G Shelton
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - M Simon
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - K N Singer
- Southwest Research Institute, Boulder, CO 80302, USA
| | - E W Stahlheber
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - J A Stansberry
- Space Telescope Science Institute, Baltimore, MD 21218, USA
| | - A J Steffl
- Southwest Research Institute, Boulder, CO 80302, USA
| | - D F Strobel
- Johns Hopkins University, Baltimore, MD 21218, USA
| | - M M Stothoff
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - T Stryk
- Roane State Community College, Oak Ridge, TN 37830, USA
| | - J R Stuart
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M E Summers
- George Mason University, Fairfax, VA 22030, USA
| | - M B Tapley
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - A Taylor
- KinetX Aerospace, Tempe, AZ 85284, USA
| | - H W Taylor
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - R M Tedford
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H B Throop
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - L S Turner
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - O M Umurhan
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - J Van Eck
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D Velez
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - M H Versteeg
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M A Vincent
- Southwest Research Institute, Boulder, CO 80302, USA
| | - R W Webbert
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S E Weidner
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - G E Weigle
- Independent consultant, Burden, KS 67019, USA
| | - J R Wendel
- NASA Headquarters, Washington, DC 20546, USA
| | - O L White
- NASA Ames Research Center, Space Science Division, Moffett Field, CA 94035, USA.,SETI Institute, Mountain View, CA 94043, USA
| | - K E Whittenburg
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | | | - S P Williams
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - H L Winters
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - A M Zangari
- Southwest Research Institute, Boulder, CO 80302, USA
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Bagenal F, Horányi M, McComas DJ, McNutt RL, Elliott HA, Hill ME, Brown LE, Delamere PA, Kollmann P, Krimigis SM, Kusterer M, Lisse CM, Mitchell DG, Piquette M, Poppe AR, Strobel DF, Szalay JR, Valek P, Vandegriff J, Weidner S, Zirnstein EJ, Stern SA, Ennico K, Olkin CB, Weaver HA, Young LA. Pluto's interaction with its space environment: Solar wind, energetic particles, and dust. Science 2016; 351:aad9045. [PMID: 26989259 DOI: 10.1126/science.aad9045] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The New Horizons spacecraft carried three instruments that measured the space environment near Pluto as it flew by on 14 July 2015. The Solar Wind Around Pluto (SWAP) instrument revealed an interaction region confined sunward of Pluto to within about 6 Pluto radii. The region's surprisingly small size is consistent with a reduced atmospheric escape rate, as well as a particularly high solar wind flux. Observations from the Pluto Energetic Particle Spectrometer Science Investigation (PEPSSI) instrument suggest that ions are accelerated and/or deflected around Pluto. In the wake of the interaction region, PEPSSI observed suprathermal particle fluxes equal to about 1/10 of the flux in the interplanetary medium and increasing with distance downstream. The Venetia Burney Student Dust Counter, which measures grains with radii larger than 1.4 micrometers, detected one candidate impact in ±5 days around New Horizons' closest approach, indicating an upper limit of <4.6 kilometers(-3) for the dust density in the Pluto system.
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Affiliation(s)
- F Bagenal
- Laboratory of Atmospheric and Space Physics, University of Colorado, Boulder, CO 80600, USA.
| | - M Horányi
- Laboratory of Atmospheric and Space Physics, University of Colorado, Boulder, CO 80600, USA
| | - D J McComas
- Southwest Research Institute, San Antonio, TX 78228, USA. University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - R L McNutt
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - H A Elliott
- Southwest Research Institute, San Antonio, TX 78228, USA
| | - M E Hill
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - L E Brown
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | | | - P Kollmann
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S M Krimigis
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA. Academy of Athens, 28 Panapistimiou, 10679 Athens, Greece
| | - M Kusterer
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - C M Lisse
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D G Mitchell
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - M Piquette
- Laboratory of Atmospheric and Space Physics, University of Colorado, Boulder, CO 80600, USA
| | - A R Poppe
- Space Sciences Laboratory, University of California, Berkeley, CA 94720, USA
| | - D F Strobel
- Johns Hopkins University, Baltimore, MD 21218, USA
| | - J R Szalay
- Laboratory of Atmospheric and Space Physics, University of Colorado, Boulder, CO 80600, USA. Southwest Research Institute, Boulder, CO 80302, USA
| | - P Valek
- Southwest Research Institute, San Antonio, TX 78228, USA
| | - J Vandegriff
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - S Weidner
- Southwest Research Institute, San Antonio, TX 78228, USA
| | - E J Zirnstein
- Southwest Research Institute, San Antonio, TX 78228, USA
| | - S A Stern
- Southwest Research Institute, Boulder, CO 80302, USA
| | - K Ennico
- NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - C B Olkin
- Southwest Research Institute, Boulder, CO 80302, USA
| | - H A Weaver
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA
| | - L A Young
- Southwest Research Institute, Boulder, CO 80302, USA
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10
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Cooper SA, Hill ME, Weller RO, Hammans SR. An unusual familial oculopharyngeal syndrome. Eur J Neurol 2006; 13:549-50. [PMID: 16722985 DOI: 10.1111/j.1468-1331.2006.01225.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Chan SK, Gullick WJ, Hill ME. Mutations of the epidermal growth factor receptor in non-small cell lung cancer -- search and destroy. Eur J Cancer 2006; 42:17-23. [PMID: 16364841 DOI: 10.1016/j.ejca.2005.07.031] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2005] [Revised: 07/06/2005] [Accepted: 07/07/2005] [Indexed: 10/25/2022]
Abstract
The targeting of the ATP binding pocket of the epidermal growth factor receptor (EGFR) tyrosine kinase, by the small molecule drugs gefitinib and erlotinib, represents a promising new therapeutic strategy in non-small cell lung cancer. However, it is now apparent that only a subset of patients responds to such treatment. Two publications in early 2004 reported the presence of activating mutations in the EGFR tyrosine kinase gene conferring exquisite sensitivity to these drugs. Several publications have since reported prospective data consistent with this finding. This brief review summarises the mutation data from 15 such studies in terms of mutation frequency by clinicopathological features and correlation with response to tyrosine kinase inhibition. A new paradigm for the routine detection of such mutations is needed to facilitate patient selection for treatment and further studies.
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Affiliation(s)
- S K Chan
- Cancer Biology Laboratory, Research School of Biosciences, University of Kent, Canterbury CT2 7NJ, United Kingdom
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12
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Chong G, Dickson JLB, Cunningham D, Norman AR, Rao S, Hill ME, Price TJ, Oates J, Tebbutt N. Capecitabine and mitomycin C as third-line therapy for patients with metastatic colorectal cancer resistant to fluorouracil and irinotecan. Br J Cancer 2005; 93:510-4. [PMID: 16091760 PMCID: PMC2361607 DOI: 10.1038/sj.bjc.6602733] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Protracted venous infusion 5-fluorouracil (5FU) combined with mitomycin C (MMC) has demonstrated significant activity against metastatic colorectal cancer. Owing to potential synergy based upon upregulation of thymidine phosphorylase by MMC, the combination of capecitabine and MMC may improve outcomes in irinotecan-refractory disease. Eligible patients with progressive disease during or within 6 months of second-line chemotherapy were treated with capecitabine (1250 mg m−2 twice daily) days 1–14 every 3 weeks and MMC (7 mg m−2 IV bolus) once every 6 weeks. A total of 36 patients were recruited, with a median age of 64 years (range 40–77), and 23 patients (78%) were performance status 0–1. The objective response rate was 15.2%. In all, 48.5% of patients had stable disease. Median failure-free survival was 5.4 months (95% CI 4.6–6.2). Median overall survival was 9.3 months (95% CI: 6.9–11.7). Grade 3 toxicities were palmar-plantar erythema 16.7%, vomiting 8.3%, diarrhoea 2.8%, anaemia 8.3%, and neutropenia 2.8%. No patients developed haemolytic uraemic syndrome. Symptomatic improvement occurred for pain, bowel symptoms, and dyspnoea. Capecitabine in combination with MMC is an effective regimen for metastatic colorectal cancer resistant to 5FU and irinotecan with an acceptable toxicity profile and a convenient administration schedule.
