1
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Fisher A, Corrigan E, Cross S, Ryan K, Staples L, Tan R, Webb N, Titov N, Dear BF. Decision-making about uptake and engagement among digital mental health service users: a qualitative exploration of therapist perspectives. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2163157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- A. Fisher
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - E. Corrigan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - S. Cross
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - K. Ryan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - L. Staples
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - R. Tan
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - N. Webb
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - N. Titov
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
| | - B. F. Dear
- The eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
- The MindSpot Clinic, MQ Health, Sydney, Australia
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2
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VELDANDI U, Kavanagh D, Vivarelli M, Bomback A, Wang Y, Bogdanowicz K, Webb N, Meier M, Smith R. WCN23-0584 A MULTICENTER, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE 3 STUDY TO ASSESS THE EFFICACY AND SAFETY OF IPTACOPAN IN IDIOPATHIC IMMUNE COMPLEX-MEDIATED MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS (IC-MPGN). Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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3
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Steer C, Jayasuriya D, Webb N, Young K, Rasekaba T, Kapur M, Blackberry I. Geriatric Assessment in the instagram Era: The Addition of Patient Derived Photographs and Photovoice Discussion to an Electronic Geriatric Assessment to Enhance the Supportive Care of Older Adults with Cancer. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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4
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Jefferson H, Brown A, Hassanabad AF, Webb N, Noss C, Adams C, Kent W. EARLY OUTCOMES OF NEOCORD DS1000 TRANSAPICAL OFF-PUMP REPAIR OF SEVERE MITRAL REGURGITATION IN HIGH-RISK PATIENTS: A SINGLE CENTRE CASE SERIES STUDY. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Brogan P, Naden R, Ardoin SP, Cooper JC, De Benedetti F, Dicaire JF, Eleftheriou D, Feldman B, Goldin J, Karol SE, Price-Kuehne F, Skuse D, Stratakis CA, Webb N, Stone JH. The pediatric glucocorticoid toxicity index. Semin Arthritis Rheum 2022; 56:152068. [PMID: 35917759 DOI: 10.1016/j.semarthrit.2022.152068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To develop a Pediatric glucocorticoid toxicity index (pGTI), a standardized, weighted clinical outcome assessment that measures change in glucocorticoid (GC) toxicity over time. METHODS Fourteen physician experts from 7 subspecialties participated. The physician experts represented multiple subspecialties in which GCs play a major role in the treatment of inflammatory disease: nephrology, rheumatology, oncology, endocrinology, genetics, psychiatry, and maternal-fetal medicine. Nine investigators were from Canada, Europe, or New Zealand, and 5 were from the United States. Group consensus methods and multi-criteria decision analysis were used. The pGTI is an aggregate assessment of GC toxicities that are common, important, and dynamic. These toxicities are organized into health domains graded as minor, moderate, or major and are weighted according to severity. The relative weights were derived by group consensus and multi-criteria decision analysis using the 1000MindsTM software platform. Two quantitative scores comprise the overall toxicity profile derived from pGTI data: (1) the Cumulative Worsening Score; and (2) the Aggregate Improvement Score. The pGTI also includes a qualitative, unweighted record of GC side-effects known as the Damage Checklist, which documents less common toxicities that, although potentially severe, are unlikely to change with varying GC dosing. RESULTS One hundred and seven (107) toxicity items were included in the pGTI and thirty-two (32) in the Damage Checklist. To assess the degree to which the pGTI corresponds to expert clinical judgement, the investigators ranked 15 cases by clinical judgement from highest to lowest GC toxicity. Expert rankings were then compared to case ranking by the pGTI, yielding excellent agreement (weighted kappa 0.86). The pGTI was migrated to a digital environment following its development and initial validation. The digital platform is designed to ensure ease-of-use in the clinic, rigor in application, and accuracy of scoring. Clinic staff enter vital signs, laboratory results, and medication changes relevant to pGTI scoring. Clinicians record findings for GC myopathy, skin toxicity, mood dysfunction, and infection. The pGTI algorithms then apply the weights to these raw data and calculate scores. Embedded logic accounts for the impact of age- and sex-related reference ranges on several health domains: blood pressure, lipid metabolism, and bone mineral density. Other algorithms account for anticipated changes in the height Z-scores used in the growth domain, thereby addressing a concern unique to GC toxicity in children. The Damage Checklist ensures comprehensive measurement of GC toxicity but does not contribute to pGTI scoring, because the scored domains emphasize manifestations of GC toxicity that are likely to change over the course of a trial. CONCLUSIONS We describe the development and initial evaluation of a weighted, composite toxicity index for the assessment of morbidity related to GC use in children and adolescents. Developing the pGTI digital platform was essential for performing the nuanced calculations necessary to ensure rigor, accuracy, and ease-of-use in both clinic and research settings.
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Affiliation(s)
- Paul Brogan
- Great Ormond Street Hospital NHS Foundation Trust, University College London Great Ormond Street Institute of Child Health, London UK
| | - Ray Naden
- McMasterUniversity, Hamilton, Ontario, Canada
| | | | - Jennifer C Cooper
- University of Colorado Anschutz Medical Alifornia, San Francisco, CA, USA
| | | | | | - Despina Eleftheriou
- Great Ormond Street Hospital NHS Foundation Trust, University College London Great Ormond Street Institute of Child Health, London UK
| | - Brian Feldman
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jon Goldin
- Great Ormond Street Hospital NHS Foundation Trust, University College London Great Ormond Street Institute of Child Health, London UK
| | - Seth E Karol
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - David Skuse
- Great Ormond Street Hospital NHS Foundation Trust, University College London Great Ormond Street Institute of Child Health, London UK
| | - Constantine A Stratakis
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Nicholas Webb
- Royal Manchester Children's Hospital, Manchester, UK; Rheumatology Clinic, Bulfinch 165, Massachusetts General Hospital, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - John H Stone
- Great Ormond Street Hospital NHS Foundation Trust, University College London Great Ormond Street Institute of Child Health, London UK.
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6
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Spatola M, Loos C, Cizmeci D, Webb N, Gorman MJ, Rossignol E, Shin S, Yuan D, Fontana L, Mukerji SS, Lauffenburger DA, Gabuzda D, Alter G. Functional compartmentalization of antibodies in the central nervous system during chronic HIV infection. J Infect Dis 2022; 226:738-750. [PMID: 35417540 PMCID: PMC9441210 DOI: 10.1093/infdis/jiac138] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/07/2022] [Indexed: 11/30/2022] Open
Abstract
The central nervous system (CNS) has emerged as a critical HIV reservoir. Thus, interventions aimed at controlling and eliminating HIV must include CNS-targeted strategies. Given the inaccessibility of the brain, efforts have focused on cerebrospinal fluid (CSF), aimed at defining biomarkers of HIV-disease in the CNS, including HIV-specific antibodies. However, how antibodies traffic between the blood and CNS, and whether specific antibody profiles track with HIV-associated neurocognitive disorders (HAND) remains unclear. Here, we comprehensively profiled HIV-specific antibodies across plasma and CSF from 20 antiretroviral therapy (ART) naive or treated persons with HIV. CSF was populated by IgG1 and IgG3 antibodies, with reduced Fc-effector profiles. While ART improved plasma antibody functional coordination, CSF profiles were unaffected by ART and were unrelated to HAND severity. These data point to a functional sieving of antibodies across the blood-brain barrier, providing previously unappreciated insights for the development of next-generation therapeutics targeting the CNS reservoir.
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Affiliation(s)
| | - Carolin Loos
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA.,Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Deniz Cizmeci
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA.,Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Nicholas Webb
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | | | - Evan Rossignol
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Sally Shin
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Dansu Yuan
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Laura Fontana
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | | | | | | | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
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7
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Wong EKS, Praga M, Nester C, Le Quintrec M, Daina E, Remuzzi G, Trapani A, Wang Y, Liu J, Junge G, Meier M, Webb N. FC 036IPTACOPAN (LNP023): A NOVEL ORAL COMPLEMENT ALTERNATIVE PATHWAY FACTOR B INHIBITOR SAFELY AND EFFECTIVELY STABILISES EGFR IN C3 GLOMERULOPATHY. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab121.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Iptacopan (LNP023) is a highly selective oral low molecular weight inhibitor of Factor B, a key complement alternative pathway protease. We have previously reported data from an interim analysis (IA) of a Phase 2 study in patients with native C3G (NCT03832114) showing that a 12-week course of iptacopan results in a 49% reduction in proteinuria with no adverse safety findings (ASN 2020 SU-OR39). The aim of this analysis was to determine whether iptacopan treatment altered eGFR slope in this same population.
Method
Adults with biopsy-proven native C3G received open-label iptacopan for 12w (10-100mg bid during w1-3 then 200mg bid w4-12). All had proteinuria >1g/24h, low plasma C3, were receiving maximally tolerated stable ACEi/ARB and were vaccinated against N. meningitidis, H. influenzae and S. pneumoniae. On study completion, all patients received ongoing iptacopan in a long-term extension study (NCT03955445). Historical data were collected on eGFR (CKD-EPI) for the two-year period prior to patients entering the study or since diagnosis where this was less than two years, and were compared with those obtained in the IA following the commencement of iptacopan. A generalized linear mixed model, with a common intercept, a pre-treatment slope and a change in the slope following iptacopan treatment was used to predict the pre-post iptacopan change in eGFR over time.
Results
12 patients (10 male, 2 female; 11 C3GN, 1 DDD) participated in the IA. Study baseline mean (SD) age was 26.1 (12.1) yrs, geometric mean (CV%) urine PCR 397 (56) g/mol and eGFR 57.9 (65.5) ml/min/1.73m2. Complete data sets were collected for all 12 patients; one patient entered the study immediately following biopsy diagnosis. During the two years prior to the iptacopan treatment, the mean eGFR slope was -14.8 ml/min/1.73m2/year (p=0.0016), consistent with the known natural history of native C3G (Nephron 2020; 144: 272–280). Treatment with iptacopan was associated with a mean increase in eGFR of 3.1 ml/min/1.73m2 from baseline to 12w, corresponding to a mean predicted eGFR preservation of 6.4 ml/min/1.73m2 over 12w as a result of iptacopan administration (Figure 1, p=0.0459). Data collected in seven patients who entered the extension study confirmed ongoing eGFR stability until 25 weeks. There were no deaths or SAEs related to iptacopan and no AEs leading to iptacopan discontinuation in this patient cohort.
Conclusion
12 weeks treatment with iptacopan 200mg bid in patients with C3G resulted in statistically significant and clinically important improvement in eGFR slope with favourable safety and tolerability in addition to significantly reducing proteinuria. Extended iptacopan treatment up to 25 weeks resulted in ongoing stability of eGFR, suggesting that this may result in clinically relevant prolongation of the time to or even potentially prevention of the development of kidney failure.
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Affiliation(s)
| | | | - Carla Nester
- Molecular Otolaryngology and Renal Research Laboratories, University of Iowa, Iowa City, IA, United States of America
- Stead Family Children’s Hospital, University of Iowa, Iowa City, IA, United States of America
| | - Moglie Le Quintrec
- Department of Nephrology and Renal Transplantation, Lapeyronie Hospital, 34295 Montpellier Cedex 5, France
| | - Erica Daina
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Angelo Trapani
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, United States of America
| | - Yaqin Wang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, United States of America
| | - Junhao Liu
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, United States of America
| | - Guido Junge
- Novartis Pharma AG, Lichtstrasse 35, 4056 Basel, Switzerland
| | - Matthias Meier
- Novartis Pharma AG, Lichtstrasse 35, 4056 Basel, Switzerland
| | - Nicholas Webb
- Novartis Pharma AG, Lichtstrasse 35, 4056 Basel, Switzerland
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Christian M, Webb N, Mehta S, Nafsika A, Woolley R, Frew E, Brettell E, Khan A, Milford D, Bockenhauer D, Saleem MA, Hall A, Koziell A, Maxwell H, Hegde S, Prajapati H, Gilbert R, Jones C, McKeever K, Cook W, Ives N. FC 132SHORT COURSE DAILY LOW-DOSE PREDNISOLONE AT THE TIME OF UPPER RESPIRATORY TRACT INFECTION (URTI) IN NON-SELECTED CHILDREN WITH RELAPSING STEROID SENSITIVE NEPHROTIC SYNDROME DOES NOT PREVENT URTI-RELATED RELAPSE: THE PREDNOS 2 TRIAL. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab134.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
At least 80% of children with steroid sensitive nephrotic syndrome (SSNS) have relapses and many are triggered by upper respiratory tract infections (URTIs). Previous small studies (4 studies, 232 patients in total), mostly in children already taking maintenance corticosteroid in countries where URTI epidemiology is different to Europe, showed that giving daily low-dose prednisolone for 5-7 days during an URTI reduces the risk of relapse. The objective of the PREDNOS 2 trial was to determine if these findings were replicated in a large UK population of children with relapsing SSNS on different background medication or none.
Method
A randomised, double-blind, placebo-controlled trial, including a model-based economic evaluation was carried out in 122 UK paediatric departments. Between February 2013 and January 2019, 365 children with relapsing SSNS (mean age: 7.6 ± 3.5 y) were recruited from 91 sites and randomised (1:1) according to a minimisation algorithm based on background treatment (no background treatment; low-dose prednisolone only; low-dose prednisolone and other immunosuppression; other immunosuppression only). At the start of an URTI, children received 6 days of prednisolone 15 mg/m2 or matching preparation of placebo. Those already taking alternate day prednisolone rounded their daily dose using trial medication to the equivalent of 15 mg/m2 or their alternate-day dose, whichever was the greater. The primary outcome was the incidence of first URTI-related relapse (URR) following any URTI over 12 months. Secondary outcomes were the overall rate of relapse, changes in background treatment, cumulative dose of prednisolone, rates of serious adverse events, incidence of corticosteroid adverse effects, change in Achenbach Child Behaviour Checklist score and quality of life. Analysis was by intention to treat. The economic evaluation used trial data and a decision-analytic model to estimate Quality-Adjusted-Life-Years (QALYs) and costs at 1-year, which were then extrapolated over 16 years.
