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Willis DE, Purvis RS, Moore R, Li J, Selig JP, Imran T, Zimmerman S, McElfish PA. Social Processes and COVID-19 Vaccination of Children of Hesitant Mothers. J Community Health 2024:10.1007/s10900-024-01340-x. [PMID: 38402520 DOI: 10.1007/s10900-024-01340-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Investigate relationships between pediatric COVID-19 vaccination and social processes of healthcare provider recommendations and school encouragement to provide insights into social processes that may support pediatric COVID-19 vaccination among hesitant mothers. METHODS We analyzed survey data from a subsample (n = 509) of vaccine-hesitant mothers to child patients (ages 2 to 17) in regional clinics across Arkansas. Data were collected between September 16th and December 6th, 2022. Full information maximum likelihood multivariable logistic regression was conducted to evaluate associations with pediatric COVID-19 vaccination. RESULTS Adjusted odds of pediatric COVID-19 vaccination were more than three times greater when a child's healthcare provider recommended vaccination compared to when they did not (aOR = 3.52; 95% CI[2.06, 6.01]). Adjusted odds of pediatric COVID-19 vaccination were 85% greater when a child's school encouraged parents to vaccinate compared to when the school did not (aOR = 1.85; 95% CI[1.13, 3.03]). CONCLUSIONS For pediatric COVID-19 vaccination, having a personal healthcare provider is not significantly different from having no personal healthcare provider if they do not recommend the child be vaccinated. PRACTICE IMPLICATIONS Clinical and public health interventions should consider social processes of healthcare provider recommendations and school encouragement.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA.
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Tabasum Imran
- College of Medicine, University of Arkansas for Medical Sciences West, Fort Smith, AR, USA
| | - Stacy Zimmerman
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR, 72762, USA
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Willis DE, Reece S, Gurel-Headley M, Selig JP, Li J, Zimmerman S, Cornett LE, McElfish PA. Social processes, practical issues, and COVID-19 vaccination among hesitant adults. Vaccine 2023; 41:5150-5158. [PMID: 37423799 PMCID: PMC11045247 DOI: 10.1016/j.vaccine.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION The purpose of this study is to examine relationships between COVID-19 vaccination, social processes, and the practical issues of healthcare coverage and workplace requirements. We examine these relationships among individuals who expressed some degree of hesitancy towards receiving the vaccine. Assessing relationships between COVID-19 vaccination, social processes, and practical issues among vaccine-hesitant individuals has implications for public health policy and intervention. METHODS We analyzed weighted data from a random sample phone survey of Arkansas adults (N = 2,201) between March 1st and March 28th, 2022 and constrained our analytical sample to those who had reported some degree of vaccine hesitancy (N = 1,251). Statistical analyses included weighted and unweighted descriptive statistics, weighted bivariate logistic regressions, and a weighted multivariate logistic regression to obtain adjusted odds ratios for COVID-19 vaccination. RESULTS More than two-thirds (62.5 %) of respondents were vaccinated, despite their hesitancy. Adjusted odds of COVID-19 vaccination were greater among Black (OR = 2.55; 95 % CI[1.63, 3.97]) and Hispanic respondents (OR = 2.46; 95 % CI[1.53, 3.95]), respondents whose healthcare provider recommended vaccination (OR = 2.50; 95 % CI[1.66, 3.77]), and as perceptions of vaccination coverage (OR = 2.04; 95 % CI[1.71, 2.43]) and subjective social status increased (OR = 1.10; 95 % CI[1.01, 1.19]). Adjusted odds of COVID-19 vaccination were greater among respondents with a workplace that recommended (OR = 1.96; 95 % CI[1.03, 3.72]) or required vaccination (OR = 12.62; 95 % CI[4.76, 33.45]) and among respondents who were not employed (OR = 1.82; 95 % CI[1.10, 3.01]) compared to those whose workplace did not recommend or require COVID-19 vaccination. CONCLUSIONS Some hesitant individuals become vaccinated despite their hesitancy-a group we refer to as "hesitant adopters." Social processes and practical issues are important correlates of vaccination among those who are hesitant. Workplace requirements appear to be of particular importance for vaccination among hesitant individuals. Provider recommendations, norms, social status, and workplace policies may be effective points of intervention among those who express vaccine hesitancy.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA.
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Morgan Gurel-Headley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Ji Li
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
| | - Stacy Zimmerman
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Lawrence E Cornett
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48(th) St., Springdale, AR 72762, USA
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Friedman D, Zimmerman S, Tan Z, Freeman J, Curtis J. Watchman device migration and embolization: a report from the NCDR LAAO registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.631] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Incomplete anchoring of the Watchman left atrial appendage closure (LAAO) device can result in substantial device migration or device embolization requiring percutaneous or surgical retrieval.
Purpose
To report rates and characteristics of in-hospital and post-discharge Watchman device migration and embolization events in the United States.
Methods
We performed a retrospective analysis of Watchman procedures (January 2016 through March 2021) reported to the National Cardiovascular Data Registry LAAO Registry. We excluded patients with prior LAAO interventions, no device released, and missing device information. In-hospital events were assessed among all patients and post-discharge events were assessed among patients with 45-day follow-up.