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Affiliation(s)
- G Chong
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - J L B Dickson
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - D Cunningham
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
- Department of Medicine, The Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK. E-mail:
| | - A R Norman
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - S Rao
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - M E Hill
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - T J Price
- Department of Medical Oncology, The Queen Elizabeth and Lyell McEwin Hospitals, Woodville, Australia
| | - J Oates
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
| | - N Tebbutt
- Department of Medicine, Royal Marsden Hospital, London and Surrey SM2 5PT, UK
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13
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Decker RB, Krimigis SM, Roelof EC, Hill ME, Armstrong TP, Gloeckler G, Hamilton DC, Lanzerotti LJ. Voyager 1 in the Foreshock, Termination Shock, and Heliosheath. Science 2005; 309:2020-4. [PMID: 16179469 DOI: 10.1126/science.1117569] [Citation(s) in RCA: 350] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Voyager 1 (V1) began measuring precursor energetic ions and electrons from the heliospheric termination shock (TS) in July 2002. During the ensuing 2.5 years, average particle intensities rose as V1 penetrated deeper into the energetic particle foreshock of the TS. Throughout 2004, V1 observed even larger, fluctuating intensities of ions from 40 kiloelectron volts (keV) to >/=50 megaelectron volts per nucleon and of electrons from >26 keV to >/=350 keV. On day 350 of 2004 (2004/350), V1 observed an intensity spike of ions and electrons that was followed by a sustained factor of 10 increase at the lowest energies and lesser increases at higher energies, larger than any intensities since V1 was at 15 astronomical units in 1982. The estimated solar wind radial flow speed was positive (outward) at approximately +100 kilometers per second (km s(-1)) from 2004/352 until 2005/018, when the radial flows became predominantly negative (sunward) and fluctuated between approximately -50 and 0 km s(-1) until about 2005/110; they then became more positive, with recent values (2005/179) of approximately +50 km s(-1). The energetic proton spectrum averaged over the postshock period is apparently dominated by strongly heated interstellar pickup ions. We interpret these observations as evidence that V1 was crossed by the TS on 2004/351 (during a tracking gap) at 94.0 astronomical units, evidently as the shock was moving radially inward in response to decreasing solar wind ram pressure, and that V1 has remained in the heliosheath until at least mid-2005.
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Affiliation(s)
- R B Decker
- Applied Physics Laboratory, Johns Hopkins University, Laurel, MD 20723, USA.
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14
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Rao S, Cunningham D, Hawkins RE, Hill ME, Smith D, Daniel F, Ross PJ, Oates J, Norman AR. Phase III study of 5FU, etoposide and leucovorin (FELV) compared to epirubicin, cisplatin and 5FU (ECF) in previously untreated patients with advanced biliary cancer. Br J Cancer 2005; 92:1650-4. [PMID: 15856037 PMCID: PMC2362051 DOI: 10.1038/sj.bjc.6602576] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to determine whether epirubicin, cisplatin and infused 5FU (ECF) improves overall survival (OS) compared to 5FU, etoposide and leucovorin (FELV) in patients with previously untreated advanced biliary cancer in a prospective randomised study. Patients were randomly assigned to receive epirubicin, cisplatin and infused 5FU ECF or bolus 5FU etoposide and leucovorin (FELV). The primary end point was OS with secondary end points of objective response rate (ORR), failure-free survival (FFS), quality of life (QOL) and toxicity. In all, 54 patients were recruited with 27 randomly assigned to each arm. The median OS for ECF was 9.02 months (95% confidence interval (CI): 6.46–11.51) and FELV 12.03 months (95% CI: 9.3–14.7), P=0.2059. Objective response rates were similar for both arms: ECF 19.2% (95% CI: 6.55–39.3); FELV 15% (95% CI: 3.2–37.9), P=0.72. There was significantly increased grade 3/4 neutropenia with FELV vs ECF (53.8 vs 29.5%, respectively, P=0.020). Symptom resolution was impressive for both regimens. This is the largest reported randomised study to date in this setting. ECF did not improve OS compared to FELV, but was associated with less acute toxicity. These data suggest that chemotherapy can prolong OS and achieve good symptomatic relief in advanced biliary cancer.
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Affiliation(s)
- S Rao
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, London, UK
| | - D Cunningham
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, London, UK
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK. E-mail:
| | | | - M E Hill
- Kent Oncology Centre, Maidstone, UK
| | - D Smith
- Clatterbridge Centre for Oncology, Clatterbridge, UK
| | - F Daniel
- Plymouth Oncology Centre, Plymouth, UK
| | - P J Ross
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, London, UK
| | - J Oates
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, London, UK
| | - A R Norman
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, London, UK
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15
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Rao S, Cunningham D, Price T, Hill ME, Ross PJ, Tebbutt N, Norman AR, Oates J, Shellito P. Phase II study of capecitabine and mitomycin C as first-line treatment in patients with advanced colorectal cancer. Br J Cancer 2004; 91:839-43. [PMID: 15266319 PMCID: PMC2409883 DOI: 10.1038/sj.bjc.6602039] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study was designed to assess the safety and efficacy of capecitabine and mitomycin C (MMC) in previously untreated patients with advanced colorectal cancer (CRC). Patients received capecitabine 2500 mg m2 day 1, orally divided in two doses of 1250 mg m−2 in the morning and evening for 14 days every 21 days and MMC 7 mg m−2 (maximum total dose 14 mg) as an intravenous bolus every 6 weeks for a total of four courses. The median age was 70 years (range 24–85) and the majority of patients (86.9%) were of performance status 1/2. The most common metastatic site was liver. In all, 84 patients were assessable for response. The overall response rate was 38% (95% CI: 27.7–49.3) and a further 33.3% of patients achieved stable disease over 12 weeks. There was good symptom resolution ranging from 64 to 86%. Grade 3/4 toxicity was as follows: hand–foot syndrome 19.7%; diarrhoea 10%; neutropenia 2.4%; infection 2.3%. Capecitabine and MMC have shown encouraging activity with a favourable toxicity profile, a convenient administration schedule, and could be considered for patients deemed unsuitable for oxaliplatin and irinotecan combinations.
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Affiliation(s)
- S Rao
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - D Cunningham
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK. E-mail:
| | - T Price
- Queen Elizabeth Hospital, Adelaide, South Australia
| | - M E Hill
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - P J Ross
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - N Tebbutt
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - A R Norman
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - J Oates
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - P Shellito
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
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16
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Assersohn L, Brown G, Cunningham D, Ward C, Oates J, Waters JS, Hill ME, Norman AR. Phase II study of irinotecan and 5-fluorouracil/leucovorin in patients with primary refractory or relapsed advanced oesophageal and gastric carcinoma. Ann Oncol 2004; 15:64-9. [PMID: 14679122 DOI: 10.1093/annonc/mdh007] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.5] [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: 12/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the efficacy and toxicity of irinotecan and 5-fluorouracil (5-FU) in primary refractory or relapsed locally advanced or metastatic oesophagogastric (O-G) carcinoma. PATIENTS AND METHODS Patients with documented progression on or within 3 months of chemotherapy were recruited between July 2000 and May 2002. Irinotecan (180 mg/m(2)) was given with 5-FU (400 mg/m(2) bolus) and leucovorin (folinic acid) (125 mg/m(2)) followed by 5-FU (1200 mg/m(2) infusion over 48 h) every 2 weeks. Response confirmed by computed tomography was assessed at 12 and 24 weeks. RESULTS Thirty-eight of 40 registered patients (95%) were assessable. Median follow-up was 9.3 months and median age was 59.0 years. Thirty-three patients (86.8%) had metastatic disease and 37 patients (97.4%) had previously received platinum-based chemotherapy. Overall response rate was 29% (95% confidence interval 15.4% to 45.9%) while an additional 34% had stable disease. Improvement in tumour-related symptoms included dysphagia 78.6%, reflux 60.0%, pain 54.5%, anorexia 64.3% and weight loss 72.7%. Grade 3/4 toxicities were anaemia 13.2%, neutropenia 26.4%, febrile neutropenia 5.2%, stomatitis 2.6%, nausea and vomiting 13.2% and diarrhoea 7.9%. Median failure-free survival was 3.7 months and median overall survival was 6.4 months. CONCLUSION 5-FU/irinotecan is a valuable regimen for second-line treatment in 5-FU/platinum-resistant O-G carcinoma.