Results
80 children completed 12 m follow-up without an URTI. Consent was withdrawn for 32 children, 14 prior to an URTI, leaving a modified intention to treat analysis population of 271 children (134 and 137 in prednisolone and placebo arms respectively). There were 384 URTIs and 82 URRs in the prednisolone arm, and 407 URTIs and 82 URRs in the placebo arm. The number of patients experiencing a URR was 56 (42.7%) and 58 (44.3%) in the prednisolone and placebo arms respectively (adjusted risk difference: -0.024, 95% CI: -0.14 to 0.095; P=0.7). There was no evidence that the treatment effect differed when data were analysed according to background treatment. There were no significant differences in secondary outcomes between treatment arms. A post-hoc subgroup analysis assessing primary outcome in 58 children of South Asian ethnicity (RR 0.66, 95% CI: 0.396 to 1.105) versus 213 of other ethnicity (RR 1.11, 95% CI: 0.806 to 1.535) showed possible efficacy of intervention in those of South Asian ethnicity (test for interaction P=0.09). Giving daily prednisolone at the time of an URTI was found to increase QALYs and decrease overall costs, when compared to standard care, a finding that was robust to sensitivity analysis.
Conclusion
In a large and methodologically-robust study, PREDNOS 2 has shown that giving 6 days of daily low-dose prednisolone at the time of an URTI does not reduce the risk of relapse of nephrotic syndrome in UK children, but could offer a cost-effective use of health care resources. Further work is needed to investigate inter-ethnic differences in treatment response, and the pathogenesis of individual viral infections and their effect on nephrotic syndrome.
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Affiliation(s)
- Martin Christian
- Nottingham Children's Hospital, Paediatric Nephrology, Nottingham, United Kingdom
| | - Nicholas Webb
- Manchester Children's Hospital, Manchester, United Kingdom
| | - Samir Mehta
- Birmingham Clinical Trials Unit, Birmingham, United Kingdom
| | | | | | - Emma Frew
- University of Birmingham, Birmingham, United Kingdom
| | | | - Adam Khan
- Birmingham Clinical Trials Unit, Birmingham, United Kingdom
| | - David Milford
- Birmingham Children's Hospital, Birmingham, United Kingdom
| | | | - Moin A Saleem
- Bristol Children's Hospital, Bristol, United Kingdom
| | - Angela Hall
- Leicester Children's Hospital, Leicester, United Kingdom
| | - Ania Koziell
- Evelina Children's Hospital, London, United Kingdom
| | | | | | | | - Rodney Gilbert
- Southampton Children's Hospital, Southampton, United Kingdom
| | - Caroline Jones
- Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Karl McKeever
- Royal Hospital for Sick Children, Belfast, United Kingdom
| | - Wendy Cook
- Nephrotic Syndrome Trust (NeST), Taunton, United Kingdom
| | - Natalie Ives
- Birmingham Clinical Trials Unit, Birmingham, United Kingdom
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9
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Rao N, Webb N, Bhatt P, Grandy S, Garcia Sanchez J. POS-288 THE BURDEN OF HEART FAILURE IN PATIENTS WITH NON–DIALYSIS-DEPENDENT ANAEMIA OF CHRONIC KIDNEY DISEASE RECEIVING ERYTHROPOIESIS-STIMULATING AGENTS: A SYSTEMATIC LITERATURE REVIEW. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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10
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Rao N, Webb N, Bhatt P, Grandy S, Garcia Sanchez J. POS-287 TREATMENT BURDEN AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH NON–DIALYSIS-DEPENDENT ANAEMIA OF CHRONIC KIDNEY DISEASE RECEIVING ERYTHROPOIESIS-STIMULATING AGENTS: A SYSTEMATIC LITERATURE REVIEW. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Hodgson HS, Webb N, Diskin L. Consultant-led triage of paediatric hospital referrals: a service evaluation. BMJ Paediatr Open 2021; 5:e000892. [PMID: 33693065 PMCID: PMC7903069 DOI: 10.1136/bmjpo-2020-000892] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/09/2020] [Accepted: 01/09/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE We established a paediatric demand management (PDM) service in our paediatric department in 2017. The aim of this consultant-delivered service is to manage referrals more efficiently by providing active triage of all referrals, daily rapid access clinics and easily accessible advice for primary healthcare professionals. This study presents an evaluation of this service. DESIGN Mixed-methods service evaluation with analysis of data for every contact with the PDM service over a 2-year period. For each patient, the method of contact, reason for contact, presenting complaint and triage outcome were recorded. Feedback from general practitioners (GPs) and patients was gathered. RESULTS Data were analysed for 7162 patients. More than a quarter (2034; 28%) of all referrals were managed with advice only. Of the 4703 outpatient clinic referrals, 1285 (27%) were managed without a clinic appointment. More than half (54%) of the requests for paediatric assessment unit (PAU) admission were managed alternatively, typically with advice only or a rapid access clinic appointment. This has reversed the increasing trend of PAU admissions from primary care of preceding years. Financial analysis suggested the avoidance of these clinic appointments, and PAU admissions provided a substantial cost saving. CONCLUSIONS Our results indicate that the PDM service has succeeded in reducing unnecessary hospital attendances by managing patients more effectively and strengthening partnerships with primary care. The service has received overwhelmingly positive feedback from GPs. This service could be replicated in other Trusts and developed in the future to facilitate further management of paediatric cases in a primary care setting.
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Affiliation(s)
| | - Nicholas Webb
- Paediatrics, Royal United Hospitals Bath NHS Trust, Bath, UK
| | - Lynn Diskin
- Paediatrics, Royal United Hospitals Bath NHS Trust, Bath, UK
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12
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Zelek WM, Cole J, Ponsford MJ, Harrison RA, Schroeder BE, Webb N, Jolles S, Fegan C, Morgan M, Wise MP, Morgan BP. Complement Inhibition with the C5 Blocker LFG316 in Severe COVID-19. Am J Respir Crit Care Med 2020; 202:1304-1308. [PMID: 32897730 PMCID: PMC7605181 DOI: 10.1164/rccm.202007-2778le] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Jade Cole
- University Hospital of Wales, Cardiff, United Kingdom and
| | - Mark J Ponsford
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
| | | | | | - Nicholas Webb
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Stephen Jolles
- University Hospital of Wales, Cardiff, United Kingdom and
| | | | - Matt Morgan
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
| | - Matt P Wise
- Cardiff University, Cardiff, United Kingdom.,University Hospital of Wales, Cardiff, United Kingdom and
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13
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Webb N, Das AM, Hulton S, Levtchenko E, Servais A, Wanner C. P0075EXPERT OPINION ON THE MULTIDISCIPLINARY MANAGEMENT OF CYSTINOSIS IN ADOLESCENT AND ADULT PATIENTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Cystinosis is a rare autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene on chromosome 17p13. It affects between 1:150,000–1:200,000 live births, with a prevalence of approximately 1.6 per million. It is a life-long progressive disease which results in an abnormal lysosomal accumulation of the amino acid cystine in multiple organs and tissues of the body. The most common presentation of cystinosis (95%) is the infantile nephropathic form, with renal symptoms developing in the first few months of life. Over the next 10–20 years, extra-renal manifestations of cystinosis become apparent, which require multidisciplinary care. Here we describe a consensus-based programme with the objective of creating clinical recommendations to support HCPs with the management of adolescents and adults living with the multi-organ effects of cystinosis.
Method
The programme was led by a Steering Committee (SC) of European clinicians with expertise in managing cystinosis. Recommendations were developed using a quasi-Delphi methodology. The SC identified and prioritised a list of key questions. An Extended Faculty (EF) of additional specialists with extensive experience managing cystinosis in patients of all ages, were invited to answer the questions via an online digital platform. The consolidated answers of expert opinion were summarised into recommendations that were supported by evidence-based guidance and additional published data where possible. The EF were invited to agree / disagree with the draft clinical recommendations. Where there was disagreement, the SC members amended the recommendations and the EF re-voted on the revisions. This process continued until consensus was achieved on all final recommendations.
Results
The expert-agreed clinical recommendations reflect the multi-organ effects of cystinosis. Thus, advice on factors relating to the nervous system, muscle involvement, ophthalmology, cardio-respiratory system, dental care and nutrition, dermatology, endocrine system, and gastrointestinal and hepatological involvement, are given, along with renal considerations. Guidance on fertility and family planning that reflect some of the major advances in recent years, are also provided. Ideas on improving psychological well-being and adherence includes recommendations on the use of validated screening tests, increasing access to occupational therapy, and interacting with patient groups. The programme has also produced an online checklist to support HCPs in their daily clinical practice by providing a focus to guide regular consultations with the patient.
Conclusion
These expert recommendations offer HCPs relevant advice that support them in the management of adolescents and adults living with the multi-organ effects of cystinosis. The recommendations complement existing international and local guidance and aim to improve patient outcomes.
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Affiliation(s)
- Nicholas Webb
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Anibh M Das
- Klinik für Päd. Nieren-, Leber- und Stoffwechselerkrankungen, Hannover, Germany
| | - Sally Hulton
- Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Aude Servais
- APHP - Hôpital Necker Enfants Malades Néphrologie, Paris, France
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Webb N, Haraldsson B, Schubart A, Milojevic J, End P, Holbro T, Junge G. MO042LNP023: A NOVEL ORAL COMPLEMENT ALTERNATIVE PATHWAY FACTOR B INHIBITOR FOR THE TREATMENT OF GLOMERULAR DISEASE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa140.mo042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
The alternative complement pathway (AP) provides the central amplification loop of complement activation and is critically involved in a number of diseases including C3 glomerulopathy (C3G), paroxysmal nocturnal haemoglobinuria (PNH) and atypical haemolytic uremic syndrome. There is also evidence for AP dysregulation in IgA and membranous nephropathies (IgAN, MN). Novartis has developed a highly selective oral low molecular weight inhibitor of complement Factor B, a key AP protease. LNP023 potently blocks AP activation in vitro and in vivo and is efficacious in passive Heymann nephritis in rats, suggesting an important role of the AP in classical-pathway mediated nephropathies.
Method
LNP023 was tested at increasing single or multiple ascending doses in a Phase I safety, tolerability, pharmacokinetic (PK) and pharmacodynamic study in healthy volunteers. Complement inhibition was measured by the ex vivo Wieslab assay and by quantifying fragment Bb level.
Results
LNP023 was well tolerated at all doses from 5 mg to 400 mg (single dose) and from 25 mg to 200 mg bid for 14 days (multiple dose). There were no deaths, SAEs or AEs leading to study drug discontinuation in LNP023-treated subjects. LNP023 dose-dependently inhibited the AP complement system. Based on the Wieslab assay, maximal inhibition of AP activity (80% or more) was observed 2 hours after a single dose of 10 mg or higher. The level of Bb decreased until 12 hours post-dose. Approximately 30% to 50% decrease in Bb, relative to baseline, was achieved for subjects receiving a single dose of LNP023 of 5mg or higher. For both assays, the duration of this inhibition was dependent upon the dose administered. Persistent inhibition was obtained in the multiple dose cohorts, the magnitude of inhibition being dose-dependent for the Wieslab assay but not for Bb. PK studies showed rapid drug absorption and no evidence of food effect. The plasma clearance was moderate and the terminal half-life was around 20h. There was an under-proportional dose-exposure relationship. Among other mechanisms, binding to highly expressed target (Factor B) is believed to affect clearance and thus exposure.
Following a successful proof of concept Phase 2 study in PNH (data not shown), LNP023 is currently being investigated in three ongoing Phase 2 studies in IgAN (NCT03373461), C3G (NCT03832114) and MN (NCT04154787). The IgAN study has an adaptive seamless design; the first part has recently completed, 46 patients having received 3 months of one of three LNP023 doses or placebo. The study remains blinded; however, similar to the FIH study safety appears excellent, with only one treatment-emergent SAE (inhalation of chlorine gas) and two SAEs in the post-treatment follow-up period. No patient discontinued randomised treatment for any reason. There were no episodes of proven infection with encapsulated bacteria. The independent data safety monitoring committee have endorsed the study proceeding to the second part with the addition of a fourth LNP023 dose and recruitment is ongoing, completion being anticipated in mid-2020.