Results
Of 120,278 Watchman procedures, device migration or embolization occurred in 0.07% of patients (n=84) during the index hospitalization and surgery was performed in 39 patients. The in-hospital mortality rate was 14% among patients with device migration or embolization and 20.5% among patients who underwent surgery. In-hospital migration or embolization was more common: at hospitals with a lower median annual procedure volume (24 vs. 41 procedures, p<0.0001), with first-generation Watchman versus next-generation Watchman FLX devices (0.08% vs. 0.04%, p=0.0048), with larger LAA ostia (median 23 mm vs. 21 mm, p=0.004), and with a smaller difference between device and LAA ostial size (median difference 4 mm vs. 5 mm, p=0.04). There were no differences by age, sex, hospital type, hospital size, or teaching versus non-teaching status. Of 98,147 patients with 45-day follow-up, device migration or embolization after discharge occurred in 0.06% (n=54) patients and cardiac surgery was performed in 7.4% (n=4) of cases. The 45-day mortality rate was 3.7% (n=2) among patients with post-discharge device migration or embolization. Post-discharge migration or embolization was more common among men (79.7% of events but 58.9% of all procedures, p=0.0019), taller patients (177.9 cm vs. 172 cm, p=0.0005), and those with greater body mass (99.9 kg vs. 85.5 kg, p=0.0055); in contrast to in-hospital events, there were no differences in hospital volume, device characteristics, or LAA characteristics.
Conclusions
Watchman device migration or embolization is rare but associated with high mortality (Figure 1) and frequently requires surgical retrieval. A substantial proportion of all device migration or embolization cases occur after discharge and different patient and procedure characteristics are associated with in-hospital versus post-discharge cases. Given the morbidity and mortality associated with device migration or embolization, risk mitigation strategies and on-site cardiac surgical back-up are of paramount importance.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health
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Affiliation(s)
- D Friedman
- Duke University , Durham , United States of America
| | - S Zimmerman
- Yale University , New Haven , United States of America
| | - Z Tan
- Yale University , New Haven , United States of America
| | - J Freeman
- Yale University , New Haven , United States of America
| | - J Curtis
- Yale University , New Haven , United States of America
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Lane JB, Stahly S, Sills A, Wagner SD, Zimmerman S, Martin D, Sukpraprut-Braaten S. Examination of Cutaneous Changes Among Patients Following SARS-CoV-2 Infection. Cureus 2022; 14:e27052. [PMID: 36000106 PMCID: PMC9389603 DOI: 10.7759/cureus.27052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/27/2022] Open
Abstract
Individuals infected with SARS-CoV-2 have been found to develop a variety of cutaneous symptoms. This study sought to describe varying cutaneous manifestations of COVID-19 in individuals presenting to an inpatient healthcare facility. We screened individuals who presented with COVID-19 for skin changes throughout the illness and administered a survey regarding demographics, medical history, and their cutaneous findings. Three individuals reported varying skin findings including wheals, petechiae, ecchymosis, and papules. One individual reported a worsening skin condition, psoriasis, as well as a new skin condition, seborrheic dermatitis. In conclusion, cutaneous manifestations of patients suffering from COVID-19 are wide-ranging and worsening skin conditions amongst these patients should be further investigated.
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Makkar A, Siraj T, Zimmerman S, Evans D, Landa E, Ganim I, Sukpraprut-Braaten S, Wagner SD, Abhilash A. Food Bolus Masquerading as a Cardiac Mass on Echocardiogram. Cureus 2021; 13:e17872. [PMID: 34527503 PMCID: PMC8431984 DOI: 10.7759/cureus.17872] [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] [Accepted: 09/09/2021] [Indexed: 11/21/2022] Open
Abstract
An echocardiogram is the most utilized imaging modality in the evaluation of patients with intracardiac masses. Of these, left atrial myxomas are the most common intracardiac tumors in which diagnostic recognition is important for appropriate management. This paper demonstrates a case study on how a proper physical exam along with proper imaging modalities may result in avoiding misdiagnosing patients with large sliding hiatal hernias who present with the complaint of chest pain. This case reveals a food bolus within a sliding hiatal hernia masquerading as an intracardiac mass. Cardiac masses can potentially be misdiagnosed using transthoracic echocardiography (TTE). While transthoracic echocardiography is uniquely resourceful as a point-of-care modality, it can be challenging to confirm whether an identified mass is attached to the myocardium or other cardiac or intrathoracic structures. The patient exhibited symptoms compatible with a cardiac mass. Primarily, the physical examination is vital in determining whether the patient should be referred for additional diagnostic modalities to assess for a cardiac mass. Auscultation of bowel sounds on the cardiac examination is consistent with a suspected hiatal hernia.
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Affiliation(s)
- Abhilash Makkar
- Internal Medicine, Unity Health - White County Medical Center, Searcy, USA
| | - Talhah Siraj
- Internal Medicine, Unity Health - White County Medical Center, Searcy, USA
| | - Stacy Zimmerman
- Internal Medicine, Unity Health - White County Medical Center, Searcy, USA
| | - David Evans
- Cardiology, Unity Health - White County Medical Center, Searcy, USA
| | - Eric Landa
- Internal Medicine, Unity Health, Searcy, USA
| | - Ismail Ganim
- Internal Medicine, Unity Health - White County Medical Center, Searcy, USA
| | | | - Stephen D Wagner
- Internal Medicine, Unity Health - White County Medical Center, Searcy, USA
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Knefati M, Ganim I, Schmidt J, Makkar A, Igtiben S, Landa E, Tarawneh A, Hicks C, Zimmerman S, Sukpraprut-Braaten S. COVID-19 With an Initial Presentation of Intraperitoneal Hemorrhage Secondary to Spontaneous Splenic Rupture. Cureus 2021; 13:e15310. [PMID: 34211811 PMCID: PMC8236337 DOI: 10.7759/cureus.15310] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 01/08/2023] Open
Abstract
The WHO declared coronavirus disease 2019 (COVID-19) a global pandemic in early 2020. As the pandemic has continued to evolve over a period of several months, many cases of unusual presentations are now emerging, which pose a greater challenge for physicians in terms of quickly identifying COVID-19 patients based on initial signs and symptoms. In this report, we present one such unusual presentation in a patient with sudden intraperitoneal hemorrhage and spontaneous splenic rupture with COVID-19 as the likely etiology and contributing factor. The patient was a 75-year-old Caucasian woman who presented to the emergency department (ED) with complaints of severe left-sided abdominal pain for several days without any preceding trauma. A CT of the abdomen/pelvis revealed a large amount of fluid in the abdomen, which raised suspicion of bleeding. An exploratory laparotomy revealed splenic rupture with hemoperitoneum, and the patient subsequently underwent an emergent splenectomy. The patient's COVID-19 antigen test returned positive during the surgery and was subsequently confirmed with a polymerase chain reaction (PCR) test. COVID-19 has been found to result primarily in respiratory symptoms through its ability to invade endothelial cells via angiotensin-converting enzyme 2 affinity. It is speculated that this mechanism may cause a predisposition to micro-thromboses, which can eventually lead to manifestations such as large lymphoid organ thrombosis. Based on this case presentation and the evolving literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spontaneous splenic rupture is an emergent differential diagnosis that should be considered in COVID-19 patients presenting with gastrointestinal complaints such as abdominal pain and nausea.