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Affiliation(s)
- L Assersohn
- Royal Marsden Hospital, London and Sutton, Surrey, UK
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17
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Abstract
Intravascular lymphoma (IVL) is an extremely rare form of extra-nodal non-Hodgkins lymphoma characterised by the proliferation of neoplastic lymphocytes within the lumina of small arteries, veins and capillaries. The great majority of reported cases appear to be of B cell lineage. There is a wide variation in clinical presentation, and multiple organs are usually affected. We report a case of a 67-year-old man who presented with constitutional symptoms and neurological deficit and was diagnosed following bone-marrow trephine. His disease responded to polychemotherapy treatment but he died 15 months after diagnosis. This case in unusual in that it is generally felt that bone marrow is relatively spared until late in the disease and is often not clearly demonstrable histologically. In addition, this case supports the limited data that responses can be obtained following polychemotherapy treatment, although the prognosis remains generally poor.
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Affiliation(s)
- N R Maisey
- Department of Medicine, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK.
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18
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Krimigis SM, Decker RB, Hill ME, Armstrong TP, Gloeckler G, Hamilton DC, Lanzerotti LJ, Roelof EC. Voyager 1 exited the solar wind at a distance of ∼85 au from the Sun. Nature 2003; 426:45-8. [PMID: 14603311 DOI: 10.1038/nature02068] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2003] [Accepted: 09/18/2003] [Indexed: 11/09/2022]
Abstract
The outer limit of the Solar System is often considered to be at the distance from the Sun where the solar wind changes from supersonic to subsonic flow. Theory predicts that a termination shock marks this boundary, with locations ranging from a few to over 100 au (1 Au approximately 1.5 x 10(8) km, the distance from Earth to the Sun). 'Pick-up ions' that originate as interstellar neutral atoms should be accelerated to tens of MeV at the termination shock, generating anomalous cosmic rays. Here we report a large increase in the intensity of energetic particles in the outer heliosphere, as measured by an instrument on the Voyager 1 spacecraft. We argue that the spacecraft exited the supersonic solar wind and passed into the subsonic region (possibly beyond the termination shock) on about 1 August 2002 at a distance of approximately 85 Au (heliolatitude approximately 34 degrees N), then re-entered the supersonic solar wind about 200 days later at approximately 87 au from the Sun. We show that the composition of the ions accelerated at the putative termination shock is that of anomalous cosmic rays and of interstellar pick-up ions.
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Affiliation(s)
- S M Krimigis
- Applied Physics Laboratory, The Johns Hopkins University, Laurel, Maryland 20723, USA.
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19
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Assersohn L, Norman AR, Cunningham D, Iveson T, Seymour M, Hickish T, Massey A, Prior Y, Hill ME. A randomised study of protracted venous infusion of 5-fluorouracil (5-FU) with or without bolus mitomycin C (MMC) in patients with carcinoma of unknown primary. Eur J Cancer 2003; 39:1121-8. [PMID: 12736112 DOI: 10.1016/s0959-8049(03)00150-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
No standard regimen has been identified for patients with a carcinoma of unknown primary (CUP). This study compared protracted venous infusion 5-fluorouracil (PVI 5-FU) with or without mitomycin C (MMC) in patients with CUP in a multicentre, prospectively randomised study. 88 patients were randomised to PVI 5-FU (300 mg/m(2)/day for a maximum of 24 weeks) +/-MMC (7 mg/m(2) 6 weekly for four courses). The overall response rate was 11.6% for PVI 5-FU alone compared with 20.0% for PVI 5-FU plus MMC (P=0.29). Median failure-free survival (FFS) was 4.1 months for PVI 5-FU and 3.6 months for PVI 5-FU plus MMC (P=0.78) with an equivalent overall survival (OS) (6.6 versus 4.7 months, P=0.60). Symptomatic benefit was observed in most patients in each arm. PVI 5-FU is a well tolerated outpatient treatment regimen for patients with CUP, although the addition of MMC provides little extra benefit. PVI 5-FU may be a potential reference regimen in randomised trials with newer chemotherapy agents in patients with CUP.
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Affiliation(s)
- L Assersohn
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
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20
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Tebbutt NC, Norman AR, Cunningham D, Hill ME, Tait D, Oates J, Livingston S, Andreyev J. Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases. Gut 2003; 52:568-73. [PMID: 12631671 PMCID: PMC1773619 DOI: 10.1136/gut.52.4.568] [Citation(s) in RCA: 167] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. AIMS This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative resection of the primary tumour. PATIENTS The incidence of intestinal obstruction, perforation, fistula formation, and gastrointestinal haemorrhage, and the requirement for abdominal radiotherapy in patients with metastatic colorectal cancer treated at a single institution over a 10 year period was determined. RESULTS Eighty two patients received initial treatment with chemotherapy without resection of the primary tumour (unresected group) and 280 patients had undergone prior resection (resected group). In the unresected group, the incidence of peritonitis, fistula formation, and intestinal haemorrhage was 2.4% (95% confidence interval (CI) 0.3-8.5%), 3.7% (95% CI 0.8-10.3%), and 3.7% (95% CI 0.8-10.3%), respectively, and was not significantly different from the resected group. Intestinal obstruction affected 13.4% (95% CI 6.9-22.7%) of patients in the unresected group and 13.2% (95% CI 9.2-17.2%) of patients in the resected group. More patients in the unresected group required >/=3 blood transfusions (14.6% v 7.5%; p=0.048) and abdominal radiotherapy (18.3% v 9.6%; p=0.03) than the resected group. CONCLUSIONS The incidence of major intestinal complications in patients with unresected colorectal cancer and synchronous metastases who receive initial treatment with chemotherapy is low. Chemotherapy may be successfully used as initial treatment for such patients with no increased risk of most major intestinal complications compared with patients who have undergone initial resection of the primary tumour.
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Affiliation(s)
- N C Tebbutt
- Gastrointestinal Unit, Royal Marsden Hospital, London and Surrey, UK
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21
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Hill ME, Rosenwaike I. The Social Security Administration's Death Master File: the completeness of death reporting at older ages. Soc Secur Bull 2002; 64:45-51. [PMID: 12428517] [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: 02/27/2023]
Abstract
We examine the completeness of death reporting in the Social Security Administration's Death Master File (DMF) through comparison with deaths by year and age group reported in official U.S. vital statistics. For most years since 1973, results suggest that the DMF includes 93 percent to 96 percent of deaths of individuals aged 65 or older. Although studies have shown that the National Center for Health Statistics' National Death Index provides superior coverage of deaths, for many researchers the DMF may be a desirable choice. Some advantages of the Death Master File are discussed.