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Affiliation(s)
| | | | | | | | - Peter End
- Novartis Pharma AG, Basel, Switzerland
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Boughey P, Jones C, Williams V, Rowe L, Marchant A, Lacey E, Evans B, Morcam C, Webb N, Davies R, Smith E, Shankland H, Leopold N, Harris W, Hudson C, Edwards R. Integrated care of older people (iCOP): an service delivering comprehensive geriatric assessment on the acute assessment unit at Singleton Hospital. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Steer C, Alidina A, Webb N, Long D, Forbes D, Underhill C, Eek R, Clarke K, Shahrokni A. FEASIBILITY OF THE ELECTRONIC RAPID FITNESS ASSESSMENT (ERFA) IN AN AUSTRALIAN REGIONAL CANCER CENTER. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Scaife J, Boughey P, Jones C, Williams V, Rowe L, Marchant A, Lacey E, Rees O, Morcam C, Webb N, Davies R, Smith E, Leopold N, Harris W, Hudson C, Edwards R. 20INTEGRATED CARE OF OLDER PEOPLE (ICOP): A NEW SERVICE DELIVERING COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) ON THE ACUTE ASSESSMENT UNIT AT SINGLETON HOSPITAL: RESULTS OF 2 PDSA CYCLES. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Scaife
- Department of Medicine for Older People, Singleton Hospital
| | - P Boughey
- Department of Medicine for Older People, Singleton Hospital
| | - C Jones
- Department of Medicine for Older People, Singleton Hospital
| | - V Williams
- Department of Medicine for Older People, Singleton Hospital
| | - L Rowe
- Department of Medicine for Older People, Singleton Hospital
| | - A Marchant
- Department of Medicine for Older People, Singleton Hospital
| | - E Lacey
- Department of Medicine for Older People, Singleton Hospital
| | - O Rees
- Department of Medicine for Older People, Singleton Hospital
| | - C Morcam
- Department of Medicine for Older People, Singleton Hospital
| | - N Webb
- Department of Medicine for Older People, Singleton Hospital
| | - R Davies
- Department of Medicine for Older People, Singleton Hospital
| | - E Smith
- Department of Medicine for Older People, Singleton Hospital
| | - N Leopold
- Department of Medicine for Older People, Singleton Hospital
| | - W Harris
- Department of Medicine for Older People, Singleton Hospital
| | - C Hudson
- Department of Medicine for Older People, Singleton Hospital
| | - R Edwards
- Department of Medicine for Older People, Singleton Hospital
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Dierov D, Webb N, Fatmi S, Nwanne C, Ciolino C, Mosesso K, Nieves J, Perales MA, Prockop SE, Ponce DM. Establishing a standardized system for review and adjudication of chronic graft-vs-host disease data in accordance with the National Institutes Consensus criteria. ACTA ACUST UNITED AC 2019; 2. [PMID: 31886456 DOI: 10.1002/acg2.62] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
GVHD is a frequent complication following allo-HCT. The NIH consensus group established new guidelines for the evaluation of chronic GVHD. However, GVHD assessment remains challenging due its complexity and requirement for laborious evaluation. We, therefore, established a standardized approach for the assessment of chronic GVHD in accordance with the NCC guidelines. At a single institution, all allograft recipients were evaluated for GVHD within the first-year post allo-HCT following a 3-step workflow (real-time assessment, consensus review, and documentation). A GVHD adjudication committee was created and a dynamic electronic GVHD data capture form was developed guiding the clinician through a comprehensive review of systems following the NCC guidelines. We found that the assessment and reporting of GVHD reached 100% compliance. The establishment of an institutional GVHD adjudication committee enabled standardized assessment of GVHD. Our workflow can be adopted by other centers to create a similar framework for dedicated GVHD evaluation.
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Affiliation(s)
- Djamilia Dierov
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nicholas Webb
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samira Fatmi
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Chamberlain Nwanne
- Health Informatics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Cristi Ciolino
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kara Mosesso
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jimmy Nieves
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Miguel-Angel Perales
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Cornell Medical College, New York, NY
| | - Susan E Prockop
- Department of Pediatrics, Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Doris M Ponce
- Department of Medicine, Adult Bone Marrow Transplant Service, Memorial Sloan Kettering Cancer Center, New York, NY.,Weill Cornell Medical College, New York, NY
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Chang A, Sivananthan D, Nataraja R, Johnstone L, Webb N, Lopez PJ. Response to the letter to the editor re 'Evidence-based treatment of multicystic dysplastic kidney: A systematic review'. J Pediatr Urol 2019; 15:293. [PMID: 30987866 DOI: 10.1016/j.jpurol.2019.03.007] [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: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/01/2022]
Affiliation(s)
- A Chang
- Monash Children's Hospital, Melbourne, Victoria, Australia.
| | - D Sivananthan
- Monash Children's Hospital, Melbourne, Victoria, Australia
| | - R Nataraja
- Monash Children's Hospital, Melbourne, Victoria, Australia
| | - L Johnstone
- Monash Children's Hospital, Melbourne, Victoria, Australia
| | - N Webb
- Monash Children's Hospital, Melbourne, Victoria, Australia
| | - P J Lopez
- Monash Children's Hospital, Melbourne, Victoria, Australia
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Irvine A, Jones A, Beattie P, Baron S, Browne F, Ashoor F, O'Neill L, Rosala-Hallas A, Sach T, Spowart C, Taams L, Walker C, Wan M, Webb N, Williamson P, Flohr C. The TREatment of severe Atopic eczema Trial (TREAT). Br J Dermatol 2018. [DOI: 10.1111/bjd.17052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Chang A, Sivananthan D, Nataraja RM, Johnstone L, Webb N, Lopez PJ. Evidence-based treatment of multicystic dysplastic kidney: a systematic review. J Pediatr Urol 2018; 14:510-519. [PMID: 30396841 DOI: 10.1016/j.jpurol.2018.09.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 07/02/2018] [Accepted: 09/27/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES There is a lack of a standardised protocol for the investigation and non-operative management of paediatric multicystic dysplastic kidney (MCDK). Institutional protocols for non-operative management remain essentially ad hoc. The primary outcome of this systematic review is to establish the incidence of hypertension associated with an MCDK. The secondary outcome is to determine the malignancy risk associated with an MCDK. The tertiary outcome is to assess the rate of MCDK involution. Subsequent to these, an evidence-based algorithm for follow-up is described. METHODOLOGY A systematic review of all relevant studies published between 1968 and April 2017 was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified by specific inclusion and exclusion criteria, all of which included data relevant to the primary, secondary and tertiary outcomes. Hypertension was defined as systolic blood pressure greater than the 95th centile for gender, age and height centile. Subset analysis was performed for hypertension associated with an MCDK. RESULTS The primary outcome measure revealed a 3.2% (27/838) risk of developing hypertension associated with an MCDK. The secondary outcome measure noted a 0.07% malignancy risk (2/2820). The tertiary outcome measure established that 53.3% (1502/2820) had evidence of involution of the dysplastic kidney. A total of 44 cohort studies (2820 patients) were analysed. CONCLUSION Given the low risk of hypertension and malignancy, which is similar to the general population, the current conservative non-operative pathway is an appropriate management strategy. An algorithm to help support clinicians with ongoing management is proposed.
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Affiliation(s)
- A Chang
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Australia
| | - D Sivananthan
- Department of Paediatric Nephrology, Monash Children's Hospital, Melbourne, Australia
| | - R M Nataraja
- Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - L Johnstone
- Department of Paediatric Nephrology, Monash Children's Hospital, Melbourne, Australia; Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - N Webb
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Australia
| | - P-J Lopez
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne, Australia; Department of Urology, Hospital Exequiel Gonzalez Cortes, Santiago, Chile; Clinica Alemana, Santiago, Chile.
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22
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Irvine AD, Jones AP, Beattie P, Baron S, Browne F, Ashoor F, O'Neill L, Rosala-Hallas A, Sach T, Spowart C, Taams L, Walker C, Wan M, Webb N, Williamson P, Flohr C. A randomized controlled trial protocol assessing the effectiveness, safety and cost-effectiveness of methotrexate vs. ciclosporin in the treatment of severe atopic eczema in children: the TREatment of severe Atopic eczema Trial (TREAT). Br J Dermatol 2018; 179:1297-1306. [PMID: 29727479 DOI: 10.1111/bjd.16717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral systemic immunomodulatory medication is regularly used off-licence in children with severe atopic eczema. However, there is no firm evidence regarding the effectiveness, safety, cost-effectiveness and impact on quality of life from an adequately powered randomized controlled trial (RCT) using systemic medication in children. OBJECTIVES To assess whether there is a difference in the speed of onset, effectiveness, side-effect profile and reduction in flares post-treatment between ciclosporin (CyA) and methotrexate (MTX), and also the cost-effectiveness of the drugs. Treatment impact on quality of life will also be examined in addition to whether FLG genotype influences treatment response. In addition, the trial studies the immune-metabolic effects of CyA and MTX. METHODS Multicentre, parallel group, assessor-blind, pragmatic RCT of 36 weeks' duration with a 24-week follow-up period. In total, 102 children aged 2-16 years with moderate-to-severe atopic eczema, unresponsive to topical treatment will be randomized (1 : 1) to receive MTX (0·4 mg kg-1 per week) or CyA (4 mg kg-1 per day). RESULTS The trial has two primary outcomes: change from baseline to 12 weeks in Objective Severity Scoring of Atopic Dermatitis (o-SCORAD) and time to first significant flare following treatment cessation. CONCLUSIONS This trial addresses important therapeutic questions, highlighted in systematic reviews and treatment guidelines for atopic eczema. The trial design is pragmatic to reflect current clinical practice.
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Affiliation(s)
- A D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland.,Paediatric Dermatology, Our Lady's Children Hospital Crumlin, Dublin, Ireland.,National Children's Research Centre, Crumlin, Dublin, Ireland
| | - A P Jones
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - P Beattie
- Royal Hospital for Children NHS Trust, Glasgow, U.K
| | - S Baron
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - F Browne
- Paediatric Dermatology, Our Lady's Children Hospital Crumlin, Dublin, Ireland
| | - F Ashoor
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - L O'Neill
- Biochemistry, Trinity College Dublin, Dublin, Ireland
| | - A Rosala-Hallas
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - T Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, U.K
| | - C Spowart
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - L Taams
- Centre for Molecular and Cellular Biology of Inflammation, King's College London, London, U.K
| | - C Walker
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - M Wan
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
| | - N Webb
- Renal Research Laboratories, Manchester Royal Infirmary, Manchester, U.K
| | - P Williamson
- Clinical Trials Research Centre, Department of Biostatistics, University of Liverpool, Liverpool, U.K
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
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- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, U.K
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Nataraja RM, Webb N, Lopez PJ. Simulation in paediatric urology and surgery, part 2: An overview of simulation modalities and their applications. J Pediatr Urol 2018; 14:125-131. [PMID: 29456118 DOI: 10.1016/j.jpurol.2017.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/29/2017] [Indexed: 01/19/2023]
Abstract
Surgical training has changed radically in the last few decades. The traditional Halstedian model of time-bound apprenticeship has been replaced with competency-based training. In our previous article, we presented an overview of learning theory relevant to clinical teaching; a summary for the busy paediatric surgeon and urologist. We introduced the concepts underpinning current changes in surgical education and training. In this next article, we give an overview of the various modalities of surgical simulation, the educational principles that underlie them, and potential applications in clinical practice. These modalities include; open surgical models and trainers, laparoscopic bench trainers, virtual reality trainers, simulated patients and role-play, hybrid simulation, scenario-based simulation, distributed simulation, virtual reality, and online simulation. Specific examples of technology that may be used for these modalities are included but this is not a comprehensive review of all available products.
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Affiliation(s)
- R M Nataraja
- Department of Paediatric Surgery, Monash Children's Hospital, Melbourne Australia; Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne Australia.
| | - N Webb
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne Australia
| | - P J Lopez
- Department of Paediatric Urology, Monash Children's Hospital, Melbourne Australia; Department of Urology, Hospital Exequiel Gonzalez Cortes, Santiago, Chile; Clinica Alemana, Santiago, Chile
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Stivaros S, Garg S, Tziraki M, Cai Y, Thomas O, Mellor J, Morris AA, Jim C, Szumanska-Ryt K, Parkes LM, Haroon HA, Montaldi D, Webb N, Keane J, Castellanos FX, Silva AJ, Huson S, Williams S, Gareth Evans D, Emsley R, Green J. Randomised controlled trial of simvastatin treatment for autism in young children with neurofibromatosis type 1 (SANTA). Mol Autism 2018; 9:12. [PMID: 29484149 PMCID: PMC5824534 DOI: 10.1186/s13229-018-0190-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background Neurofibromatosis 1 (NF1) is a monogenic model for syndromic autism. Statins rescue the social and cognitive phenotype in animal knockout models, but translational trials with subjects > 8 years using cognition/behaviour outcomes have shown mixed results. This trial breaks new ground by studying statin effects for the first time in younger children with NF1 and co-morbid autism and by using multiparametric imaging outcomes. Methods A single-site triple-blind RCT of simvastatin vs. placebo was done. Assessment (baseline and 12-week endpoint) included peripheral MAPK assay, awake magnetic resonance imaging spectroscopy (MRS; GABA and glutamate+glutamine (Glx)), arterial spin labelling (ASL), apparent diffusion coefficient (ADC), resting state functional MRI, and autism behavioural outcomes (Aberrant Behaviour Checklist and Clinical Global Impression). Results Thirty subjects had a mean age of 8.1 years (SD 1.8). Simvastatin was well tolerated. The amount of imaging data varied by test. Simvastatin treatment was associated with (i) increased frontal white matter MRS GABA (t(12) = - 2.12, p = .055), GABA/Glx ratio (t(12) = - 2.78, p = .016), and reduced grey nuclei Glx (ANCOVA p < 0.05, Mann-Whitney p < 0.01); (ii) increased ASL perfusion in ventral diencephalon (Mann-Whitney p < 0.01); and (iii) decreased ADC in cingulate gyrus (Mann-Whitney p < 0.01). Machine-learning classification of imaging outcomes achieved 79% (p < .05) accuracy differentiating groups at endpoint against chance level (64%, p = 0.25) at baseline. Three of 12 (25%) simvastatin cases compared to none in placebo met 'clinical responder' criteria for behavioural outcome. Conclusions We show feasibility of peripheral MAPK assay and autism symptom measurement, but the study was not powered to test effectiveness. Multiparametric imaging suggests possible simvastatin effects in brain areas previously associated with NF1 pathophysiology and the social brain network. Trial registration EU Clinical Trial Register (EudraCT) 2012-005742-38 (www.clinicaltrialsregister.eu).