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Affiliation(s)
| | | | | | | | | | - Eric Landa
- Internal Medicine, Unity Health, Searcy, USA
| | - Ahmad Tarawneh
- Pulmonary and Critical Care Medicine, Unity Health, Searcy, USA
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Hester JC, Zimmerman S, Nimmo TA, Cunningham W, Liu J, Sukpraprut-Braaten S, Pasquel FJ. Euglycemic Diabetic Ketoacidosis Secondary to SGLT2-inhibitor Use in Combination With a Ketogenic Diet. J Endocr Soc 2021. [PMCID: PMC8089890 DOI: 10.1210/jendso/bvab048.776] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are cardiorenal protective agents increasingly used in patients with diabetes. Cases of euglycemic diabetic ketoacidosis (euDKA) have been reported particularly among patients with type 1 diabetes. Our case is an example that highlights the role SGLT-2 inhibitors play in the development of euDKA in a patient with type 2 diabetes with confounding factors of strict adherence to a ketogenic diet and ankle fracture. A 72-year-old female with a history of type 2 diabetes presented to the emergency department (ED) with right ankle pain and obvious deformity after a mechanical fall. Radiography of the right lower extremity confirmed distal fracture of the tibia and fibula. After reduction of her fracture in the ED, she was admitted in anticipation of an open reduction internal fixation. Her diabetes was controlled on empagliflozin monotherapy and adhering to a ketogenic diet. She monitored her blood ketones daily at home and reported values in the 3–4 mmol/L range. On admission, her basic metabolic panel (BMP) revealed a blood glucose of 148 mg/dL, bicarbonate of 20 mEq/L, anion gap of 18 mEq/L, Cr of 1.3 mg/dl, and eGFR of 40 mL/min. Her beta-hydroxybutyrate (BHB) was 5.09 mmol/L. The initial assessment was presumed starvation ketosis. On hospital day three, she complained of continued nausea, polydipsia, and abdominal pain. Chart review revealed nocturia with approximately 3–4 voids per night. Repeat BMP showed a blood glucose of 152 mg/dL, bicarbonate of 16 mEq/L, anion gap still at 18 mEq/L, Cr 1.4 mg/dl, and eGFR of 37 mL/min. Since admission, all of her blood glucose levels ranged between 118–178 mg/dL. She denied dyspnea but exhibited Kussmaul respirations on physical exam. Repeat labs revealed a BHB of 8.92 mmol/L, and arterial blood gas (ABG) showed pH 7.2, pCO2 23, pO2 100, bicarbonate 8.6 mEq/L, consistent with high-anion gap metabolic acidosis, confirming the diagnosis of euDKA. Her empagliflozin had been held since admission, but she had not received any insulin up to this point due to euglycemia. She was immediately started on a weight-based dose of 12 units of insulin glargine with subsequent improvement of her BHB and anion gap. This patient’s use of an SGLT2-inhibitor in combination with her being on a ketogenic diet, contributed to a nonregulated state of ketone production leading to euDKA in the perioperative period. As SGLT2-inhibitors become more readily available, it is important to educate physicians and patients about the risk of euDKA during fasting, ketogenic diets, and the perioperative period.
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Zimmerman S, Abdelkefi A. Enhanced design considerations on the buckling and dynamics of Gannet-inspired systems during water entry. Bioinspir Biomim 2020; 16:026011. [PMID: 33096538 DOI: 10.1088/1748-3190/abc468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
To provide a more complete analysis of Gannet birds and Gannet-inspired drones during diving, this work considers an improved beam model to describe the static and dynamic characteristics of Gannet and Gannet-like drones at impact. The beam model consists of two different geometric and material property beams under continuity conditions to better understand the geometrical and material parameters' influence on the structural statics and dynamics of these kinds of systems. Using Hamilton's principle, the equations of motion, continuity, and boundary conditions considering Euler-Bernoulli and Timoshenko theories are derived. Then, applying the continuity and boundary conditions, the static and dynamic analyses are conducted to examine the impact buckling speeds, the buckled shapes, the natural frequencies at different impact velocities for bioinspired drone design, and the post-buckled mode shapes. The buckled configurations suggest that the body of the Gannet most likely has a different bending and torsional stiffness than the neck. The results indicate that the amount of softening in the joints contributes significantly to not only the speed at which the bird will buckle, but also the buckling profile of the bird. To obtain a physical buckling profile of the Gannet, a stiffer boundary condition at the end of the bird body model is needed due to the increased bending stiffness properties of the body compared to the neck as well as the position of the wings and feet surpassing the end of the body. The results also demonstrate that to build a bioinspired diving drone that falls within a smaller air-vehicle range, the amount of error between theories in predicting the static and dynamic buckling behavior of the system becomes significantly more evident. The dynamic characteristics and mode shapes of the Gannet-like systems are provided for further drone design insight on the impact speeds the drone can achieve without responding to an external excitation frequency from a propeller or actuator.