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Affiliation(s)
- M E Hill
- Pennsylvania State University, USA
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22
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Holmes JH, Connolly NC, Paull DL, Hill ME, Guyton SW, Ziegler SF, Hall RA. Magnitude of the inflammatory response to cardiopulmonary bypass and its relation to adverse clinical outcomes. Inflamm Res 2002; 51:579-86. [PMID: 12558191 DOI: 10.1007/pl00012432] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [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: 10/24/2022] Open
Abstract
INTRODUCTION Cardiopulmonary bypass (CPB) induces an inflammatory response believed to contribute to postoperative morbidity. We hypothesized that the magnitude of the inflammatory response following CPB would be associated with adverse clinical outcomes. METHODS Twenty-nine patients had plasma TNF, IL-6, IL-8, elastase, histamine, complement C5a, and complement C3a measured by ELISA before, during, and after cardiac operations employing CPB. Inflammatory mediator levels were analyzed with respect to outcomes. RESULTS Mediator levels peaked at 4 h post-CPB and either returned to baseline or substantially decreased by 24 h. Patients with peak mediator levels above the median for the group as a whole were classified as 'hyper-responders'; those with levels below the median were classified as 'normal responders'. While IL-8, C3a, and IL-6 levels were independently associated with adverse outcomes, TNF, histamine, and C5a levels were not. Elastase levels trended towards adverse outcomes. IL-8 'hyper-responders' experienced significantly greater postoperative weight gain and had higher IL-8 levels at 24 h (p<0.05), with trends towards renal impairment and protracted supplemental oxygen requirements. C3a 'hyper-responders' strongly trended towards increased bleeding, delayed extubation, greater postoperative weight gain, and decreased levels of independent functioning at discharge (p < or = 0.10). IL-6 'hyper-responders' experienced significantly more postoperative bleeding, delayed extubation, and higher IL-6 levels at 24 h compared to 'normal responders' (p < 0.05). They strongly trended towards greater postoperative weight gain and decreased levels of independent functioning at discharge (p < or = 0.10). CONCLUSIONS Patients who have an exaggerated inflammatory response to CPB tend to bleed more, require more respiratory support, demonstrate greater capillary leak via weight gain, and display a decline in independent functioning relative to normal responders. Thus, it appears that the magnitude of the inflammatory response to CPB adversely influences clinical outcomes.
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Affiliation(s)
- J H Holmes
- Department of General Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
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23
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Waters JS, Tait D, Cunningham D, Padhani AR, Hill ME, Falk S, Lofts F, Norman A, Oates J, Hill A. A multicentre phase II trial of primary chemotherapy with cisplatin and protracted venous infusion 5-fluorouracil followed by chemoradiation in patients with carcinoma of the oesophagus. Ann Oncol 2002; 13:1763-70. [PMID: 12419749 DOI: 10.1093/annonc/mdf301] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We undertook a multicentre phase II trial to evaluate the safety and efficacy of primary chemotherapy followed by chemoradiation for localised adenocarcinoma or squamous carcinoma of the oesophagus. PATIENTS AND METHODS Chemotherapy comprised five 3-weekly cycles of cisplatin and protracted continuous infusion 5-fluorouracil, with conformally planned radiotherapy commencing at the start of the fifth cycle. RESULTS The planned treatment programme was completed by 39 of 72 patients (54%), and a further 13% completed chemotherapy and proceeded to surgical oesophagectomy. Response rates to chemotherapy and to the entire treatment programme were 47% [95% confidence interval (CI) 34% to 60%] and 56% (CI 43% to 68%). The dysphagia score improved in 54% of patients. The median survival duration was 14.6 months with 1- and 2-year survival rates of 58.7% and 44.1%, respectively. Grade III/IV chemotherapy-related toxicity occurred in 38% of patients, and there were no treatment-related deaths. CONCLUSIONS This is a feasible and active treatment regimen providing palliative benefits for patients with poor-prognosis localised oesophageal cancer.
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Affiliation(s)
- J S Waters
- Cancer Research Campaign Section of Medicine and Gastrointestinal Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton, Surrey
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Abstract
The aim of this study was to investigate the influence of baseline quality of life (QoL) on survival in patients with advanced colorectal cancer. From 1992 to 1998, four randomised clinical trials in advanced colorectal cancer were conducted at this institution. The European Organization for Research and Treatment of Cancer-Quality of Life Core 30 (EORTC-QLQ-C30) questionnaire was completed prior to the commencement of chemotherapy. Analyses were performed on median-dichotomised baseline Quality of Life (QoL) and clinical prognostic factors. Baseline QoL questionnaires were completed by 501 patients. One-year survival was 38.3 and 72.5% (P<0.0001) for patients with global QoL scores below and above the median (67), respectively. Other than cognitive functioning, fatigue, appetite, constipation, diarrhoea and financial domains, all QoL scales were significant independent predictors of survival (P<0.035). In the final model, the global QoL score remained highly significant as an independent predictor of survival (P<0.0001). Baseline QoL is a strong independent predictor of survival in patients with advanced colorectal cancer. Measurements should be routinely recorded in clinical trials to stratify cohorts and aid in trial comparison.
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Affiliation(s)
- N R Maisey
- Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
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25
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Holmes JH, Lieberman JM, Probert CB, Marks WH, Hill ME, Paull DL, Guyton SW, Sacchettini J, Hall RA. Elevated intestinal fatty acid binding protein and gastrointestinal complications following cardiopulmonary bypass: a preliminary analysis. J Surg Res 2001; 100:192-6. [PMID: 11592792 DOI: 10.1006/jsre.2001.6237] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [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: 11/22/2022]
Abstract
BACKGROUND Cardiopulmonary bypass (CPB) is associated with poorly understood alterations in gastrointestinal (GI) perfusion. Intestinal fatty acid binding protein (IFABP), a cytosolic protein uniquely located in mature small-intestinal enterocytes, has been shown to be a sensitive biochemical marker of early intestinal ischemia when assayed in urine. We hypothesized that if significant small-intestinal ischemia occurs with CPB, then urine IFABP levels should be concomitantly elevated. METHODS Twenty-nine patients (15 low risk and 14 high risk) undergoing cardiac surgery with CPB were studied prospectively. Serial urine IFABP levels were measured and results were correlated with clinical outcomes. RESULTS None of the low-risk patients had IFABP elevations or experienced GI complications. Five of the high-risk patients had IFABP elevations, and three of the five developed GI complications. Within the high-risk cohort, the only significant difference between patients with or without IFABP elevations was the GI complication rate (P = 0.03). Overall, patients with IFABP elevations had a significantly higher mean ASA class and significant increases in mean CPB and aortic cross-clamp times, mean time to oral intake, median ICU and postoperative lengths of stay, and GI complications. CONCLUSIONS In low-risk bypass patients, small-bowel mucosal perfusion appeared to be maintained, while in the high-risk population, 21% of the patients sustained clinically significant mucosal compromise. In this pilot study, urine IFABP was 100% sensitive and 92% specific with respect to GI complications. Since elevated urine IFABP concentrations appeared to correlate with clinical GI complications, urine IFABP may be a useful marker to identify the patient at risk for postbypass GI complications.
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Affiliation(s)
- J H Holmes
- Department of General Surgery, Virginia Mason Medical Center, Seattle, WA 98111, USA
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Hill ME, Adolphsen C, Baumgartner W, Callin RS, Lin XE, Seidel M, Slaton T, Whittum DH. High-gradient millimeter-wave accelerator on a planar dielectric substrate. Phys Rev Lett 2001; 87:094801. [PMID: 11531569 DOI: 10.1103/physrevlett.87.094801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2000] [Indexed: 05/23/2023]
Abstract
We report the first high-gradient studies of a millimeter-wave accelerator, employing for the first time a planar dielectric accelerator, powered by means of a 0.5-A, 300-MeV, 11.424-GHz drive electron beam, synchronous at the 8th harmonic, 91.392 GHz. Embedded in a ring-resonator circuit within the electron beam line vacuum, this structure was operated at 20 MeV/m, with a circulating power of 200 kW, for 2 x 10(5) pulses, with no sign of breakdown, dielectric charging, or other deleterious high-gradient phenomena. We also present the first measurement of the quadrupolar content of an accelerating mode.
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Affiliation(s)
- M E Hill
- Department of Physics, Harvard University, Cambridge, Massachusetts 02138, USA.