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Affiliation(s)
- Stavros Stivaros
- Academic Unit of Paediatric Radiology, Royal Manchester Children’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Shruti Garg
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Room 3.311, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
| | - Maria Tziraki
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Ying Cai
- Departments of Neurobiology, Psychiatry and Biobehavioral Sciences and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, Brain Research Institute, University of California, California, LA 90095 USA
| | - Owen Thomas
- Academic Unit of Radiology, Salford Royal Foundation NHS Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Joseph Mellor
- Computer Science, University of Manchester, Manchester, UK
| | - Andrew A. Morris
- Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Carly Jim
- Manchester Metropolitan University, Manchester, UK
| | - Karolina Szumanska-Ryt
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Laura M Parkes
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Hamied A. Haroon
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Daniela Montaldi
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Nicholas Webb
- Department of Paediatric Nephrology, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - John Keane
- Computer Science, University of Manchester, Manchester, UK
| | - Francisco X. Castellanos
- Hassenfeld Children’s Hospital at NYU Langone, Nathan S. Kline Institute for Psychiatric Research, New York, USA
| | - Alcino J. Silva
- Departments of Neurobiology, Psychiatry and Biobehavioral Sciences and Psychology, Integrative Center for Learning and Memory, Brain Research Institute, Brain Research Institute, University of California, California, LA 90095 USA
| | - Sue Huson
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - Stephen Williams
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - D. Gareth Evans
- Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Academic Health Sciences Centre, Manchester, UK
| | - Richard Emsley
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Room 3.311, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL UK
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Perrier S, Gauquelin L, Tétreault M, Tran L, Webb N, Srour M, Mitchell J, Brunel-Guitton C, Majewski J, Long V, Keller S, Gambello M, Simons C, Vanderver A, Bernard G. Recessive mutations in NDUFA2
cause mitochondrial leukoencephalopathy. Clin Genet 2017; 93:396-400. [DOI: 10.1111/cge.13126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/07/2017] [Accepted: 08/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S. Perrier
- Department of Neurology and Neurosurgery; McGill University; Montreal Canada
| | - L. Gauquelin
- Department of Neurology and Neurosurgery; McGill University; Montreal Canada
- Department of Pediatrics; McGill University; Montreal Canada
| | - M. Tétreault
- Department of Human Genetics; McGill University; Montreal Canada
- McGill University and Genome Quebec Innovation Centre; Montreal Canada
| | - L.T. Tran
- Department of Neurology and Neurosurgery; McGill University; Montreal Canada
- Department of Pediatrics; McGill University; Montreal Canada
- Department of Medical Genetics, Montreal Children's Hospital; McGill University Health Center; Montreal Canada
- Child Health and Human Development Program; Research Institute of the McGill University Health Centre; Montreal Canada
| | - N. Webb
- Department of Human Genetics; McGill University; Montreal Canada
- Division of Medical Genetics, Department of Pediatrics; CHU Sainte-Justine and Université de Montréal; Montreal Canada
- Montreal Neurological Institute; McGill University; Montreal Canada
| | - M. Srour
- Department of Neurology and Neurosurgery; McGill University; Montreal Canada
- Department of Pediatrics; McGill University; Montreal Canada
- Child Health and Human Development Program; Research Institute of the McGill University Health Centre; Montreal Canada
| | - J.J. Mitchell
- Department of Pediatrics; McGill University; Montreal Canada
- Department of Medical Genetics, Montreal Children's Hospital; McGill University Health Center; Montreal Canada
| | - C. Brunel-Guitton
- Division of Medical Genetics, Department of Pediatrics; CHU Sainte-Justine and Université de Montréal; Montreal Canada
| | - J. Majewski
- Department of Human Genetics; McGill University; Montreal Canada
- McGill University and Genome Quebec Innovation Centre; Montreal Canada
| | - V. Long
- Department of Human Genetics, Division of Medical Genetics; Emory University School of Medicine; Atlanta Georgia
| | - S. Keller
- Department of Pediatrics, Division of Pediatric Neurology; Emory University School of Medicine; Atlanta Georgia
| | - M.J. Gambello
- Department of Human Genetics, Division of Medical Genetics; Emory University School of Medicine; Atlanta Georgia
| | - C. Simons
- Institute for Molecular Bioscience; The University of Queensland; St. Lucia Australia
| | - A. Vanderver
- Department of Neurology, Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania
- Division of Neurology; Children's Hospital of Philadelphia; Philadelphia Pennsylvania
| | - G. Bernard
- Department of Neurology and Neurosurgery; McGill University; Montreal Canada
- Department of Pediatrics; McGill University; Montreal Canada
- Department of Medical Genetics, Montreal Children's Hospital; McGill University Health Center; Montreal Canada
- Child Health and Human Development Program; Research Institute of the McGill University Health Centre; Montreal Canada
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Brocklebank V, Johnson S, Sheerin TP, Marks SD, Gilbert RD, Tyerman K, Kinoshita M, Awan A, Kaur A, Webb N, Hegde S, Finlay E, Fitzpatrick M, Walsh PR, Wong EKS, Booth C, Kerecuk L, Salama AD, Almond M, Inward C, Goodship TH, Sheerin NS, Marchbank KJ, Kavanagh D. Factor H autoantibody is associated with atypical hemolytic uremic syndrome in children in the United Kingdom and Ireland. Kidney Int 2017; 92:1261-1271. [PMID: 28750931 PMCID: PMC5652378 DOI: 10.1016/j.kint.2017.04.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/31/2017] [Accepted: 04/28/2017] [Indexed: 01/23/2023]
Abstract
Factor H autoantibodies can impair complement regulation, resulting in atypical hemolytic uremic syndrome, predominantly in childhood. There are no trials investigating treatment, and clinical practice is only informed by retrospective cohort analysis. Here we examined 175 children presenting with atypical hemolytic uremic syndrome in the United Kingdom and Ireland for factor H autoantibodies that included 17 children with titers above the international standard. Of the 17, seven had a concomitant rare genetic variant in a gene encoding a complement pathway component or regulator. Two children received supportive treatment; both developed established renal failure. Plasma exchange was associated with a poor rate of renal recovery in seven of 11 treated. Six patients treated with eculizumab recovered renal function. Contrary to global practice, immunosuppressive therapy to prevent relapse in plasma exchange-treated patients was not adopted due to concerns over treatment-associated complications. Without immunosuppression, the relapse rate was high (five of seven). However, reintroduction of treatment resulted in recovery of renal function. All patients treated with eculizumab achieved sustained remission. Five patients received renal transplants without specific factor H autoantibody-targeted treatment with recurrence in one who also had a functionally significant CFI mutation. Thus, our current practice is to initiate eculizumab therapy for treatment of factor H autoantibody-mediated atypical hemolytic uremic syndrome rather than plasma exchange with or without immunosuppression. Based on this retrospective analysis we see no suggestion of inferior treatment, albeit the strength of our conclusions is limited by the small sample size.
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Affiliation(s)
- Vicky Brocklebank
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Sally Johnson
- Great North Children's Hospital, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle, UK
| | - Thomas P Sheerin
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Stephen D Marks
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rodney D Gilbert
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kay Tyerman
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Meredith Kinoshita
- The Department for Paediatric Nephrology & Transplantation, The Children's University Hospital, Dublin, Ireland
| | - Atif Awan
- The Department for Paediatric Nephrology & Transplantation, The Children's University Hospital, Dublin, Ireland
| | - Amrit Kaur
- Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Nicholas Webb
- Department of Paediatric Nephrology, Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Eric Finlay
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Patrick R Walsh
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Edwin K S Wong
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK
| | | | - Larissa Kerecuk
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Alan D Salama
- UCL Centre for Nephrology, Royal Free London NHS Foundation Trust, Rowland Hill Street, London, UK
| | - Mike Almond
- Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, UK
| | - Carol Inward
- Department of Paediatric Nephrology, Bristol Royal Hospital for Children, Bristol, UK
| | - Timothy H Goodship
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Neil S Sheerin
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Kevin J Marchbank
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - David Kavanagh
- National Renal Complement Therapeutics Centre, Newcastle University, Newcastle upon Tyne, UK.
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Stockdale A, Webb N, Wootton J, Drennan J, Brown S, Stokes M. Muscle Strength and Functional Ability in Recreational Female Golfers and Less Active Non-Golfers over the Age of 80 Years. Geriatrics (Basel) 2017; 2:E12. [PMID: 31011022 PMCID: PMC6371107 DOI: 10.3390/geriatrics2010012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/27/2017] [Accepted: 03/01/2017] [Indexed: 12/21/2022] Open
Abstract
Muscle strength and functional ability decline with age. Physical activity can slow the decline but whether recreational golf is associated with slower decline is unknown. This cross-sectional, observational study aimed to examine the feasibility of testing muscle strength and functional ability in older female golfers and non-golfers in community settings. Thirty-one females over aged 80, living independently (golfers n = 21, mean age 83, standard deviation (±) 2.1 years); non-golfers, n = 10 (80.8 ± 1.03 years) were studied. Maximal isometric contractions of handgrip and quadriceps were tested on the dominant side. Functional ability was assessed using the Timed Up and Go (TUG) and health-related quality of life using the Short Form-36 questionnaire. Grip strength, normalised to body mass, was greater in golfers (0.33 ± 0.06 kgF/kg) than non-golfers (0.29 ± 0.06), however, the difference was not statistically significant (p = 0.051). Quadriceps strength did not differ (golfers 2.78 ± 0.74 N/kg; non-golfers 2.69 ± 0.83; p = 0.774). TUG times were significantly faster (p = 0.027) in golfers (10.4 ± 1.9 s) than non-golfers (12.6 ± 3.21 s; within sarcopenic category). Quality of life was significantly higher in golfers for the physical categories (Physical Function p < 0.001; Physical p = 0.033; Bodily pain p = 0.028; Vitality p = 0.047) but psychosocial categories did not differ. These findings indicated that the assessment techniques were feasible in both groups and sensitive enough to detect some differences between groups. The indication that golf was associated with better physical function than non-golfers in females over 80 needs to be examined by prospective randomised controlled trials to determine whether golf can help to achieve the recommended guidelines for strengthening exercise to protect against sarcopenia.
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Affiliation(s)
- Alison Stockdale
- Faculty of Health Sciences, Building 45, University of Southampton, Southampton SO17 1BJ, UK.
| | - Nicholas Webb
- Faculty of Health Sciences, Building 45, University of Southampton, Southampton SO17 1BJ, UK.
| | - Jessica Wootton
- Faculty of Health Sciences, Building 45, University of Southampton, Southampton SO17 1BJ, UK.
| | - Jonathan Drennan
- School of Nursing & Midwifery, University College Cork, Cork T12 AK54, Ireland.
| | - Simon Brown
- Faculty of Health Sciences, Building 45, University of Southampton, Southampton SO17 1BJ, UK.
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nottingham NG7 2UH, UK.
| | - Maria Stokes
- Faculty of Health Sciences, Building 45, University of Southampton, Southampton SO17 1BJ, UK.
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nottingham NG7 2UH, UK.
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Spitzer B, Perales MA, Kernan NA, Prockop SE, Zabor EC, Webb N, Castro-Malaspina H, Papadopoulos EB, Young JW, Scaradavou A, Kobos R, Giralt SA, O'Reilly RJ, Boulad F. Second Allogeneic Stem Cell Transplantation for Acute Leukemia Using a Chemotherapy-Only Cytoreduction with Clofarabine, Melphalan, and Thiotepa. Biol Blood Marrow Transplant 2016; 22:1449-1454. [PMID: 27184623 DOI: 10.1016/j.bbmt.2016.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 05/02/2016] [Indexed: 01/07/2023]
Abstract
Relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT) remains one of the leading causes of mortality in patients with leukemia. Treatment options in this population remain limited, with concern for both increased toxicity and further relapse. We treated 18 patients with acute leukemia for marrow ± extramedullary relapse after a previous alloHSCT with a myeloablative cytoreductive regimen including clofarabine, melphalan, and thiotepa followed by a second or third transplantation from the same or a different donor. All patients were in remission at the time of the second or third transplantation. All evaluable patients engrafted. The most common toxicity was reversible transaminitis associated with clofarabine. Two patients died from transplantation-related causes. Seven patients relapsed after their second or third transplanation and died of disease. Nine of 18 patients are alive and disease free, with a 3-year 49% probability of overall survival (OS). Patients whose remission duration after initial alloHSCT was >6 months achieved superior outcomes (3-year OS, 74%, 95% confidence interval, 53% to 100%), compared with those relapsing within 6 months (0%) (P < .001). This new cytoreductive regimen has yielded promising results with acceptable toxicity for second or third transplantations in patients with high-risk acute leukemia who relapsed after a prior transplantation, using various graft and donor options. This approach merits further evaluation in collaborative group studies.