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Affiliation(s)
- S Zimmerman
- Department of Mechanical and Aerospace Engineering, New Mexico State University, Las Cruces, NM, 88003, United States of America
| | - A Abdelkefi
- Department of Mechanical and Aerospace Engineering, New Mexico State University, Las Cruces, NM, 88003, United States of America
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Orth J, Li Y, Simning A, Zimmerman S, Temkin‐Greener H. Nursing Home Residents with Dementia Experience Better End‐of‐Life Care and Outcomes in Nursing Homes with Alzheimer’s Special Care Units. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13349] [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: 11/27/2022] Open
Affiliation(s)
- J. Orth
- School of Medicine and Dentistry University of Rochester Rochester NY United States
| | - Y. Li
- University of Rochester Medical Center Rochester NY United States
| | - A. Simning
- University of Rochester Medical Center Rochester NY United States
| | - S. Zimmerman
- University of North Carolina at Chapel Hill Chapel Hill NC United States
| | - H. Temkin‐Greener
- School of Medicine and Dentistry University of Rochester Rochester NY United States
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Zimmerman S, Abdelkefi A. Investigations on the buckling and dynamics of diving-inspired systems when entering water. Bioinspir Biomim 2020; 15:036015. [PMID: 32066135 DOI: 10.1088/1748-3190/ab76d8] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work provides comparative modeling approaches to determine the velocities and natural frequencies of plunge-diving bird and bioinspired drone systems when entering water. These systems are chosen to further explain the survival of diving birds as they impact water and to provide insight into the design geometry and material choice of bioinspired diving drones. A nonlinear reduced-order model is developed and utilized to analyze the dive at impact considering both Timoshenko and Euler-Bernoulli beam theories. Using Hamilton's principle, the equations of motion are first derived. Then, static and dynamic buckling analyses are conducted. For this study, a geometrically simplified cone-beam system is considered, where the cone represents the head and the beam represents both the neck and body of the plunge-diving systems. The first study is to analyze the effects different diving drone materials and cone dimensions play on the sensitivity of the system. The second study applies geometric parameters to the cone-beam system representative of a plunge-diving bird (Northern gannet) and a surface-diving bird (Double-crested cormorant). The results show that choosing a material with a higher Young's modulus and a cone with a smaller half angle increase the velocity at which buckling occurs. The buckling velocities of the predicted Northern gannet model appear to be much greater than the average recorded diving speeds, suggesting that the bird is capable of plunge-diving at more extreme conditions. The natural frequencies are found for the aforementioned plunge-diving systems to predict failure if any external frequencies are known to act on the system while on a mission, such as conditions dependent on the climate or environment. It is shown in all buckling studies that the Euler-Bernoulli beam theory consistently overestimates the responses when compared with the Timoshenko beam theory. In the dynamic responses, Euler-Bernoulli beam theory overestimates for the pre-buckling region, then underestimates at the start of the post-buckling region until a point where the two theories cross paths. The amount of error with Euler-Bernoulli beam theory depends heavily on the slenderness ratio of the beam due to the theory being a simplification of the Timoshenko beam theory. It is noted that as the development of a more realistic bird model improves, the thickness will become significant and the use of Euler-Bernoulli beam theory at the point of impact will no longer be a valid assumption.
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Affiliation(s)
- S Zimmerman
- Department of Mechanical and Aerospace Engineering, New Mexico State University, Las Cruces, NM 88003, United States of America
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Ireland C, Damico R, Kolb T, Mathai S, Zimmerman S, Shah A, Mukherjee M, Wigley F, Hassoun P, Kass D, Tedford R, Hsu S. Clinical Surrogates of Right Ventricular-Pulmonary Arterial Uncoupling. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.222] [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] Open
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Zimmerman S, Ceballes S, Taylor G, Chang B, Jung S, Abdelkefi A. Nonlinear modeling and experimental verification of Gannet-inspired beam systems during diving. Bioinspir Biomim 2019; 14:026002. [PMID: 30562725 DOI: 10.1088/1748-3190/aaf98c] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A nonlinear model is proposed to answer at which diving speeds and beak angles will cause injury to Gannet-inspired beam systems during plunge-diving. In doing so, the critical velocities at which buckling occurs with various types of boundary conditions are first obtained for vertical dives and the resulting forces at the point of impact are determined. The Gannet-inspired system is modeled as an Euler-Bernoulli beam to represent the neck and body of the Gannet, while the head of the Gannet is modeled as a cone with varying half-angles. The experimental investigations of Gannet-like diving systems are first introduced to present the varying parameters and assumptions of the simplified model. Next, the resulting forces during impact are investigated and a study is conducted to compare various approximations of the drag coefficient for the cone-shaped head. Considering the mid-plane stretching nonlinearity, the equations of motion for the structural system under various types of boundary conditions are derived using the Hamilton's principle. The characteristic equations, buckled configurations, and critical velocities are determined for each set of boundary conditions. The results show that the system with the smallest half-beak angle and thus the lowest drag force and beam length delays the critical velocity and is most representative of a Gannet during diving. The obtained results demonstrate great agreement with the conducted experiments. For clamped-clamped boundary conditions, the critical velocity is found to be the greatest because of the increased stability at both ends of the beam. It is also noted that a nonlinear approximation for the coefficient of drag offers the best fit with the provided experimental values when compared to a hyperbolic tangent approximation, which predicts the coefficient of drag to be less than that obtained in experiments, and thus predicts that the systems will buckle at higher velocities.