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Gerbert B, Moe JC, Saag MS, Benson CA, Jacobsen DM, Feraios A, Hill ME, Bronstone A, Caspers N, Volberding PA. Toward a definition of HIV expertise: a survey of experienced HIV physicians. AIDS Patient Care STDS 2001; 15:321-30. [PMID: 11445014 DOI: 10.1089/108729101750279696] [Citation(s) in RCA: 12] [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: 11/12/2022] Open
Abstract
Medical care for human immunodeficiency virus (HIV)-infected persons has grown increasingly complex, yet few studies have examined experienced HIV physicians' views about current HIV medical care. The objective of this study was to examine the relationship between physicians' HIV experience, self-perceived expertise, and confidence with providing 18 aspects of HIV medical care and between confidence in aspects of care and medical specialty. At geographically diverse, HIV continuing medical education programs conducted in the fall of 1999, 359 currently practicing HIV physicians completed a written survey measuring participants' demographic characteristics, experience, HIV expertise, and level of confidence providing essential aspects of HIV care. Participants currently managed a median of 50 HIV-infected patients with a career total of 300. Significant correlations were found between experience and expertise items and experience and 15 of 18 confidence items. Confidence levels varied from 11% to 85% highly confident across 18 aspects of HIV care. Physicians' confidence with providing aspects of HIV care varied by the three predominant specialty groups (infectious diseases, internal medicine, and family practice/general medicine). Physicians who have informally specialized in HIV care reported a range of self-perceived expertise and confidence, indicating the complexity of HIV medical care today. Our results suggest that even the most experienced HIV physicians in the United States continue to benefit from more experience and that each medical specialty examined in this study brings its own set of skills needed to provide optimal HIV care. This study constitutes a first step toward defining and formalizing HIV medical care.
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Affiliation(s)
- B Gerbert
- Division of Behavioral Sciences, University of California San Francisco, San Francisco, California 94117, USA.
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Minore B, Hill ME, Kurm MJ, Vergidis D. Knowledgeable, consistent, competent care: meeting the challenges of delivering quality cancer care in remote northern communities. Int J Circumpolar Health 2001; 60:196-204. [PMID: 11507969] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
The Northwestern Ontario Regional Cancer Centre (NWORCC) has created outreach services that provide chemotherapy and supportive care to clients in thirteen small, remote communities. Located 100-600 km from the NWORCC, these satellite oncology services are staffed by local physicians, specially prepared nurses and support staff. The present paper reports selected findings from an evaluation of the service, based on two rounds of site visits, interviews and surveys of providers and clients. Although the consensus was that quality care was being delivered, local hospitals and other organizations had to address a variety of challenges. Those discussed in the paper include: maintaining provider competency, strengthening supportive care networks, and adjusting staffing and other resources to meet increased demands for care.
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Affiliation(s)
- B Minore
- Centre for Rural and Northern Health Research, Thunder Bay, Ontario, Canada.
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30
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Hill ME, Creed GA, McMullan TF, Tyers AG, Hilton-Jones D, Robinson DO, Hammans SR. Oculopharyngeal muscular dystrophy: phenotypic and genotypic studies in a UK population. Brain 2001; 124:522-6. [PMID: 11222452 DOI: 10.1093/brain/124.3.522] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [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: 11/12/2022] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant disorder of late onset that commonly presents with ptosis and dysphagia. The genetic basis of the condition has been identified recently as a stable trinucleotide repeat expansion in exon 1 of the poly(A) binding protein 2 gene (PABP2), in which (GCG)(6) is the normal repeat length. The prevalence of OPMD is greatest in patients of French-Canadian origin. It is not clear if expansion repeat length is a reliable test in other populations. In this study, we analysed the phenotypic and genotypic characteristics of 31 patients with OPMD in the UK. Ptosis was the first reported symptom in two-thirds of the patients, and half of the subjects studied had evidence of ophthalmoplegia. All but one family had a pathological expansion in the PABP2 gene, ranging from (GCG)(8) to (GCG)(13). In contrast to the French-Canadian population, (GCG)(10) was almost as common as (GCG)(9), evidence against a strong founder effect in the UK population. There was a weak association between repeat length and age of disease onset. Patients with longer repeat lengths, such as (GCG)(13), developed severe limb weakness early in the disease. We were unable to detect the (GCG)(7) polymorphism in over 200 normal controls, suggesting that the frequency of this expansion is lower than that found in the French-Canadian population. One family was negative for the expansion. Affected members presented with the classical features of OPMD, namely ptosis, dysphagia and cytoplasmic inclusions on muscle biopsy, although with some atypical features, such as early age of onset, high serum levels of creatine kinase and a profound ophthalmoplegia. This family is an example of a GCG expansion-negative oculopharyngeal syndrome requiring further genetic investigation. We conclude that PABP2 analysis is a reliable non-invasive diagnostic test for OPMD in the UK population.
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Affiliation(s)
- M E Hill
- Wessex Neurology Centre, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
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Abstract
PURPOSE A case of a solitary pancreatic metastasis from a primary colonic carcinoma is reported. METHODS The history and use of carcinoembryonic antigen, computed tomography, and positron emission tomography in this case and the follow-up of colorectal cancer are reviewed. RESULTS Recurrent disease was suspected by an increasing carcinoembryonic antigen level. However, conventional imaging with computed tomography on more than one occasion failed to identify any recurrence. The pancreatic metastasis was accurately localized by positron emission tomography scanning and confirmed on subsequent laparotomy. A histologically complete resection was performed and the patient remained in remission with a normal carcinoembryonic antigen 12 months postoperatively. CONCLUSION This case reports an unusual site of solitary metastasis in colorectal cancer and supports the further investigation of positron emission tomography in follow-up of colorectal cancer.
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Affiliation(s)
- M G Tutton
- Colorectal Department, Mayday University Hospital, Surrey, United Kingdom
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Scrocchi LA, Hill ME, Saleh J, Perkins B, Drucker DJ. Elimination of glucagon-like peptide 1R signaling does not modify weight gain and islet adaptation in mice with combined disruption of leptin and GLP-1 action. Diabetes 2000; 49:1552-60. [PMID: 10969840 DOI: 10.2337/diabetes.49.9.1552] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [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] [Indexed: 11/13/2022]
Abstract
Leptin and glucagon-like peptide 1 (GLP-1) exhibit opposing actions in the endocrine pancreas. GLP-1 stimulates insulin biosynthesis, secretion, and islet growth, whereas leptin inhibits glucose-dependent insulin secretion and insulin gene transcription. In contrast, GLP-1 and leptin actions overlap in the central nervous system, where leptin has been shown to activate GLP-1 circuits that inhibit food intake. To determine the physiological importance of GLP-1 receptor (GLP-1R)-leptin interactions, we studied islet function and feeding behavior in ob/ob:GLP-1R(-/-) mice. Although GLP-1R actions are thought to be essential for glucose-dependent insulin secretion, the levels of fasting glucose, glycemic excursion after glucose loading, glucose-stimulated insulin, and pancreatic insulin RNA content were similar in ob/ob:GLP-1R(+/+) versus ob/ob:GLP-1R(-/-) mice. Despite evidence linking GLP-1R signaling to the regulation of islet neogenesis and proliferation, ob/ob:GLP-1R(-/-) mice exhibited significantly increased islet numbers and area and an increase in the number of large islets compared with GLP-1R(+/+) or (-/-) mice (P < -0.01 to 0.05). Similarly, growth rates and both shortand long-term control of food intake were comparable in ob/ob:GLP-1R(+/+) versus ob/ob:GLP-1R4(-/-) mice. Furthermore, leptin produced a similar inhibition of food intake in GLP-1R(-/-), ob/ob:GLP-1R(+/+), and ob/ob:GLP1R4(-/-) mice. These findings illustrate that although leptin and GLP-1 actions overlap in the brain and endocrine pancreas, disruption of GLP-1 signaling does not modify the response to leptin or the phenotype of leptin deficiency in the ob/ob mouse, as assessed by long-term control of body weight or the adaptive beta-cell response to insulin resistance in vivo.