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Affiliation(s)
- Barbara Spitzer
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Miguel-Angel Perales
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Nancy A Kernan
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
| | - Susan E Prockop
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
| | - Emily C Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nicholas Webb
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hugo Castro-Malaspina
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Esperanza B Papadopoulos
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - James W Young
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Andromachi Scaradavou
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rachel Kobos
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sergio A Giralt
- Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Richard J O'Reilly
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
| | - Farid Boulad
- Bone Marrow Transplant Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
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Appelbe D, Adeogun O, Webb N, Majeed R, Lewis M, Williamson P. Development and evaluation of an electronic diary for recording patient reported outcomes in the overt study. Trials 2015. [PMCID: PMC4658787 DOI: 10.1186/1745-6215-16-s2-o64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Walton DJ, Harrison FA, Bachetti M, Barret D, Boggs SE, Christensen FE, Craig WW, Fuerst F, Grefenstette BW, Hailey CJ, Madsen KK, Middleton MJ, Rana V, Roberts TP, Stern D, Sutton AD, Webb N, Zhang W. NUSTARANDXMM-NEWTONOBSERVATIONS OF THE EXTREME ULTRALUMINOUS X-RAY SOURCE NGC 5907 ULX1: A VANISHING ACT. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/799/2/122] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Walton DJ, Harrison FA, Grefenstette BW, Miller JM, Bachetti M, Barret D, Boggs SE, Christensen FE, Craig WW, Fabian AC, Fuerst F, Hailey CJ, Madsen KK, Parker ML, Ptak A, Rana V, Stern D, Webb N, Zhang WW. BROADBAND X-RAY SPECTRA OF THE ULTRALUMINOUS X-RAY SOURCE HOLMBERG IX X-1 OBSERVED WITHNuSTAR,XMM-NEWTON,ANDSUZAKU. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/0004-637x/793/1/21] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Götz D, Osborne J, Cordier B, Paul J, Evans P, Beardmore A, Martindale A, Willingale R, O'Brien P, Basa S, Rossin C, Godet O, Webb N, Greiner J, Nandra K, Meidinger N, Perinati E, Santangelo A, Mercier K, Gonzalez F. The microchannel x-ray telescope for the gamma-ray burst mission SVOM. ACTA ACUST UNITED AC 2014. [DOI: 10.1117/12.2054898] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Plotnicki L, Höcker B, Krupka K, Kohl C, Rahmel A, Pape L, Hoyer P, Marks SD, Webb N, Söylemezoglu O, Topaloglu R, Szabó A, Seeman T, Cornelissen EA, Knops N, Grenda R, Tönshoff B. The CERTAIN Registry: A Novel, Web-Based Registry and Research Platform for Paediatric Renal Transplantation in Europe. Transplantation 2012. [DOI: 10.1097/00007890-201211271-02401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Salimi H, Roche M, Webb N, Gray LR, Chikere K, Sterjovski J, Ellett A, Wesselingh SL, Ramsland PA, Lee B, Churchill MJ, Gorry PR. Macrophage-tropic HIV-1 variants from brain demonstrate alterations in the way gp120 engages both CD4 and CCR5. J Leukoc Biol 2012; 93:113-26. [PMID: 23077246 DOI: 10.1189/jlb.0612308] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BR-derived HIV-1 strains have an exceptional ability to enter macrophages via mechanisms involving their gp120 Env that remain incompletely understood. Here, we used cell-based affinity-profiling methods and mathematical modeling to generate quantitative VERSA metrics that simultaneously measure Env-CD4 and Env-CCR5 interactions. These metrics were analyzed to distinguish the phenotypes of M-tropic and non-M-tropic CCR5-using HIV-1 variants derived from autopsy BRs and LNs, respectively. We show that highly M-tropic Env variants derived from brain can be defined by two distinct and simultaneously occurring phenotypes. First, BR-derived Envs demonstrated an enhanced ability to interact with CD4 compared with LN-derived Envs, permitting entry into cells expressing scant levels of CD4. Second, BR-derived Envs displayed an altered mechanism of engagement between CD4-bound gp120 and CCR5 occurring in tandem. With the use of epitope mapping, mutagenesis, and structural studies, we show that this altered mechanism is characterized by increased exposure of CD4-induced epitopes in gp120 and by a more critical interaction between BR-derived Envs and the CCR5 N-terminus, which was associated with the predicted presence of additional atomic contacts formed at the gp120-CCR5 N-terminus interface. Our results suggest that BR-derived HIV-1 variants with highly efficient macrophage entry adopt conformations in gp120 that simultaneously alter the way in which the Env interacts with CD4 and CCR5.
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Affiliation(s)
- Hamid Salimi
- Center for Virology, Burnet Institute, Melbourne, Victoria, Australia
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36
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Webb N. A Neuropsychologist by Any Other Name: A Review of Principles and Practice of Lifespan Neuropsychology. Arch Clin Neuropsychol 2010. [DOI: 10.1093/arclin/acq085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Webb N, Harden P, Lewis C, Tizzard S, Walsh G, Wray J, Watson A. Building consensus on transition of transplant patients from paediatric to adult healthcare. Arch Dis Child 2010; 95:606-11. [PMID: 20515964 DOI: 10.1136/adc.2009.176255] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Despite improvements in recent years at many centres, there remains an overall lack of consistency in the healthcare and support services provided to young people during their transition from paediatric to adult transplant units. Concerns that such deficiencies may be causally related to subsequent graft loss through patient non-concordance have prompted calls for the delivery of a more patient-centred service. To address these issues, representatives from major transplantation centres in the UK (cardiac, hepatic, renal) and across all disciplines were brought together to produce a series of consensus statements specifying key actions needed to improve the quality and consistency of transition healthcare. DESIGN Participants at the meeting included transplant physicians and surgeons from both adult and paediatric centres, allied health professionals (nurse specialists, psychologists, psychosocial support workers, transplant coordinators, youth workers), as well as young or adolescent transplant patients, their parents/carers and representatives of various support groups concerned with the young transitioning patient. The meeting consisted of presentations, group discussions (plenary and breakout) and a final discussion led by the seven participants who comprised the consensus panel. RESULTS Seven consensus statements emerged from the meeting, which are strongly representative of the current opinion of families and the UK transplant community. CONCLUSIONS The actions they specify may therefore be seen as recommendations for timely and wide adoption, and as guidelines for best practice.
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Affiliation(s)
- Nicholas Webb
- Royal Manchester Children's Hospital, Manchester M13 9WL, UK.
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Phillips M, Haines M, Peck E, Lee H, Phillips B, Wein B, Bekenstein J, O'Grady J, Schoenberg M, Ogrocki P, Maddux B, Whitney C, Gould D, Riley D, Maciunas R, Espe-Pfeifer P, Arguello J, Taber S, Duff K, Fields A, Newby R, Weissgerber K, Epping A, Panepinto J, Scott P, Reesman J, Zabel A, Wodka E, Ferenc L, Comi A, Cohen N, Bigelow S, McCrea Jones L, Sandoval R, Vilar-Lopez R, Puente N, Hidalgo-Ruzante N, Bure A, Ojeda C, Puente A, Zolten A, Mallory L, Heyanka D, Golden C, McCue R, Heyanka D, Mackelprang J, Reuther B, Golden C, Odland A, Scarisbrick D, Heyanka D, Martin P, Golden C, Mazur-Mosiewicz A, Holcomb M, Dean R, Schneider J, Morgan D, Scott J, Leber W, Adams R, Marceaux J, Triebel K, Griffith H, Gifford K, Potter E, Webbe F, Barker W, Loewenstein D, Duara R, Gifford K, Mahaney T, Srinivasan V, Cummings T, Frankl M, Bayan R, Webbe F, Mulligan K, Duncan N, Greenaway M, Sakamoto M, Spiers M, Libon D, Pimontel M, Gavett B, Jefferson A, Nair A, Green R, Stern R, Mahaney T, Frankl M, Cummings T, Mulligan K, Webbe F, Lou K, Gavett B, Jefferson A, Nair A, Green R, Morere D, Gifford K, Ferro J, Ezrine G, Kiefel J, Hinton V, Greco S, Corradino G, Pantone J, MacLeod R, Stern R, Hart J, Lavach J, Pick L, Szymanski C, Ilardi D, Marcus D, Burns T, Mahle W, Jenkins P, Davis A, McDermott A, Pierson E, Freeman Floyd E, McIntosh D, Dixon F, Davis A, Boseck J, Berry K, Whited A, Gelder B, Davis A, Dodd J, Berry K, Boseck J, Koehn E, Gelder B, Riccio C, Kahn D, Perez E, Reynolds C, Scott M, Nguyen-Driver M, Ruchinskas R, Lennen D, Steiner R, Sikora D, Freeman K, Carboni J, Fong G, Fong G, Carboni J, Whigham K, O'Toole K, Schneider B, Burns T, Olivier T, Nemeth D, Whittington L, Moreau A, Webb N, Weimer M, Gontier J, Labrana J, Rioseco F, Lichtenberg P, Puente A, Puente A, Bure A, Buddin H, Teichner G, Golden C, Pacheco E, Chong J, Gold S, Mittenberg W, Miller A, Bruce J, Hancock L, Peterson S, Jacobson J, Guse E, Tyrer J, Lasater J, Fritz J, Lynch S, Yarger L, Bryant K, Zychowski L, Nippoldt-Baca L, Lehman C, Arffa S, Marceaux J, Dilks L, Arthur A, Myers B, Levy J, Blancett S, Martincin K, Thrasher A, Koushik N, McArthur S, Baird A, Foster P, Drago V, Yung R, Crucian G, Heilman K, Castellon S, Livers E, Oppenheim A, Carter C, Ganz P, San Miguel-Montes L, Escabi-Quiles Y, Allen D, Gavett B, Stern R, Nowinski C, Cantu R, Martukovich R, McKee A, Davis A, Roberds E, Lutz J, Williams R, Gupta A, Schoenberg M, Werz M, Maciunas R, Koubeissi M, Poreh A, Luders H, Barwick F, Arnett P, Morse C, Gonzalez-Heydrich J, Luna L, Rao S, McClendon J, Rotelle P, Waber D, Holland A, Boyer K, Faraone S, Whitney J, Guild D, Biederman J, Baerwald J, Ryan G, Baerwald J, Ryan G, Guerrero J, Carmona J, Parsons T, Rizzo A, Lance B, Courtney C, Baerwald J, Ryan G, Perna R, Jackson A, Luton L, O'Toole K, Harrison D, Alosco M, Emerson K, Hill B, Bauer L, Tremont G, Zychowski L, Yarger L, Kegel N, Arffa S, Crockett D, Hunt S, Parks R, Vernon-Wilkinsion R, Hietpas-Wilson T, Zartman A, Gordon S, Krueger K, VanBuren K, Yates A, Hilsabeck R, Campbell J, Riner B, Crowe S, Noggle C, Thompson J, Barisa M, Maulucci A, Noggle C, Thompson J, Barisa M, Maulucci A, Noggle C, Latham K, Thompson J, Barisa M, Maulucci A, Sumowski J, Chiaravalloti N, Lengenfelder J, DeLuca J, Iturriaga L, Henry G, Heilbronner R, Carmona J, Mittenberg W, Enders C, Stevens A, Dux M, Henry G, Heilbronner R, Mittenberg W, Enders C, Myers A, Arffa S, Holland A, Nippoldt-Baca L, Yarger L, Acocella-Stollerman J, Lee E, Peck E, Lee H, Khawaja S, Phillips B, Crockett A, Greve K, Comer C, Ord J, Etherton J, Bianchini K, Curtis K, Harrison A, Edwards M, Harrison A, Edwards M, Cottingham M, Goldberg H, Harrison D, Victor T, Perry L, Pazienza S, Boone K, Bowers T, Triebel K, Denney R, Halfaker D, Tussey C, Barber A, Martin P, Denney R, Deal W, Bailey C, Denney R, Marcopulos B, Schaefer L, Rabin L, Kakkanatt T, Popalzai A, Chantasi K, Heyanka D, Magyar Y, Cruz R, Weiss L, Schatz P, Gibney B, Lietner D, Koushik N, Brooks B, Iverson G, Horton A, Odland A, Reynolds C, Horton A, Reynolds C, Davis A, Finch W, Skierkiewicz A, Rothlisberg B, McIntosh D, Davis A, Finch W, Golden C, Chang M, McIntosh D, Rothlisberg B, Paulson S, Davis A, Starling J, Whited A, Chang M, Roberds E, Dodd J, Martin P, Goldstein G, DeFilippis N, Carlozzi N, Tulsky D, Kurkowski R, Browne K, Wortman K, Gershon R, Heyanka D, Odland A, Golden C, Rodriguez M, Myers A, West S, Golden C, Holster J, Bolanos