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Affiliation(s)
- S Zimmerman
- Department of Mechanical and Aerospace Engineering, New Mexico State University, Las Cruces, NM 88003, United States of America
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Carder PC, Zimmerman S. INTEREST GROUP SESSION - ASSISTED LIVING: LICENSED NURSE AND ADMINISTRATOR CHARACTERISTICS IN U.S. RESIDENTIAL CARE COMMUNITIES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2912] [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: 11/14/2022] Open
Affiliation(s)
- P C Carder
- Portland State University, Portland, Oregon
| | - S Zimmerman
- School of Social Work, University of North Carolina, Chapel Hill, North Carolina
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14
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Sloane P, Zimmerman S, Silbersack J. MIGRATION OF U.S. AND CANADA RETIREES TO LATIN AMERICAN COLONIAL CITIES: LESSONS LEARNED. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3594] [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)
| | - S Zimmerman
- School of Social Work, University of North Carolina
| | - J Silbersack
- Cecil G. Sheps Center for Health Services Research, University of North Carolina - Chapel Hill
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Zimmerman S, Sloane PD, Ward K, Miller S, Wretman C. CONSIDERATIONS REGARDING IMPLEMENTING NON-PHARMACOLOGICAL PRACTICES IN ASSISTED LIVING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1271] [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)
- S Zimmerman
- School of Social Work, University of North Carolina, Chapel Hill, North Carolina,United States
| | - P D Sloane
- University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - K Ward
- University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - S Miller
- University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - C Wretman
- University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
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Wallden B, Church S, Pekker I, Zimmerman S, Popa S, Sullivan A, Ngouenet C, Harris E, Dowidar N, Bergdahl A, Schaper C, Danaher P, Ferree S. Impact of tissue processing and interferents on the reproducibility and robustness of a multi-plex gene expression assay measuring tumor inflammation. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Jeelani R, Chosed R, Zimmerman S, Chang T, Robinson R, Roudebush W. Blastocoel cell-free DNA content is related to changes in ploidy status (chromosomal loss/gain) in day-5 embryos. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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Bahn J, Gao F, Li X, Zimmerman S, Chen K, Zhao C, Maneval D, Thompson C. PO-264 Preclinical studies with pegvorhyaluronidase alfa (PEGPH20) in combination with FOLFIRINOX (FFX) chemotherapy in models of pancreatic ductal adenocarcinoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
Abstract:It has been known for 70 years that the human pupil dilates when a person responds to a cognitive task. Further, it is known that parasympathetic pupillary innervation decreases with raised attention state while sympathetic innervation increases. But the information the pupil transmits during elevated attention states about such neurological dynamics and a quantitative measure of this information have defied statistical modelling. Now we describe experiments using a short-term memory task called an acoustic impulse test in which the pupillary dynamics in response to random acoustic impulses are recorded with a high resolution (0.01mm) pupillometer with the result that parasympathetic and sympathetic pupillary dilation components are quantifiable, as is the information transmitted by these components.
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Zimmerman S, Cohen L, Washington T, Ward K, Giorgio P. TOOLS FOR QUALITY IMPROVEMENT IN ASSISTED LIVING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2587] [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: 11/12/2022] Open
Affiliation(s)
- S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina,
| | - L. Cohen
- Duke University, Durham, North Carolina,
| | | | - K. Ward
- University of North Carolina, Chapel Hill, North Carolina,
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21
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Zimmerman S, Sloane P, Miller S, Reed D, Preisser J, Hanlon J. TREATING BEHAVIORAL SYMPTOMS OF DEMENTIA IN ASSISTED LIVING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1037] [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)
- S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina,
| | - P.D. Sloane
- University of North Carolina, Chapel Hill, North Carolina,
| | - S. Miller
- University of North Carolina, Chapel Hill, North Carolina,
| | - D. Reed
- University of North Carolina, Chapel Hill, North Carolina,
| | - J. Preisser
- University of North Carolina, Chapel Hill, North Carolina,
| | - J.T. Hanlon
- University of Pittsburgh, Pittsburgh, Pennsylvania
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22
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Degenholtz H, Zimmerman S, Resnick B. FROM EVIDENCE TO PRACTICE AND POLICY: TRANSLATING PROMISING PRACTICES INTO SUSTAINABLE PROGRAMS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2752] [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)
| | - S. Zimmerman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - B. Resnick
- University of Maryland School of Nursing
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Zimmerman S, Reed D, Preisser J, Sloane P. ANTIBIOTIC STEWARDSHIP IN LONG-TERM CARE: RESULTS FROM AN IMPLEMENTATION STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3335] [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: 11/14/2022] Open
Affiliation(s)
- S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina
| | - D. Reed
- University of North Carolina, Chapel Hill, North Carolina
| | - J. Preisser
- University of North Carolina, Chapel Hill, North Carolina
| | - P.D. Sloane
- University of North Carolina, Chapel Hill, North Carolina
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Zimmerman S, Gwyther L. IMPROVING DEMENTIA CARE AND OUTCOMES ACROSS SETTINGS OF CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1035] [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: 11/14/2022] Open