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Affiliation(s)
- L A Scrocchi
- Department of Medicine, Banting and Best Diabetes Centre, Toronto General Hospital, University of Toronto, Ontario, Canada
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Vaughan MM, Moore J, Riches PG, Johnston SR, A'Hern RP, Hill ME, Eisen T, Ayliffe MJ, Thomas JM, Gore ME. GM-CSF with biochemotherapy (cisplatin, DTIC, tamoxifen, IL-2 and interferon-alpha): a phase I trial in melanoma. Ann Oncol 2000; 11:1183-9. [PMID: 11061616 DOI: 10.1023/a:1008348005349] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/12/2022] Open
Abstract
BACKGROUND Ineffective tumour antigen processing is recognised as an important cause of failure of immunotherapy in melanoma. GM-CSF may augment the cytotoxic lymphocyte response by activating antigen-presenting cells. This study evaluates a schedule combining GM-CSF with biochemotherapy. PATIENTS AND METHODS Nineteen patients with advanced malignant melanoma received cisplatin (25 mg/m2 days 1-3). dacarbazine (220 mg/m2 days 1-3), interleukin-2 (9 MIU/m2/24 h) and interferon-alpha2b (5 MIU/m2) both days 6-10 and days 17-21, and tamoxifen 40 mg/day continuously. Subcutaneous GM-CSF was given in escalating doses to three cohorts: 1) 450 microg/m2 days 4-5 and 15-16; 2) as 1) plus 225 microg/m2 days 6-10 and 17-21; 3) 450 microg/m2 days 4-10 and 15-21. Each cycle was 28 days. RESULTS Constitutional side effects were the major non-haematological toxicity and lymphopaenia the main haematological toxicity. Six patients responded (32%, 95% confidence interval: 13%-57%), two patients had complete remission. There was an apparent trend for increasing responses with increasing GM-CSF dose; zero of six responses in cohort 1, two of seven in cohort 2 and three of six in cohort 3 (P = 0.016). Median overall survival was 6.2 months. Increasing GM-CSF doses significantly increased serum concentrations of neopterin and TNF-alpha. CONCLUSIONS The combination of GM-CSF with biochemotherapy is feasible and there appears to be a dose-response relationship with GM-CSF in terms of host immunological response, and possibly clinical efficacy.
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Affiliation(s)
- M M Vaughan
- Melanoma Unit, Royal Marsden NHS Trust, London, UK
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35
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Hill ME, Preston SH, Rosenwaike I. Age reporting among white Americans aged 85+: results of a record linkage study. Demography 2000; 37:175-86. [PMID: 10836175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
This study investigates age reporting on the death certificates of older white Americans. We link a sample of death certificates for native-born whites aged 85+ in 1985 to Social Security Administration records and to records of the U.S. censuses of 1900, 1910, and 1920. When ages in these sources are compared, inconsistencies are found to be minimal, even beyond age 95. Results show little distortion and no systematic biases in the reported age distribution of deaths. To explore the effect of age misreporting on old-age mortality, we estimate "corrected" age-specific death rates by the extinct-generation method for the U.S. white cohort born in 1885. With few exceptions, corrected and uncorrected rates in single years differ by less than 3% and are not systematically biased. When we compare corrected rates with those for the same birth cohort in France, Japan, and Sweden, we find that white American mortality at older ages is exceptionally low.
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Affiliation(s)
- M E Hill
- Population Studies Center, University of Pennsylvania, Philadelphia 19104-6298, USA.
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Gregory RK, Hill ME, Moore J, A'Hern RP, Johnston SR, Blake P, Shephard J, Barton D, Gore ME. Combining platinum, paclitaxel and anthracycline in patients with advanced gynaecological malignancy. Eur J Cancer 2000; 36:503-7. [PMID: 10717527 DOI: 10.1016/s0959-8049(99)00309-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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
Two meta-analyses have suggested that the addition of an anthracycline to platinum-based chemotherapy may improve survival in advanced ovarian cancer, and two randomised trials have demonstrated superiority of paclitaxel over cyclophosphamide in platinum combinations. A combination of platinum, anthracycline and paclitaxel would, therefore, be a reasonable experimental arm of any future randomised trial in patients with epithelial ovarian carcinoma (EOC). Patients who required chemotherapy for EOC but were ineligible for standard trials or had other gynaecological tumours that required similar platinum-based chemotherapy were considered for this pilot. The platinum/anthracycline/paclitaxel regimen (G-CAT) was given 3-weekly and consisted of doxorubicin 50 mg/m(2) or epirubicin 60 mg/m(2) intravenously (i.v.) bolus, paclitaxel 175 mg/m(2) (i.v.) over 3 h and either cisplatin 75 mg/m(2) (i.v.) or carboplatin AUC 6, with granulocyte colony-stimulating factor (G-CSF) at the neutrophil nadir. Different combinations were used in order to determine the least toxic regimen. Toxicity and response were assessed according to CTC and WHO criteria, respectively. 26 patients entered the study, 13 with EOC and 13 with other gynaecological cancers (peritoneal, fallopian tube, mixed Mullerian). Median age was 49 years (range: 27-67). 8 patients received carboplatin/doxorubicin/paclitaxel, 8 cisplatin/doxorubicin/paclitaxel and 10 carboplatin/epirubicin/paclitaxel. A total of 135 cycles of chemotherapy were delivered, with a median of 6 cycles per patient (range: 2-6). 54 (40%) cycles required G-CSF support and 17 (65%) patients required at least one dose reduction. All patients experienced grade 4 neutropenia and 13 (50%) patients developed grade 3-4 thrombocytopenia (12 of whom had received carboplatin). There were 4 (15%) patients with grade 3/4 infections but no septic deaths. Non-haematological toxicities were manageable, lethargy occurred in 75% of cisplatin-treated patients. Grade 1/2 cardiotoxicity, as assessed pre- and post-treatment by left ventricular ejection fraction, was observed in 6/13 (46%) patients who had received doxorubicin and 2/7 (29%) epirubicin-treated patients. No clinically detectable cardiac toxicity was encountered. The response rate in 25 evaluable patients was 76% (12 CR, 7 PR). Dose intensity was highest in the carboplatin/epirubicin/paclitaxel combination. G-CAT shows high activity and can be administered safely, but only very fit patients are suitable for this regimen as it is associated with considerable toxicity. Carboplatin/epirubicin/paclitaxel was the best tolerated regimen overall.
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Affiliation(s)
- R K Gregory
- The Gynaecology Oncology Unit, Royal Marsden NHS Trust, Fulham Road, London, UK
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Maisey NR, Hill ME, Webb A, Cunningham D, Flux GD, Padhani A, Ott RJ, Norman A, Bishop L. Are 18fluorodeoxyglucose positron emission tomography and magnetic resonance imaging useful in the prediction of relapse in lymphoma residual masses? Eur J Cancer 2000; 36:200-6. [PMID: 10741278 DOI: 10.1016/s0959-8049(99)00249-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Treatment of both Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) frequently results in a residual mass visible radiologically. Such patients may receive radiotherapy unnecessarily because the residual mass may represent benign fibrotic tissue rather than residual active lymphoma. Radiotherapy has been shown to have significant short and more worrying long-term toxicity. Refining the criteria for its use would be a major advance. A number of clinical investigations have been evaluated to more accurately determine the nature of such lesions, including erythrocyte sedimentation rate (ESR), magnetic resonance imaging (MRI) and high-dose gallium-67 scanning (HDGS) but none has proven utility. 18[F]-fluorodeoxyglucose positron emission tomography (FDG-PET) is an imaging technique that has been shown to be useful in distinguishing fibrosis from residual active disease in solid tumours. The aim of this study was to compare FDG PET and MRI in the assessment of residual masses following treatment for lymphoma. Patients with NHL/HD who had a residual mass following chemotherapy were eligible for this study. Patients had a combination of MRI and/or PET. All scans were completed within 5 months of the end of treatment. Patients were followed-up for relapse. 56 patients had an MRI scan, 24 had a PET scan and 22 patients had both investigations. Overall sensitivity and specificity, respectively, were for MRI 45% and 74%, PET 50% and 69%, and PET/MRI concurring 50% and 67%. There was a trend for improved relapse-free survival (RFS) with a negative result of both MRI and PET, but this was not statistically significant. The predictive value for both tests failed to reach statistical significance. Subgroup analysis suggests that PET may be better at predicting relapse in patients with NHL, especially those with masses above the diaphragm. There is no convincing evidence that either MRI or PET or the combination can reliably predict relapse within residual masses after treatment for lymphoma. A negative PET scan however appears to be more informative than a positive result and may well aid clinical decision making. There are a number of factors that may produce false-positive results, including post-treatment inflammatory changes, the sensitivity of the test in the setting of minimal residual disease and the heterogeneity of the histological subtypes studied. A negative PET (or MRI) result in lymphoma residual masses following therapy may negate the necessity for further therapy such as chemotherapy or radiotherapy and their concomitant toxicities.