J, Corsun-Ascher C, Golden C, Robbins J, Restrepo L, Prinzi L, Garcia J, Golden C, Holster J, Bolanos J, Garcia J, Golden C, Osgood J, Trice A, Ernst W, Mahaney T, Gifford K, Oelschlager J, Gurrea J, Tourgeman I, Odland A, Golden C, Tourgeman I, Gurrea J, Stack M, Boddy R, Demsky Y, Golden C, Judd T, Jurecska D, Holmes J, Aguerrevere L, Greve K, Capps D, Izquierdo R, Feldman C, Boddy R, Scarisbrick D, Rice J, Tourgeman I, Golden C, Scarisbrick D, Boddy R, Corsun-Ascher C, Heyanka D, Golden C, Woon F, Hedges D, Odland A, Heyanka D, Martin P, Golden C, Yamout K, Heinrichs R, Baade L, Soetaert D, Perle J, Odland A, Martin P, Golden C, Armstrong C, Bello D, Randall C, Allen D, McLaren T, Konopacki K, Peery S, Miranda F, Saleh M, Moise F, Mendoza J, Mak E, Gomez R, Mihaila E, Parrella M, White L, Harvey P, Marshall D, Gomez R, Keller J, Rogers E, Misa J, Che A, Tennakoon L, Schatzberg A, Sutton G, Allen D, Strauss G, Bello D, Armstrong C, Randall C, Duke L, Ross S, Randall C, Bello D, Armstrong C, Sutton G, Ringdahl E, Thaler N, McMurray J, Sanders L, Isaac H, Allen D, Rumble S, Klonoff P, Wilken J, Sullivan C, Fratto T, Sullivan A, McKenzie T, Ensley M, Saunders C, Quig M, Kane R, Simsarian J, Restrepo L, Rodriguez M, Robbins J, Morrow J, Golden C, Yung R, Sullivan W, Stringer K, Ferguson B, Drago V, Foster P, Lanting S, Brooks B, Iverson G, Horton A, Reynolds C, Scarisbrick D, Odland A, Perle J, Golden C, West S, Collins K, Frisch D, Golden C, Guerrero J, Baerwald J, Yung R, Sullivan W, Stringer K, Ferguson B, Drago V, Foster P, Mackelprang J, Heyanka D, Lennertz L, Morin I, Marker C, Collins M, Dodd J, Goldstein G, DeFilippis N, Holcomb M, Kimball T, Luther E, Belsher B, Botelho V, Reed R, Hernandez B, Noda A, Yesavage J, Kinoshita L, Kakos L, Gunstad J, Hughes J, Spitznagel M, Potter V, Stanek K, Szabo A, Waechter D, Josephson R, Rosneck J, Schofield H, Getz G, Magnuson S, Bryant K, Miller A, Martincin K, Pastel D, Poreh A, Davis J, Ramos C, Sherer C, Bertram D, Wall J, Bryant K, Poreh A, Magnuson S, Miller A, Martincin K, Pastel D, Gow C, Francis J, Olson L, Sautter S, Ord J, Capps D, Greve K, Bianchini K, Stettler T, Daniel M, Kleman V, Etchells M, Rabinowitz A, Barwick F, Arnett P, Proto D, Barker A, Gouvier W, Jones K, Williams J, Lockwood C, Mansoor Y, Homer-Smith E, Moses J, Stolberg P, Jones W, Krach S, Loe S, Mortimer J, Avirett E, Maricle D, Miller D, Avirett E, Mortimer J, Maricle D, Miller D, Avirett E, Mortimer J, Miller D, Maricle D, McGill C, Moneta L, Gioia G, Isquith P, Lazarus G, Puente A, Ahern D, Faust D, Bridges A, Ahern D, Faust D, Bridges A, Hobson V, Hall J, Harvey M, Spering C, Cullum M, Lacritz L, Massman P, Waring S, O'Bryant S, Frisch D, Morrow J, West S, Golden C, West S, Dougherty M, Rice J, Golden C, Morrow J, Frisch D, Pearlson J, Golden C, Thorgusen S, Watson J, Miller A, Kesner R, Levy J, Lambert A, Fazeli P, Marceaux J, Vance D, Marceaux J, Fazeli P, Vance D, Frankl M, Cummings T, Mahaney T, Webbe F, Spering C, Cooper J, Hobson V, O'Bryant S, Bolanos J, Holster J, Metoyer K, Garcia J, Golden C, Brown C, O'Toole K, Brown C, O'Toole K, Granader Y, Keller S, Bender H, Rathi S, Nass R, MacAllister W, Maehr A, Kiefel J, Bigras C, Slick D, Dewey L, Tao R, Motes M, Emslie G, Rypma B, Kahn D, Riccio C, Reynolds C, Eberle N, Mucci G, Chase A, Boyle M, Gallaway M, Bowyer S, Lajiness-O'Neill R, Gifford K, Mahaney T, Cohen R, Gorman P, Levin Allen S, O'Hara E, LeGoff D, Chute D, Barakat L, Laboy G, San Miguel-Montes L, Rios-Motta M, Pita-Garcia I, Van Horn H, Cuevas M, Ross P, Kinjo C, Basanez T, Patel S, Dinishak D, Zhou W, Ortega M, Zareie R, Lane B, Rosen A, Myers A, Domboski K, Ireland S, Mittenberg W, Mazur-Mosiewicz A, Holcomb M, Dean R, Myerson C, Katzen H, Mittel A, McClendon M, Guevara A, Nahab F, Gallo B, Levin B, Fay T, Brooks B, Sherman E, Szabo A, Gunstad J, Spitznagel M, McCaffery J, McGeary J, Paul R, Sweet L, Cohen R, Hancock L, Bruce J, Peterson S, Jacobson J, Tyrer J, Guse E, Lasater J, Fritz J, Lynch S, O'Rourke J, Queller S, Whitlock K, Beglinger L, Stout J, Duff K, Paulsen J, Kim M, Jang J, Chung J, Zukerman J, Miller S, Waterman G, Sadek J, Singer E, Heaton R, van Gorp W, Castellon S, Hinkin C, Yamout K, Baade L, Panos S, Becker B, Kim M, Foley J, Jang J, Chung J, Castellon S, Hinkin C, Kim M, Jang J, Foley J, Chung J, Miller S, Castellon S, Marcotte T, Hinkin C, Merrick E, Kazakov D, Duke L, Field R, Allen D, Mayfield J, Barney S, Thaler N, Allen D, Donohue B, Mayfield J, Mauro C, Shope C, Riber L, Dhami S, Citrome L, Tremeau F, Heyanka D, Corsun-Ascher C, Englebert N, Golden C, Block C, Sautter S, Stolberg P, Terranova J, Jones W, Allen D, Mayfield J, Ramanathan D, Medaglia J, Chiou K, Wardecker B, Slocomb J, Vesek J, Wang J, Hills E, Good D, Hillary F, Kimpton T, Kirshenbaum A, Madathil R, Trontel H, Hall S, Chiou K, Slocomb J, Ramanathan D, Medaglia J, Wardecker B, Vesek J, Wang J, Hills E, Good D, Hillary F, Salinas C, Tiedemann S, Webbe F, Williams C, Wood R, Ringdahl E, Thaler N, Hodges T, Mayfield J, Allen D, Kazakov D, Haderlie M, Terranova J, Martinez A, Allen D, Mayfield J, Medaglia J, Ramanathan D, Chiou K, Wardecker B, Franklin R, Genova H, Deluca J, Hillary F, Pastrana F, Wurst L, Zeiner H, Garcia A, Bender H, Rice J, West S, Dougherty M, Boddy R, Golden C, Tyrer J, Bruce J, Hancock L, Guse E, Jacobson J, Lynch S, Yung R, Sullivan W, Stringer K, Ferguson B, Drago V, Foster P, Scarisbrick D, Heyanka D, Frisch D, Golden C, Prinzi L, Morrow J, Robbins J, Golden C, Fallows R, Amin K, Virden T, Borgaro S, Hubel K, Miles G, Gomez R, Nazarian S, Mucci G, Moreno-Torres M, San Miguel-Montes L, Otero-Zeno T, Rios M, Douglas K, McGhee R, Sakamoto M, Spiers M, Vanderslice-Barr J, Elbin R, Covassin T, Kontos A, Larson E, Stiller-Ostrowski J, McLain M, Serina N, John S, Rautiola M, Waldstein S, Che A, Gomez R, Keller J, Tennakoon L, Marshall D, Rogers E, Misa J, Schatzberg A, Stiles M, Ericson R, Earleywine M, Ericson R, Earleywine M, Tourgeman I, Boddy R, Gurrea J, Buddin H, Golden C, Holcomb M, Mazur-Mosiewicz A, Dean R, Miele A, Lynch J, McCaffrey R, Miele A, Vanderslice-Barr J, Lynch J, McCaffrey R, Wershba R, Stevenson M, Thomas M, Sturgeon J, Youngjohn J, Morgan D, Bello D, Hollimon M, Schneider J, Edgington C, Scott J, Adams R, Morgan D, Bello D, Hollimon M, Schneider J, Edgington C, Scott J, Adams R, Heinrichs R, Baade L, Soetaert D, Barisa M, Noggle C, Thompson J, Barisa M, Noggle C, Thompson J, Barisa M, Noggle C, Thompson J, Pimental P, Riedl K, Kimsey M, Sartori A, Griffith H, Okonkwo O, Marson D, Bertisch H, Schaefer L, McKenzie S, Mittelman M, Hibbard M, Sherr R, Diller L, McTaggart A, Williams R, Troster A, Clark J, Owens T, O'Jile J, Schmitt A, Livingston R, Smernoff E, Galusha J, Piazza J, Gutierrez M, Yeager C, Hyer L, Vaughn E, LaPorte D, Schoenberg M, Werz M, Pedigo T, Lavach J, Hart J, Vyas S, Dorta N, Granader Y, Roberts E, Hill B, Musso M, Pella R, Barker A, Proto D, Gouvier W, Gibson K, Bowers T, Bowers T, Gibson K, Hinkle S, Barisa M, Noggle C, Thompson J, Thompson J, Noggle C, Barisa M, Maulucci A, Thompson J, Noggle C, Barisa M, Maulucci A, Thompson J, Noggle C, Barisa M, Maulucci A, Benitez A, Gunstad J, Spitznagel M, Szabo A, Rogers E, Gomez R, Keller J, Marshall D, Tennakoon L, Che A, Misa J, Schatzber A, Strauss G, Ringdahl E, Barney S, Jetha S, Duke L, Ross S, Watrous B, Allen D, Maucieri L, Noggle C, Barisa M, Thompson J, Maulucci A, Noggle C, Barisa M, Thompson J, Maulucci A, Noggle C, Barisa M, Thompson J, Maulucci A, Noggle C, Thompson J, Barisa M, Maulucci A, Noggle C, Thompson J, Barisa M, Maulucci A, Getz G, Dandridge A, Klein R, La Point S, Holcomb M, Mazur-Mosiewicz A, Dean R, Bailey C, Samples H, Broshek D, Barth J, Freeman J, Schatz P, Neidzwski K, Moser R, Reesman J, Suli-Moci E, Wells C, Moneta L, Dean P, Gioia G, Belsher B, Hutson L, Greenberg L, Sullivan C, Hull A, Poole J, Schatz P, Pardini J, Lovell M, Strauser E, Parish R, Carr W, Paggi M, Anderson-Barnes V, Kelly M, Hutson L, Loughlin J, Sullivan C, Kelley E, Poole J, Hutson L, Loughlin J, Sullivan C, Belsher B, Hull A, Greenberg L, Poole J, Carr W, Parish R, Paggi M, Anderson-Barnes V, Ahlers S, Roebuck Spencer T, O'Neill D, Carter J, Bleiberg J, Lange R, Brubacher J, Iverson G, Madler B, Heran M, MacKay A, Andolfatto G, Krol A, Mrazik M, Lebby P, Johnson W, Sweatt J, Turitz M, Greenawald K, Lesser S, Ormonde A, Lavach J, Hart J, Demakis G, Rimland C, Lengenfelder J, Sumowski J, Smith A, Chiaravalloti N, DeLuca J, Pierson E, Koehn E, Lajiness-O'Neill R, Hyer L, Yeager C, Manatan K, Sherman S, Atkinson M, Massey-Connolly S, Gugnani M, Stack R, Carson A, Mirza N, Johnson E, Lovell M, Perna R, Jackson A, Roy S, Zebeigly A, Larochette A, Bowie C, Harrison A, Nippoldt-Baca L, Bleil J, Arffa S, Thompson J, Noggle C, Mark B, Maulucci A, Umaki T, Denney R, Greenberg L, Hull A, Belsher B, Lee H, Sullivan C, Poole J, Abrigo E, Hurewitz F, Kounios J, Noggle C, Barisa M, Thompson J, Maulucci A, Greve K, Aguerrevere L, Bianchini K, Etherton J, Heinly M, Kontos A, Covassin T, Elbin R, Larson E, Stearne D, Johnson D, Gilliland K, Vincent A, Chafetz M, Herkov M, Morais H, Schwait A, Mangiameli L, Greenhill T. Grand Rounds. Arch Clin Neuropsychol 2009. [DOI: 10.1093/arclin/acp045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abdo AA, Ackermann M, Ajello M, Atwood WB, Axelsson M, Baldini L, Ballet J, Barbiellini G, Bastieri D, Baughman BM, Bechtol K, Bellazzini R, Berenji B, Blandford RD, Bloom ED, Bonamente E, Borgland AW, Bregeon J, Brez A, Brigida M, Bruel P, Burnett TH, Caliandro GA, Cameron RA, Caraveo PA, Casandjian JM, Cecchi C, Celik O, Charles E, Chaty S, Chekhtman A, Cheung CC, Chiang J, Ciprini S, Claus R, Cohen-Tanugi J, Conrad J, Cutini S, Dermer CD, de Palma F, Digel SW, Dormody M, do Couto e Silva E, Drell PS, Dubois R, Dumora D, Farnier C, Favuzzi C, Fegan SJ, Focke WB, Frailis M, Fukazawa Y, Fusco P, Gargano F, Gasparrini D, Gehrels N, Germani S, Giebels B, Giglietto N, Giordano F, Glanzman T, Godfrey G, Grenier IA, Grove JE, Guillemot L, Guiriec S, Hanabata Y, Harding AK, Hayashida M, Hays E, Horan D, Hughes RE, Jóhannesson G, Johnson AS, Johnson RP, Johnson TJ, Johnson WN, Kamae T, Katagiri H, Kawai N, Kerr M, Knödlseder J, Kuehn F, Kuss M, Lande J, Latronico L, Lemoine-Goumard M, Longo F, Loparco F, Lott B, Lovellette MN, Lubrano P, Makeev A, Mazziotta MN, McConville W, McEnery JE, Meurer C, Michelson PF, Mitthumsiri W, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nolan PL, Norris JP, Nuss E, Ohsugi T, Omodei N, Orlando E, Ormes JF, Paneque D, Panetta JH, Parent D, Pelassa V, Pepe M, Pierbattista M, Piron F, Porter TA, Rainò S, Rando R, Razzano M, Rea N, Reimer A, Reimer O, Reposeur T, Ritz S, Rochester LS, Rodriguez AY, Romani RW, Roth M, Ryde F, Sadrozinski HFW, Sanchez D, Sander A, Saz Parkinson PM, Sgrò C, Smith DA, Smith PD, Spandre G, Spinelli P, Starck JL, Strickman MS, Suson DJ, Tajima H, Takahashi H, Tanaka T, Thayer JB, Thayer JG, Thompson DJ, Tibaldo L, Torres DF, Tosti G, Tramacere A, Uchiyama Y, Usher TL, Vasileiou V, Vilchez N, Vitale V, Wang P, Webb N, Winer BL, Wood KS, Ylinen T, Ziegler M. Detection of high-energy gamma-ray emission from the globular cluster 47 Tucanae with Fermi. Science 2009; 325:845-8. [PMID: 19679807 DOI: 10.1126/science.1177023] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [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
We report the detection of gamma-ray emissions above 200 megaelectron volts at a significance level of 17sigma from the globular cluster 47 Tucanae, using data obtained with the Large Area Telescope onboard the Fermi Gamma-ray Space Telescope. Globular clusters are expected to emit gamma rays because of the large populations of millisecond pulsars that they contain. The spectral shape of 47 Tucanae is consistent with gamma-ray emission from a population of millisecond pulsars. The observed gamma-ray luminosity implies an upper limit of 60 millisecond pulsars present in 47 Tucanae.