Affiliation(s)
- S. Zimmerman
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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25
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Sloane P, Zimmerman S, Beeber A, Gwyther L, Matchar B, Lathren C, Ward K. HELPING FAMILY CAREGIVERS ATTEND TO MEDICAL SIGNS AND SYMPTOMS OF RELATIVES WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1036] [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)
- P.D. Sloane
- University of North Carolina, Chapel Hill, North Carolina,
| | - S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina,
| | - A.S. Beeber
- University of North Carolina, Chapel Hill, North Carolina,
| | | | | | - C. Lathren
- University of North Carolina, Chapel Hill, North Carolina,
| | - K. Ward
- University of North Carolina, Chapel Hill, North Carolina,
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Hanson L, Zimmerman S, Song M, Lin F, Rosemond C, Carey T, Mitchell S. PROMOTING GOALS OF CARE TO IMPROVE DECISION MAKING IN NURSING HOMES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1039] [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)
- L. Hanson
- University of North Carolina, Chapel Hill, North Carolina,
| | - S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina,
| | - M. Song
- Emory University, Atlanta, Georgia,
| | - F. Lin
- University of North Carolina, Chapel Hill, North Carolina,
| | - C. Rosemond
- University of North Carolina, Chapel Hill, North Carolina,
| | - T. Carey
- University of North Carolina, Chapel Hill, North Carolina,
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Kistler C, Sloane P, Zimmerman S. DECISION-MAKING AROUND DIAGNOSIS AND TREATMENT OF SUSPECTED INFECTIONS IN LONG-TERM CARE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3332] [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: 11/14/2022] Open
Affiliation(s)
- C.E. Kistler
- University of North Carolina, Chapel Hill, North Carolina
| | - P.D. Sloane
- University of North Carolina, Chapel Hill, North Carolina
| | - S. Zimmerman
- University of North Carolina, Chapel Hill, North Carolina
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Reuter R, Zimmerman S, Billars M. 0613 Development of an automated system for measuring supplement intake of grazing animals. J Anim Sci 2016. [DOI: 10.2527/jam2016-0613] [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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29
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Zimmerman S, Zimmerman PR. 1199 Analysis and review of publicly available GreenFeed results. J Anim Sci 2016. [DOI: 10.2527/jam2016-1199] [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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Bahn JD, DesJardins C, Condon KB, Fathallah A, Zimmerman S, Maneval DC, Littlefield BA, Thompson CB. Abstract P1-03-09: Pegylated recombinant human hyaluronidase PH20 (PEGPH20) enhances efficacy of eribulin mesylate (HALAVEN®) in triple negative breast cancer xenografts. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-03-09] [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: 11/16/2022]
Abstract
Abstract
Hyaluronan (hyaluronic acid, HA), a glycosaminoglycan found in tissue throughout the body, overaccumulates in the tumor microenvironment (TME) of many non-hematologic malignancies, including breast cancer. HA overaccumulation in breast cancer patients correlates with tumor progression and decreased survival (Tammi 2008). Pegylated recombinant human hyaluronidase PH20 (PEGPH20), an investigational therapeutic agent entering Phase 3 clinical development in pancreatic cancer, enzymatically removes HA from the TME. In preclinical animal models, PEGPH20-mediated HA degradation is associated with remodeling of the tumor stroma, reduction of tumor pressure, expansion of tumor blood vessels and facilitated delivery of chemotherapy (Thompson 2010, Provenzano 2012, Jacobetz 2013). Accordingly, preclinical studies investigated the combination of PEGPH20 with eribulin mesylate (ERI, HALAVEN®), a microtubule dynamics inhibitor with a novel mechanism of action (Towle 2001, Jordan 2005), currently approved for treatment of certain patients with advanced breast cancer. NCr nu/nu mice were inoculated subcutaneously with human triple-negative breast cancer (TNBC) HCC1806 or HCC1806/HAS3 cells; the latter subline was engineered to accumulate high HA levels, confirmed by immunohistochemistry, via overexpression of hyaluronan synthase 3 (HAS3). When tumors reached ∼350 mm3, animals were randomly assigned to four treatments groups: vehicle, ERI (0.7 mg/kg, IV, QW), PEGPH20 (37.5 µg/kg, IV, BIW), or ERI plus PEGPH20. In the parental HCC1806 model, addition of PEGPH20 did not significantly change the antitumor effects of ERI. In contrast, combining PEGPH20 with ERI in the HCC1806/HAS3 model increased the antitumor effects of ERI by 27% (94.5% vs. 119.7% TGI, ERI alone vs. ERI+PEGPH20, respectively; p=0.05) and resulted in 6 of 7 complete tumor regressions.
In a complementary study in HCC1806/HAS3 tumors evaluating ERI pharmacokinetics with and without PEGPH20, mice were assigned to three treatments groups: ERI (0.5 mg/kg, IV), simultaneous ERI plus PEGPH20 (37.5 µg/kg, IV); or ERI plus PEGPH20 predosed 24 h prior to ERI. Animals were sacrificed at 0.5, 1, 4, 24, 48, 72 and 96 h post ERI dose, and ERI levels in tumor, muscle, plasma and liver were subsequently analyzed by liquid/liquid extraction and LC-MS/MS chromatography. Simultaneous administration of ERI and PEGPH20 increased ERI maximum tumor concentration (Cmax) slightly and approximately doubled ERI tumor exposure (AUC); whereas the 24 h pretreatment with PEGPH20 approximately doubled ERI Cmax and increased ERI AUC more than two-fold. No significant differences in plasma ERI levels were observed between groups, and no significant differences in ERI levels in liver or muscle tissue were observed between groups. Taken together, these data suggest that PEGPH20-mediated HA removal significantly increases both ERI tumor concentrations and antitumor effectiveness in an HA-high TNBC model. A clinical phase 1b/2 clinical trial is planned to evaluate PEGPH20 plus ERI in first-line HER2-negative metastatic breast cancer.