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Affiliation(s)
- N R Maisey
- Department of Medicine, Royal Marsden NHS Trust, Sutton, Surrey, UK
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Hill ME. Multivariate survivorship analysis using two cross-sectional samples. Demography 1999; 36:497-503. [PMID: 10604077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
As an alternative to survival analysis with longitudinal data, I introduce a method that can be applied when one observes the same cohort in two cross-sectional samples collected at different points in time. The method allows for the estimation of log-probability survivorship models that estimate the influence of multiple time-invariant factors on survival over a time interval separating two samples. This approach can be used whenever the survival process can be adequately conceptualized as an irreversible single-decrement process (e.g., mortality, the transition to first marriage among a cohort of never-married individuals). Using data from the Integrated Public Use Microdata Series (Ruggles and Sobek 1997), I illustrate the multivariate method through an investigation of the effects of race, parity, and educational attainment on the survival of older women in the United States.
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Affiliation(s)
- M E Hill
- Population Studies Center, University of Pennsylvania, Philadelphia 19104-6298, USA.
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Drucker DJ, Boushey RP, Wang F, Hill ME, Brubaker PL, Yusta B. Biologic properties and therapeutic potential of glucagon-like peptide-2. JPEN J Parenter Enteral Nutr 1999; 23:S98-100. [PMID: 10483906 DOI: 10.1177/014860719902300524] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 01/11/2023]
Abstract
BACKGROUND Glucagon-like peptide-2 (GLP-2), a 33 amino acid, proglucagon-derived peptide with intestinotrophic activity, is secreted from enteroendocrine cells in the small and large intestine. METHODS This review describes recent advances in our understanding of GLP-2 physiology from rodent experiments in vivo. RESULTS GLP-2 administration induces mucosal epithelial proliferation in small and large bowel and stomach. GLP-2 is rapidly degraded by the enzyme dipeptidyl peptidase IV (DPP-IV) to produce the biologically inactive form GLP-2(3-33), however, GLP-2 analogs that confer resistance to DPP-IV exhibit enhanced biologic activity in vivo. GLP-2-treated bowel retains normal to enhanced functional absorptive capacity. Furthermore, GLP-2 infusion prevents total parenteral nutrition (TPN)-associated intestinal hypoplasia, and enhances bowel adaptation and nutrient absorption in rats following small bowel resection. GLP-2 also reverses weight loss and improves histologic and biochemical parameters of disease activity in mice with experimental colitis. CONCLUSIONS GLP-2 is an intestine-derived peptide with intestinotrophic properties that may be therapeutically useful in diseases characterized by intestinal damage or insufficiency.
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Affiliation(s)
- D J Drucker
- Department of Medicine, Banting and Best Diabetes Centre, The Toronto Hospital, University of Toronto, Canada
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Abstract
The primary function of islet A cells is the synthesis and secretion of glucagon, an essential hormonal regulator of glucose homeostasis. The proglucagon gene is also expressed in enteroendocrine L cells of the intestinal epithelium, which produce glucagon-like peptide 1 (GLP-1) and glucagon-like peptide 2 (GLP-2), regulators of insulin secretion and intestinal growth, respectively. We show here that Pax6, a critical determinant of islet cell development and proglucagon gene expression in islet A cells, is also essential for glucagon gene transcription in the small and large intestine. Pax6 is expressed in enteroendocrine cells, binds to the G1 and G3 elements in the proglucagon promoter, and activates proglucagon gene transcription. The dominant negative Pax6 allele, SEYNeu, represses proglucagon gene transcription in enteroendocrine cells. Mice homozygous for the SEYNeu mutation exhibit markedly reduced levels of proglucagon mRNA transcripts in the small and large intestine, and GLP-1 or GLP-2-immunopositive enteroendocrine cells were not detected in the intestinal mucosa. These findings implicate an essential role for Pax6 in the development and function of glucagon-producing cells in both pancreatic and intestinal endodermal lineages.
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Affiliation(s)
- M E Hill
- Department of Medicine, The Banting and Best Diabetes Centre, Toronto General Hospital, Ontario, Canada
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Popescu RA, Wotherspoon AC, Cunningham D, Norman A, Prendiville J, Hill ME. Surgery plus chemotherapy or chemotherapy alone for primary intermediate- and high-grade gastric non-Hodgkin's lymphoma: the Royal Marsden Hospital experience. Eur J Cancer 1999; 35:928-34. [PMID: 10533473 DOI: 10.1016/s0959-8049(99)00069-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary gastric lymphomas (PGL) have traditionally been treated with surgery followed by chemotherapy or radiotherapy. Surgery was thought to improve staging, optimise local disease control and reduce risk of perforation or bleeding, but recent studies question its role. In this study, patients with intermediate- or high-grade PGL who received chemotherapy from 1985 to 1996 at the Royal Marsden Hospital were identified using a prospectively accrued database. A total of 37 patients (6 with low-grade mucosa-associated lymphoid tissue lymphoma (MALT-L), 9 with high-grade MALT-L, 20 with diffuse large B-cell (DLBC) lymphoma and 2 other histologies), 17 of whom had localised disease, were treated with either surgery plus chemotherapy or chemotherapy alone. 5-year overall survival for localised and advanced PGL was 94 and 50%, respectively, with no differences between the two treatments over a 53 months median follow-up. No perforations or serious bleeding occurred. Surgery is associated with important morbidity and we detected no benefit of surgery prior to chemotherapy in this limited series of patients.
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Affiliation(s)
- R A Popescu
- Department of Medicine, Royal Marsden Hospital NHS Trust, Surrey, U.K
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Hill ME, Ferguson DJ, Austyn JM, Newsom-Davis J, Willcox HN. Potent immunostimulatory dendritic cells can be cultured in bulk from progenitors in normal infant and adult myasthenic human thymus. Immunology 1999; 97:325-32. [PMID: 10447749 PMCID: PMC2326831 DOI: 10.1046/j.1365-2567.1999.00799.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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] [Indexed: 11/20/2022] Open
Abstract
Low density cells can readily be enriched from thymus tissue both of children undergoing cardiac surgery and of older patients with myasthenia gravis, and can be cryostored in bulk. When fresh or thawed cells are cultured with granulocyte-macrophage colony-stimulating factor and stem cell factor with or without tumour necrosis factor-alpha (TNF-alpha), they generate numerous cells with the characteristic ultrastructural, phenotypic and functional properties of dendritic cells. These proved to be very potent, both as stimulators of primary mixed leucocyte responses and as costimulators in oxidative mitogenesis. Especially after exposure to TNF-alpha, these dendritic cells also processed a natural epitope from a 437-residue polypeptide and presented it efficiently to an autoimmune T-cell clone (of T helper type 0 phenotype). Thus, immunostimulatory dendritic cells can be cultured in relative abundance from progenitors in infant and adult human thymus. Both are convenient sources of potent antigen-presenting cells of identifiable origins, e.g. for use in selecting human T-cell lines.