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Affiliation(s)
- A A Abdo
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
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Abdo A, Ackermann M, Ajello M, Atwood W, Axelsson M, Baldini L, Ballet J, Barbiellini G, Baring M, Bastieri D, Baughman B, Bechtol K, Bellazzini R, Berenji B, Bignami G, Blandford R, Bloom E, Bonamente E, Borgland A, Bregeon J, Brez A, Brigida M, Bruel P, Burnett T, Caliandro G, Cameron R, Camilo F, Caraveo P, Carlson P, Casandjian J, Cecchi C, Çelik Ö, Charles E, Chekhtman A, Cheung C, Chiang J, Ciprini S, Claus R, Cognard I, Cohen-Tanugi J, Cominsky L, Conrad J, Corbet R, Cutini S, Dermer C, Desvignes G, de Angelis A, de Luca A, de Palma F, Digel S, Dormody M, do Couto e Silva E, Drell P, Dubois R, Dumora D, Edmonds Y, Farnier C, Favuzzi C, Fegan S, Focke W, Frailis M, Freire P, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Gehrels N, Germani S, Giebels B, Giglietto N, Giordano F, Glanzman T, Godfrey G, Grenier I, Grondin MH, Grove J, Guillemot L, Guiriec S, Hanabata Y, Harding A, Hayashida M, Hays E, Hobbs G, Hughes R, Jóhannesson G, Johnson A, Johnson R, Johnson T, Johnson W, Johnston S, Kamae T, Katagiri H, Kataoka J, Kawai N, Kerr M, Knödlseder J, Kocian M, Kramer M, Kuss M, Lande J, Latronico L, Lemoine-Goumard M, Longo F, Loparco F, Lott B, Lovellette M, Lubrano P, Madejski G, Makeev A, Manchester R, Marelli M, Mazziotta M, McConville W, McEnery J, McLaughlin M, Meurer C, Michelson P, Mitthumsiri W, Mizuno T, Moiseev A, Monte C, Monzani M, Morselli A, Moskalenko I, Murgia S, Nolan P, Norris J, Nuss E, Ohsugi T, Omodei N, Orlando E, Ormes J, Paneque D, Panetta J, Parent D, Pelassa V, Pepe M, Pesce-Rollins M, Piron F, Porter T, Rainò S, Rando R, Ransom S, Ray P, Razzano M, Rea N, Reimer A, Reimer O, Reposeur T, Ritz S, Rochester L, Rodriguez A, Romani R, Roth M, Ryde F, Sadrozinski HW, Sanchez D, Sander A, Saz Parkinson P, Scargle J, Schalk T, Sgrò C, Siskind E, Smith D, Smith P, Spandre G, Spinelli P, Stappers B, Starck JL, Striani E, Strickman M, Suson D, Tajima H, Takahashi H, Tanaka T, Thayer J, Thayer J, Theureau G, Thompson D, Thorsett S, Tibaldo L, Torres D, Tosti G, Tramacere A, Uchiyama Y, Usher T, Van Etten A, Vasileiou V, Venter C, Vilchez N, Vitale V, Waite A, Wallace E, Wang P, Watters K, Webb N, Weltevrede P, Winer B, Wood K, Ylinen T, Ziegler M. A Population of Gamma-Ray Millisecond Pulsars Seen with the Fermi Large Area Telescope. Science 2009; 325:848-52. [DOI: 10.1126/science.1176113] [Citation(s) in RCA: 175] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- A. A. Abdo
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - M. Ackermann
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - M. Ajello
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - W. B. Atwood
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - M. Axelsson
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Astronomy, Stockholm University, SE-106 91 Stockholm, Sweden
| | - L. Baldini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - J. Ballet
- Laboratoire AIM, CEA/IRFU/CNRS/Université Paris Diderot, Service d’Astrophysique, CEA Saclay, 91191 Gif-sur-Yvette, France
| | - G. Barbiellini
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, I-34127 Trieste, Italy
- Dipartimento di Fisica, Università di Trieste, I-34127 Trieste, Italy
| | - M. G. Baring
- Department of Physics and Astronomy, Rice University, Houston, TX 77251, USA
| | - D. Bastieri
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy
- Dipartimento di Fisica “G. Galilei,” Università di Padova, I-35131 Padova, Italy
| | - B. M. Baughman
- Department of Physics, Center for Cosmology and Astroparticle Physics, Ohio State University, Columbus, OH 43210, USA
| | - K. Bechtol
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - R. Bellazzini
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - B. Berenji
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - G. F. Bignami
- Istituto Universitario di Studi Superiori, I-27100 Pavia, Italy
| | - R. D. Blandford
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - E. D. Bloom
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - E. Bonamente
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - A. W. Borgland
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - J. Bregeon
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - A. Brez
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - M. Brigida
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - P. Bruel
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - T. H. Burnett
- Department of Physics, University of Washington, Seattle, WA 98195, USA
| | - G. A. Caliandro
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - R. A. Cameron
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - F. Camilo
- Columbia Astrophysics Laboratory, Columbia University, New York, NY 10027, USA
| | - P. A. Caraveo
- INAF–Istituto di Astrofisica Spaziale e Fisica Cosmica, I-20133 Milano, Italy
| | - P. Carlson
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Royal Institute of Technology (KTH), AlbaNova, SE-106 91 Stockholm, Sweden
| | - J. M. Casandjian
- Laboratoire AIM, CEA/IRFU/CNRS/Université Paris Diderot, Service d’Astrophysique, CEA Saclay, 91191 Gif-sur-Yvette, France
| | - C. Cecchi
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - Ö. Çelik
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - E. Charles
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. Chekhtman
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
- George Mason University, Fairfax, VA 22030, USA
| | - C. C. Cheung
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - J. Chiang
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - S. Ciprini
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - R. Claus
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - I. Cognard
- Laboratoire de Physique et Chimie de l’Environnement, UMR 6115 CNRS, F45071 Orléans Cedex 02, and Station de Radioastronomie de Nançay, Observatoire de Paris, CNRS/INSU, F18330 Nançay, France
| | - J. Cohen-Tanugi
- Laboratoire de Physique Théorique et Astroparticules, Université Montpellier 2, CNRS/IN2P3, Montpellier, France
| | - L. R. Cominsky
- Department of Physics and Astronomy, Sonoma State University, Rohnert Park, CA 94928, USA
| | - J. Conrad
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Royal Institute of Technology (KTH), AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - R. Corbet
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
- University of Maryland, Baltimore County, Baltimore, MD 21250, USA
| | - S. Cutini
- Agenzia Spaziale Italiana (ASI) Science Data Center, I-00044 Frascati (Roma), Italy
| | - C. D. Dermer
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - G. Desvignes
- Laboratoire de Physique et Chimie de l’Environnement, UMR 6115 CNRS, F45071 Orléans Cedex 02, and Station de Radioastronomie de Nançay, Observatoire de Paris, CNRS/INSU, F18330 Nançay, France
| | - A. de Angelis
- Dipartimento di Fisica, Università di Udine and Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Gruppo Collegato di Udine, I-33100 Udine, Italy
| | - A. de Luca
- Istituto Universitario di Studi Superiori, I-27100 Pavia, Italy
| | - F. de Palma
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - S. W. Digel
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - M. Dormody
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - E. do Couto e Silva
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - P. S. Drell
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - R. Dubois
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - D. Dumora
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - Y. Edmonds
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - C. Farnier
- Laboratoire de Physique Théorique et Astroparticules, Université Montpellier 2, CNRS/IN2P3, Montpellier, France
| | - C. Favuzzi
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - S. J. Fegan
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - W. B. Focke
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - M. Frailis
- Dipartimento di Fisica, Università di Udine and Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, Gruppo Collegato di Udine, I-33100 Udine, Italy
| | | | - Y. Fukazawa
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - S. Funk
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - P. Fusco
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - F. Gargano
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - D. Gasparrini
- Agenzia Spaziale Italiana (ASI) Science Data Center, I-00044 Frascati (Roma), Italy
| | - N. Gehrels
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
- University of Maryland, College Park, MD 20742, USA
| | - S. Germani
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - B. Giebels
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - N. Giglietto
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - F. Giordano
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - T. Glanzman
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - G. Godfrey
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - I. A. Grenier
- Laboratoire AIM, CEA/IRFU/CNRS/Université Paris Diderot, Service d’Astrophysique, CEA Saclay, 91191 Gif-sur-Yvette, France
| | - M. H. Grondin
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - J. E. Grove
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - L. Guillemot
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - S. Guiriec
- University of Alabama, Huntsville, AL 35899, USA
| | - Y. Hanabata
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - A. K. Harding
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - M. Hayashida
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - E. Hays
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - G. Hobbs
- Australia Telescope National Facility, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Epping, NSW 1710, Australia
| | - R. E. Hughes
- Department of Physics, Center for Cosmology and Astroparticle Physics, Ohio State University, Columbus, OH 43210, USA
| | - G. Jóhannesson
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. S. Johnson
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - R. P. Johnson
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - T. J. Johnson
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
- University of Maryland, College Park, MD 20742, USA
| | - W. N. Johnson
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - S. Johnston
- Australia Telescope National Facility, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Epping, NSW 1710, Australia
| | - T. Kamae
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - H. Katagiri
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - J. Kataoka
- Waseda University, 1104 Totsukamachi, Shinjukuku, Tokyo 1698050, Japan
| | - N. Kawai
- Cosmic Radiation Laboratory, Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 3510198, Japan
- Department of Physics, Tokyo Institute of Technology, Meguro City, Tokyo 152-8551, Japan
| | - M. Kerr
- Department of Physics, University of Washington, Seattle, WA 98195, USA
| | - J. Knödlseder
- Centre d’Étude Spatiale des Rayonnements, CNRS/UPS, BP 44346, F-30128 Toulouse Cedex 4, France
| | - M. L. Kocian
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - M. Kramer
- Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - M. Kuss
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - J. Lande
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - L. Latronico
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - M. Lemoine-Goumard
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - F. Longo
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, I-34127 Trieste, Italy
- Dipartimento di Fisica, Università di Trieste, I-34127 Trieste, Italy
| | - F. Loparco
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - B. Lott
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - M. N. Lovellette
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - P. Lubrano
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - G. M. Madejski
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. Makeev
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
- George Mason University, Fairfax, VA 22030, USA
| | - R. N. Manchester
- Australia Telescope National Facility, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Epping, NSW 1710, Australia
| | - M. Marelli
- INAF–Istituto di Astrofisica Spaziale e Fisica Cosmica, I-20133 Milano, Italy
| | - M. N. Mazziotta
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - W. McConville
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
- University of Maryland, College Park, MD 20742, USA
| | - J. E. McEnery
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - M. A. McLaughlin
- Department of Physics, West Virginia University, Morgantown, WV 26506, USA
| | - C. Meurer
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Stockholm University, AlbaNova, SE-106 91 Stockholm, Sweden
| | - P. F. Michelson
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - W. Mitthumsiri
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - T. Mizuno
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - A. A. Moiseev
- University of Maryland, College Park, MD 20742, USA
- Center for Research and Exploration in Space Science and Technology, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - C. Monte
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - M. E. Monzani
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. Morselli
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma “Tor Vergata,” I-00133 Roma, Italy
| | - I. V. Moskalenko
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - S. Murgia
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - P. L. Nolan
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - J. P. Norris
- Department of Physics and Astronomy, University of Denver, Denver, CO 80208, USA
| | - E. Nuss
- Laboratoire de Physique Théorique et Astroparticules, Université Montpellier 2, CNRS/IN2P3, Montpellier, France
| | - T. Ohsugi
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - N. Omodei
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - E. Orlando
- Max-Planck-Institut für Extraterrestrische Physik, 85748 Garching, Germany
| | - J. F. Ormes
- Department of Physics and Astronomy, University of Denver, Denver, CO 80208, USA
| | - D. Paneque
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - J. H. Panetta
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - D. Parent
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - V. Pelassa
- Laboratoire de Physique Théorique et Astroparticules, Université Montpellier 2, CNRS/IN2P3, Montpellier, France
| | - M. Pepe
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - M. Pesce-Rollins
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - F. Piron
- Laboratoire de Physique Théorique et Astroparticules, Université Montpellier 2, CNRS/IN2P3, Montpellier, France
| | - T. A. Porter
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - S. Rainò
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - R. Rando
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy
- Dipartimento di Fisica “G. Galilei,” Università di Padova, I-35131 Padova, Italy
| | - S. M. Ransom
- National Radio Astronomy Observatory (NRAO), Charlottesville, VA 22903, USA
| | - P. S. Ray
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - M. Razzano
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - N. Rea
- Sterrenkundig Institut “Anton Pannekoek,” 1098 SJ Amsterdam, Netherlands
- Institut de Ciencies de l’Espai (IEECCSIC), Campus UAB, 08193 Barcelona, Spain
| | - A. Reimer
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A6020 Innsbruck, Austria
| | - O. Reimer
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
- Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A6020 Innsbruck, Austria
| | - T. Reposeur
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - S. Ritz
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - L. S. Rochester