Citation Format: Bahn JD, DesJardins C, Condon KB, Fathallah A, Zimmerman S, Maneval DC, Littlefield BA, Thompson CB. Pegylated recombinant human hyaluronidase PH20 (PEGPH20) enhances efficacy of eribulin mesylate (HALAVEN®) in triple negative breast cancer xenografts. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-03-09.
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Affiliation(s)
- JD Bahn
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - C DesJardins
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - KB Condon
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - A Fathallah
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - S Zimmerman
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - DC Maneval
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - BA Littlefield
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
| | - CB Thompson
- Halozyme Therapeutics, San Diego, CA; Eisai Inc., Andover, MA
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Huhtanen P, Cabezas-Garcia E, Utsumi S, Zimmerman S. Comparison of methods to determine methane emissions from dairy cows in farm conditions. J Dairy Sci 2015; 98:3394-409. [DOI: 10.3168/jds.2014-9118] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/23/2015] [Indexed: 11/19/2022]
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Sloane PD, Figueiro M, Garg S, Cohen LW, Reed D, Williams CS, Preisser J, Zimmerman S. Effect of home-based light treatment on persons with dementia and their caregivers. Light Res Technol 2015; 47:161-176. [PMID: 26273229 PMCID: PMC4530796 DOI: 10.1177/1477153513517255] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Sleep disorders are problematic for persons with dementia and their family caregivers. This randomized controlled trial with crossover evaluated the effects of an innovative blue-white light therapy on 17 pairs of home-dwelling persons with dementia and their caregivers. Subjects with dementia received blue-white light and control ('red-yellow' light) for six weeks separated by a four-week washout. Neither actigraphic nor most self-reported sleep measures significantly differed for subjects with dementia. For caregivers, both sleep and role strain improved. No evidence of retinal light toxicity was observed. Six weeks of modest doses of blue-white light appear to improve sleep in caregivers but not in persons with dementia. Greater or prolonged circadian stimulation may be needed to determine if light is an effective treatment for persons with dementia.
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Affiliation(s)
- PD Sloane
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S Garg
- Department of Ophthalmology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - LW Cohen
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Reed
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - CS Williams
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Preisser
- Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Zimmerman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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van Buul L, van der Steen J, Achterberg W, Schellevis F, Essink R, de Greeff S, Natsch S, Sloane P, Zimmerman S, Twisk J, Veenhuizen R, Hertogh C. O1.23: The effect of tailored antibiotic stewardship programmes on appropriateness of antibiotic prescribing in nursing homes. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70106-8] [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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34
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Zimmerman S, Cohen LW. The Challenge of Translating Culture Change. The Gerontologist 2014. [DOI: 10.1093/geront/gnu086] [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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35
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Elliot A, Cohen LW, Reed D, Nolet K, Zimmerman S. A "Recipe" for Culture Change? Findings From the THRIVE Survey of Culture Change Adopters. The Gerontologist 2014; 54 Suppl 1:S17-24. [DOI: 10.1093/geront/gnt133] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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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36
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Khurram I, Beinart R, Zipunnikov V, Calkins H, Nazarian S, Zimmerman S. Optimal Techniques for Late Gadolinium-Enhanced MRI: Comparison of Delay Time, Slice Thickness, and Multiplanar Reconstruction vs Maximum Intensity Projection for Assessment of Fibrosis in Atrial Fibrillation. Heart Rhythm 2013. [DOI: 10.1016/j.hrthm.2013.09.042] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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37
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Rosenfeld JA, Kim KH, Angle B, Troxell R, Gorski JL, Westemeyer M, Frydman M, Senturias Y, Earl D, Torchia B, Schultz RA, Ellison JW, Tsuchiya K, Zimmerman S, Smolarek TA, Ballif BC, Shaffer LG. Further Evidence of Contrasting Phenotypes Caused by Reciprocal Deletions and Duplications: Duplication of NSD1 Causes Growth Retardation and Microcephaly. Mol Syndromol 2013; 3:247-54. [PMID: 23599694 DOI: 10.1159/000345578] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2012] [Indexed: 12/15/2022] Open
Abstract
Microduplications of the Sotos syndrome region containing NSD1 on 5q35 have recently been proposed to cause a syndrome of microcephaly, short stature and developmental delay. To further characterize this emerging syndrome, we report the clinical details of 12 individuals from 8 families found to have interstitial duplications involving NSD1, ranging in size from 370 kb to 3.7 Mb. All individuals are microcephalic, and height and childhood weight range from below average to severely restricted. Mild-to-moderate learning disabilities and/or developmental delay are present in all individuals, including carrier family members of probands; dysmorphic features and digital anomalies are present in a majority. Craniosynostosis is present in the individual with the largest duplication, though the duplication does not include MSX2, mutations of which can cause craniosynostosis, on 5q35.2. A comparison of the smallest duplication in our cohort that includes the entire NSD1 gene to the individual with the largest duplication that only partially overlaps NSD1 suggests that whole-gene duplication of NSD1 in and of itself may be sufficient to cause the abnormal growth parameters seen in these patients. NSD1 duplications may therefore be added to a growing list of copy number variations for which deletion and duplication of specific genes have contrasting effects on body development.