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Affiliation(s)
- M E Hill
- Neurosciences Group, Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, UK
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Abstract
This paper investigates the social and economic circumstances of childhood that predict the probability of survival to age 85 among African-Americans. It uses a unique study design in which survivors are linked to their records in U.S. Censuses of 1900 and 1910. A control group of age and race-matched children is drawn from Public Use Samples for these censuses. It concludes that the factors most predictive of survival are farm background, having literate parents, and living in a two-parent household. Results support the interpretation that death risks are positively correlated over the life cycle.
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Affiliation(s)
- S H Preston
- Population Studies Center, University of Pennsylvania, Philadelphia 19104-6298, USA
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Beeson D, Bond AP, Corlett L, Curnow SJ, Hill ME, Jacobson LW, MacLennan C, Meager A, Moody AM, Moss P, Nagvekar N, Newsom-Davis J, Pantic N, Roxanis I, Spack EG, Vincent A, Willcox N. Thymus, thymoma, and specific T cells in myasthenia gravis. Ann N Y Acad Sci 1998; 841:371-87. [PMID: 9668262 DOI: 10.1111/j.1749-6632.1998.tb10950.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D Beeson
- Institute of Molecular Medicine, University of Oxford, United Kingdom
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45
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Affiliation(s)
- M E Hill
- GI Unit, Royal Marsden NHS Trust, Sutton, Surrey, U.K
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Stamps AC, Elmore MA, Hill ME, Kelly K, Makda AA, Finnen MJ. A human cDNA sequence with homology to non-mammalian lysophosphatidic acid acyltransferases. Biochem J 1997; 326 ( Pt 2):455-61. [PMID: 9291118 PMCID: PMC1218691 DOI: 10.1042/bj3260455] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A novel human homologue of Escherichia coli, yeast and plant 1-acylglycerol-3-phosphate acyltransferase has been isolated from U937 cell cDNA. Expression of the cloned sequence in 1-acylglycerol-3-phosphate acyltransferase-deficient E. coli resulted in increased incorporation of oleic acid into cellular phospholipids. Membranes made from COS7 cells transfected with the cDNA exhibited higher acyltransferase activity towards a range of donor fatty acyl-CoAs and lysophosphatidic acid. Northern-blot analysis of the cDNA sequence indicated high levels of expression in immune cells and epithelium. Rapid amplification of cDNA ends revealed differentially expressed splice variants, which suggests regulation of the enzyme by alternative splicing. This cDNA therefore represents the first described sequence of a mammalian gene homologous to non-mammalian lysophosphatidic acid acyltransferases.
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Affiliation(s)
- A C Stamps
- Yamanouchi Research Institute, Littlemore, Oxford, U.K
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Hill ME, Constenla DO, A'Hern RP, Henk JM, Rhys-Evans P, Breach N, Archer D, Gore ME. Cisplatin and 5-fluorouracil for symptom control in advanced salivary adenoid cystic carcinoma. Oral Oncol 1997; 33:275-8. [PMID: 9307718 DOI: 10.1016/s0964-1955(97)00026-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Adenoid cystic carcinoma is a relatively rare tumour which arises in the parotid and submandibular salivary glands. Initial management is surgical, often with post-operative radiotherapy, but local relapse is common and distant metastasis not infrequent. Chemotherapy is generally reserved for cases where symptoms are not controlled by other means, since the tumour is slow growing and the response rate frequently disappointing. Cisplatin and 5-fluorouracil (5-FU) both show single agent activity in this disease but had not been previously investigated in combination. All patients referred for palliative chemotherapy of metastatic, symptomatic, histologically confirmed adenoid cystic carcinoma between November 1990 and February 1994 were considered for this study. The drugs were administered as follows: cisplatin 100 mg/m2 with appropriate pre- and post-hydration and 5-FU on a 4-day schedule of 1 g/m2/day. A total of 11 patients (7 male, 4 female) with median age 53 years (range 34-69) received 46 courses of chemotherapy (median four, range one to six). All patients had prior surgery and 8 had previously received radiotherapy. There were no objective responses of > 50% reduction in tumour size. 3 patients had a minor response and two progressed on treatment. The symptomatic response rate, however, was 64%, which compares favourably with other previously reported regimens. Toxicity was manageable. The median time to tumour progression was 9 months (range 0-38) and median survival was 12 months (range 1-65). This cisplatin/5-FU regimen would appear to produce a low rate of objective response but useful palliative benefits in advanced symptomatic adenoid cystic carcinoma. Prior series suggest that a higher objective response rate may be possible with a platinum/anthracycline/fluorouracil combination, and investigation of such a regimen is warranted.
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Affiliation(s)
- M E Hill
- Head and Neck Unit, Royal Marsden NHS Trust, London, U.K
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Makda AA, Elmore MA, Hill ME, Stamps A, Tejura S, Finnen MJ. Differential effects of CB1 and CB2 agonists on cAMP levels and MAP kinase activation in human peripheral blood mononuclear cells. Biochem Soc Trans 1997; 25:217S. [PMID: 9191261 DOI: 10.1042/bst025217s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- A A Makda
- Yamanouchi Research Institute, Oxford
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Hill ME, Daniels RH, Elmore MA, Finnen MJ. Lipids derived from the mevalonate pathway in HL-60 cells modulate the interactions of beta 2 integrins with their ligands. Biochem Soc Trans 1997; 25:349S. [PMID: 9191394 DOI: 10.1042/bst025349s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M E Hill
- Yamanouchi Research Institute, Littlemore Park, Oxford
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Constenla DO, Hill ME, A'Hern RP, Henk JM, Rhys-Evans P, Breach N, Archer D, Gore ME. Chemotherapy for symptom control in recurrent squamous cell carcinoma of the head and neck. Ann Oncol 1997; 8:445-9. [PMID: 9233523 DOI: 10.1023/a:1008203613364] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The role of chemotherapy in patients with recurrent squamous cell carcinomas of the head and neck (SCCHN) is unclear. The aim of this study was to assess the ability of combination chemotherapy to control symptoms in this setting. PATIENTS AND METHODS Using a prospectively accrued database all patients referred for chemotherapy with symptomatic relapse following surgery were identified. Objective response was recorded using standard criteria and maximum symptom response was assessed retrospectively from case notes using a published scoring scale. RESULTS A total of 57 (median age 56, range 37-85) patients were studied who had received mainly cisplatin/5-fluorouracil combinations. Thirty-seven had previously received radiotherapy. Fifty-two patients had evaluable disease; 18 (35%) had objective responses (14 PRs and 4 CRs). There were a total of 103 symptoms recorded with eight different individual symptoms. Forty-four (43%) symptoms improved on treatment, 52 (50%) were unchanged and 7 (7%) worsened. The number of patients with improvement in the most frequently recorded symptoms were as follows: pain 11/28 (39%), swelling 12/23 (52%) and dysphagia 6/18 (33%). Sixty-seven percent of patients with objective response also had an improvement in their symptoms but a significant proportion (33%) of non-responders had a symptomatic response. Lack of objective response was not correlated with worsening symptoms. Grade 3/4 toxicity was uncommon (6%-17%) and there were no toxic deaths. A majority of patients (82%) experienced either no change or an improvement in performance status. CONCLUSION These results demonstrate that chemotherapy improves many of the symptoms associated with recurrent SCCHN, without deterioration in performance status. Symptomatic improvement is more likely if there is evidence of significant tumour shrinkage, but even non-responding patients can benefit.
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Affiliation(s)
- D O Constenla
- Head and Neck Unit, Royal Marsden NHS Trust, London, UK
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