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. Y. Rodriguez
- Institut de Ciencies de l’Espai (IEECCSIC), Campus UAB, 08193 Barcelona, Spain
| | - R. W. Romani
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - M. Roth
- Department of Physics, University of Washington, Seattle, WA 98195, USA
| | - F. Ryde
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Royal Institute of Technology (KTH), AlbaNova, SE-106 91 Stockholm, Sweden
| | - H. F. W. Sadrozinski
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - D. Sanchez
- Laboratoire Leprince-Ringuet, École Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - A. Sander
- Department of Physics, Center for Cosmology and Astroparticle Physics, Ohio State University, Columbus, OH 43210, USA
| | - P. M. Saz Parkinson
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - J. D. Scargle
- Space Sciences Division, NASA Ames Research Center, Moffett Field, CA 94035, USA
| | - T. L. Schalk
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - C. Sgrò
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - E. J. Siskind
- NYCB RealTime Computing Inc., Lattingtown, NY 11560, USA
| | - D. A. Smith
- CNRS/IN2P3, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
- Université de Bordeaux, Centre d’Études Nucléaires Bordeaux Gradignan, UMR 5797, 33175 Gradignan, France
| | - P. D. Smith
- Department of Physics, Center for Cosmology and Astroparticle Physics, Ohio State University, Columbus, OH 43210, USA
| | - G. Spandre
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa, Italy
| | - P. Spinelli
- Dipartimento di Fisica “M. Merlin” dell’Università e del Politecnico di Bari, I-70126 Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari, Italy
| | - B. W. Stappers
- Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - J. L. Starck
- Laboratoire AIM, CEA/IRFU/CNRS/Université Paris Diderot, Service d’Astrophysique, CEA Saclay, 91191 Gif-sur-Yvette, France
| | - E. Striani
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma “Tor Vergata,” I-00133 Roma, Italy
- Dipartimento di Fisica, Università di Roma “Tor Vergata,” I-00133 Roma, Italy
| | - M. S. Strickman
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - D. J. Suson
- Department of Chemistry and Physics, Purdue University Calumet, Hammond, IN 46323, USA
| | - H. Tajima
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - H. Takahashi
- Department of Physical Sciences, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - T. Tanaka
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - J. B. Thayer
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - J. G. Thayer
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - G. Theureau
- Laboratoire de Physique et Chimie de l’Environnement, UMR 6115 CNRS, F45071 Orléans Cedex 02, and Station de Radioastronomie de Nançay, Observatoire de Paris, CNRS/INSU, F18330 Nançay, France
| | - D. J. Thompson
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - S. E. Thorsett
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
| | - L. Tibaldo
- Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova, Italy
- Dipartimento di Fisica “G. Galilei,” Università di Padova, I-35131 Padova, Italy
| | - D. F. Torres
- Institut de Ciencies de l’Espai (IEECCSIC), Campus UAB, 08193 Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - G. Tosti
- Istituto Nazionale di Fisica Nucleare, Sezione di Perugia, I-06123 Perugia, Italy
- Dipartimento di Fisica, Università degli Studi di Perugia, I-06123 Perugia, Italy
| | - A. Tramacere
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
- Consorzio Interuniversitario per la Fisica Spaziale, I-10133 Torino, Italy
| | - Y. Uchiyama
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - T. L. Usher
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - A. Van Etten
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - V. Vasileiou
- University of Maryland, Baltimore County, Baltimore, MD 21250, USA
- Center for Research and Exploration in Space Science and Technology, NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - C. Venter
- NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
- Unit for Space Physics, NorthWest University, Potchefstroom Campus, Private Bag X6001, Potchefstroom 2520, South Africa
| | - N. Vilchez
- Centre d’Étude Spatiale des Rayonnements, CNRS/UPS, BP 44346, F-30128 Toulouse Cedex 4, France
| | - V. Vitale
- Istituto Nazionale di Fisica Nucleare, Sezione di Roma “Tor Vergata,” I-00133 Roma, Italy
- Dipartimento di Fisica, Università di Roma “Tor Vergata,” I-00133 Roma, Italy
| | - A. P. Waite
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - E. Wallace
- Department of Physics, University of Washington, Seattle, WA 98195, USA
| | - P. Wang
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - K. Watters
- W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics, and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305, USA
| | - N. Webb
- Centre d’Étude Spatiale des Rayonnements, CNRS/UPS, BP 44346, F-30128 Toulouse Cedex 4, France
| | - P. Weltevrede
- Australia Telescope National Facility, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Epping, NSW 1710, Australia
| | - B. L. Winer
- Department of Physics, Center for Cosmology and Astroparticle Physics, Ohio State University, Columbus, OH 43210, USA
| | - K. S. Wood
- Space Science Division, Naval Research Laboratory, Washington, DC 20375, USA
| | - T. Ylinen
- Oskar Klein Centre for Cosmo Particle Physics, AlbaNova, SE-106 91 Stockholm, Sweden
- Department of Physics, Royal Institute of Technology (KTH), AlbaNova, SE-106 91 Stockholm, Sweden
- School of Pure and Applied Natural Sciences, University of Kalmar, SE-391 82 Kalmar, Sweden
| | - M. Ziegler
- Santa Cruz Institute for Particle Physics, Department of Physics and Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064, USA
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Lewis M, Shaw J, Reid C, Evans J, Webb N, Verrier-Jones K. Demography and management of childhood established renal failure in the UK (chapter 13). Nephrol Dial Transplant 2008; 22 Suppl 7:vii165-75. [PMID: 17724044 DOI: 10.1093/ndt/gfm336] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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: 12/24/2022] Open
Abstract
The incidence and prevalence of ERF in children in the UK are relatively static at 8.0 and 47.7 per million population under the age of 15 years, respectively. The prevalence of ERF in children from the South Asian community is almost three times that of the White population whilst the incidence is over three times that of the White population and similar to the increase seen in the adult population. The high incidence and prevalence are related to the high incidence of inherited diseases which cause ERF in the South Asian community. ERF in children is more common in males than females (male to female ratio 1.54:1). This is due to a preponderance of males with renal dysplasia and obstructive uropathy causing ERF. For the South Asian patients, the gender ratio is 1:1 as the inherited diseases are mainly autosomal recessive. Renal dysplasia is the single most common cause of ERF in childhood, followed closely by glomerular disorders and then obstructive uropathy. The majority of prevalent paediatric ERF patients (76%) have a renal allograft. Of these, 28% are from living donations. The proportion of patients from ethnic minority groups with a functioning allograft is significantly smaller than that in the White population (P < 0.0001). Despite this, the rate of living related donation is no higher in the ethnic minority population. In prevalent patients PD is twice as commonly used as HD with the majority managed with automated PD. For patients at one year from starting RRT, 49% are on PD, 10% on HD and 41% have a transplant.
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Affiliation(s)
- Malcolm Lewis
- Central Manchester & Manchester Childrens University Hospitals NHS Trust, UK.
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Ettenger R, Hoyer PF, Grimm P, Webb N, Loirat C, Mahan JD, Mentser M, Niaudet P, Offner G, Vandamme-Lombaerts R, Hexham JM. Multicenter trial of everolimus in pediatric renal transplant recipients: results at three year. Pediatr Transplant 2008; 12:456-63. [PMID: 18466433 DOI: 10.1111/j.1399-3046.2007.00832.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There are few prospective clinical trials of mTOR inhibitors (or proliferation signal inhibitors) combined with CNI inhibitors in de novo pediatric renal transplantation. Results reported here are from a multicenter, open-label study in de novo pediatric renal transplant patients (<or=16 yr), in which patients received everolimus with cyclosporine and corticosteroids for one yr, then entered an extension study for a further two yr. Nineteen patients completed the one-yr study, of whom three discontinued study medication. Fifteen of the remaining 16 patients entered the extension study, eight of whom were aged <10 yr (Group 1) and seven were aged 10-16 yr (Group 2). Mean daily dose of everolimus during the first 36 months was 1.53 mg/m(2) BSA. Biopsy-proven acute rejection occurred in three patients in Group 2 and in one patient in Group 1. Biopsy-proven chronic allograft rejection was reported in four patients (two in each age group). Graft survival at one yr was 100%; one patient in Group 2 lost their graft subsequently during the extension. For patients entering the extension, patient survival at three yr was 100%. There were three cases of viral infection, including one case of cytomegalovirus infection. At three yr, mean total cholesterol was 5.5 +/- 0.8 mm/L (213 +/- 31 mg/dL) and four patients received statin therapy. Mean serum creatinine at 36 months was 96 +/- 36 microm/L (1.1 +/- 0.4 mg/dL). This is the first long-term prospective study to demonstrate that a regimen of everolimus, cyclosporine, and corticosteroids provides good efficacy, tolerability, and safety in de novo pediatric renal transplant patients.
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Affiliation(s)
- Robert Ettenger
- Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA 90095-1752, USA.
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Iyer RV, Yu J, Garrett CR, Litwin A, Khushalani N, Tarquini M, Webb N, Phelan J, Javle MM. Multicenter phase II study of gemcitabine, capecitabine, and bevacizumab in patients with advanced pancreatic cancer (APC): Final analysis of clinical and quality of life endpoints. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lewis M, Shaw J, Reid C, Evans J, Webb N, Verrier-Jones K. Growth in children with established renal failure a Registry analysis (Chapter 14). Nephrol Dial Transplant 2007; 22 Suppl 7:vii176-80. [PMID: 17724045 DOI: 10.1093/ndt/gfm337] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 11/14/2022] Open
Abstract
Short stature is a major problem in paediatric ERF patients with 29% of transplant patients and 41% of dialysis patients below the second percentile for height. Only 6.5% of transplant patients and 15.5% of dialysis patients are receiving rhGH. There is no significant difference in the height distribution of patients commencing RRT and those who have had a functioning allograft for at least 1 year. In patients with at least 2 years between presentation and RRT, there is a significant fall in height Z score. This overall statistic is strongly influenced by the very poor growth of patients with glomerular disease.
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Affiliation(s)
- Malcolm Lewis
- Central Manchester & Manchester Childrens University Hospitals NHS Trust, UK.
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Lewis M, Shaw J, Reid C, Evans J, Webb N, Verrier-Jones K. Aspects of anaemia management in children with established renal failure (Chapter 15). Nephrol Dial Transplant 2007; 22 Suppl 7:vii181-3. [PMID: 17724046 DOI: 10.1093/ndt/gfm338] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite the universal availability of erythropoietin and intravenous iron, 14% of transplant patients and 30% of dialysis patients have a haemoglobin (Hb) <10.5 g/dl. Only 11% of anaemic transplant patients were receiving erythropoietin. There was a linear relationship between estimated glomerular filtration rate (eGFR) and Hb with the risk of anaemia occurring at a much higher eGFR than would be expected in the chronic kidney disease (CKD) population. There was also a significant association between the use of mycophenolate and anaemia. Around 95% of dialysis patients were receiving erythropoietin and 47% intravenous iron. It is speculated that raising the target Hb for this population to 13 g/dl could shift the whole distribution curve to the left, reducing the proportion with anaemia. Doing this would require careful monitoring to steepen the distribution curve and limit the upper tail if complications of high haematocrits are to be avoided.
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Affiliation(s)
- Malcolm Lewis
- Central Manchester & Manchester Childrens University Hospitals NHS Trust, UK.
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Middleton R, Bradbury M, Webb N, O'Donoghue D, Van't Hoff W. Cystinosis. A clinicopathological conference. "From toddlers to twenties and beyond" Adult-Paediatric Nephrology Interface Meeting, Manchester 2001. Nephrol Dial Transplant 2004; 18:2492-5. [PMID: 14605270 DOI: 10.1093/ndt/gfg445] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Rachel Middleton
- Department of Renal Medicine, Hope Hospital, Stott Lane, Salford, Manchester M6 8HD, U.K.
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Webster A, Chapman JR, Craig JC, Mahan J, Orton L, Pankhurst T, Webb N. Polyclonal and monoclonal antibodies for treating acute rejection episodes in kidney transplant recipients. Hippokratia 2004. [DOI: 10.1002/14651858.cd004756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Edwards HGM, Farwell DW, Johnson AF, Lewis IR, Webb N, Ward NJ. Spectroscopic studies of an ambient-pressure process for the selective hydrogenation of polybutadienes. Macromolecules 2002. [DOI: 10.1021/ma00028a005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gadd GE, Evans PJ, Kennedy S, James M, Elcombe M, Cassidy D, Moricca S, Holmes J, Webb N, Dixon A, Prasad P. Gas Storage in Fullerenes. ACTA ACUST UNITED AC 1999. [DOI: 10.1080/10641229909350304] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
The possible coupling between regulation of the affinities for branchial Zn and Ca influx was investigated in juvenile rainbow trout Oncorhynchus mykiss acclimated to relatively hard fresh water ([Ca]=1.0 mmol l-1). The Km for branchial Ca influx was manipulated experimentally by exposing the fish to 2.3 micromol l-1 waterborne Zn for a total of 28 days. This procedure resulted in rapidly increased Km values for both Ca and Zn influx, an effect that remained through the experimental period. There was a significant linear correlation (r=0.88, P<0.02) between Km values for Ca and Zn measured at the same time points. Zn exposure caused progressively increasing maximum rate of transport, Jmax, values for Zn relative to the control value, but there was little, if any, effect on Jmax for Ca. These results support the idea of a shared transport site for Zn and Ca at the apical membrane of the gill epithelium and suggest that there is a certain degree of coregulation of branchial Zn and Ca uptake in rainbow trout. Removal of Ca from the water resulted in a large (six- to 24-fold) increase in affinity (decreased Km) for Zn influx and a modest (1.1- to 1.8-fold) increase in Jmax for Zn. Thus, Ca is a competitive inhibitor of Zn influx. In water lacking Ca, the Km for Zn in Zn-acclimated fish was no different from that of the control fish, suggesting that the Ca2+/Zn2+ transporter was regulated to improve Ca uptake.
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Affiliation(s)
- C Hogstrand
- T. H. Morgan School of Biological Sciences, 101 Morgan Building, University of Kentucky, Lexington, KY 40506-0225, USA.
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