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Affiliation(s)
- J A Rosenfeld
- Signature Genomic Laboratories, PerkinElmer, Inc., Spokane, Wash., USA
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Koziol-McLain J, Ritchie M, Zimmerman S. VIOLENCE INTERVENTION PROGRAMME (VIP); IMPROVING NEW ZEALAND'S HEALTH SYSTEM RESPONSE TO FAMILY VIOLENCE. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580f.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kultti A, Zimmerman S, Huang L, Jadin L, Jiang P, Frost G, Shepard H, Huang J. 325 Mesenchymal Stem Cells Promote Proliferation of Breast Cancer Cells Via Hyaluronan-CD44 Interaction. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lev S, Gasparich G, Choi F, King L, Moore J, Zimmerman S. Establishing the detection threshold for Bacillus subtilis in a complex matrix using an inorganic fingerprint approach. Talanta 2011; 85:1734-7. [DOI: 10.1016/j.talanta.2011.06.072] [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] [Received: 05/25/2011] [Revised: 06/24/2011] [Accepted: 06/27/2011] [Indexed: 10/18/2022]
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Jolley CJ, Zimmerman S, Shah S, Davison N, Singh S. P207 Obstructive sleep apnoea in patients undergoing bariatric surgery--a London teaching hospital experience. Thorax 2010. [DOI: 10.1136/thx.2010.151068.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cook T, Zimmerman S, Kim W, Boonn W. TH-C-201B-11: Automated Extraction and Reporting of Dose Information from Computed Tomography Examinations. Med Phys 2010. [DOI: 10.1118/1.3469528] [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] Open
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Zimmerman S, Cook T, Kim W, Boonn W. TH-C-201B-01: Changes in Radiation Dose of Abdominal and Pelvic Computed Tomography Examinations over a Seven Year Period. Med Phys 2010. [DOI: 10.1118/1.3469518] [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] Open
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44
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Magnusson R, Shokooh-Saremi M, Hu Y, Lee KJ, Platzer SJW, Nebioglu AK, Zimmerman S, Wawro D. Fabrication of guided-mode resonance elements by nanoimprint lithography. J Nanosci Nanotechnol 2010; 10:1606-1615. [PMID: 20355547 DOI: 10.1166/jnn.2010.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This paper addresses utilization of nanoimprint lithography for fabrication of nanopatterned resonant photonic elements. These compact periodic films resonate sharply when illuminated with light. The attendant spectral and angular signatures are useful in design of photonic devices for various applications. It is of interest to design and optimize resonant leaky-mode elements with prescribed filtering, polarization, and security attributes. Applying nanoimprint lithography techniques, we fabricate prototype devices using polymer materials produced by Dymax Corporation. The initial prototypes are designed for use in the near-IR and telecommunications spectral regions. We apply holographic surface-relief gratings as master templates. With these templates, we have formed submasters in PDMS (polydimethylsiloxane) to function as imprint stamps for the soft lithography steps. Using these submasters, we fabricate periodic surfaces in UV-curable polymers with resonant films deposited on the surface by sputtering. Several example devices possessing resonance efficiencies exceeding 90% are presented along with their spectral and angular characteristics.
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Affiliation(s)
- R Magnusson
- Department of Electrical Engineering, University of Texas at Arlington, Box 19016, Arlington, Texas 76019, USA
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Postolache T, Zimmerman S, Lapidus M, Cabassa J, D'Agostino D, Langenberg P, Tonelli L. Changes in Severity of Allergy and Anxiety Symptoms Are Positively Correlated in Patients with Recurrent Mood Disorders Who Are Exposed to Seasonal Peaks of Aeroallergens. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stearns SC, Park J, Zimmerman S, Gruber-Baldini AL, Konrad TR, Sloane PD. Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings. The Gerontologist 2007; 47:662-71. [DOI: 10.1093/geront/47.5.662] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [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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Bobe G, Zimmerman S, Hammond EG, Freeman AE, Porter PA, Luhman CM, Beitz DC. Butter composition and texture from cows with different milk fatty acid compositions fed fish oil or roasted soybeans. J Dairy Sci 2007; 90:2596-603. [PMID: 17517699 DOI: 10.3168/jds.2006-875] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Changing the milk fatty acid composition can improve the nutritional and physical properties of dairy products and their acceptability to consumers. A more healthful milk fatty acid composition can be achieved by altering the cow's diet, for example, by feeding supplemental fish oil (FO) or roasted soybeans (RSB), or by selecting cows with a more unsaturated milk fatty acid composition. We examined whether feeding supplemental FO or RSB to cows that had a more unsaturated milk fatty acid composition acted additively to produce butter with improved fatty acid composition and texture. Using a 3 x 3 Latin square design with 2 replications, we fed diets to multiparous Holstein cows (60 to 200 DIM) chosen for producing either more or less unsaturated milk fatty acid composition (n = 6 for each group) for three 3-wk periods. The control diet contained 3.7% crude fat and the 2 experimental diets contained, on a dry matter basis, 0.8% of additional lipids in the form of 0.9% of FO or 5% of RSB. The milk, collected in the third week of feeding, was used to make butter, which was analyzed for its fatty acid composition and physical properties. Dry matter intake, milk yield, and milk composition were not significantly affected by cow diet or by cow selection. Cows that produced a more unsaturated and healthful milk fat prior to the feeding study, according to a "health-promoting index" [HPI = (sum of % of unsaturated fatty acids)/ (%12:0 + 4 x %14:0 + %16:0)], maintained a higher HPI in their butter during the feeding study than did cows with a low HPI. Milk from cows fed supplemental FO or RSB yielded more unsaturated butters with a higher HPI. This butter also was softer when the cows were fed RSB. Feeding RSB to cows chosen for their high milk HPI yielded the most unsaturated butter with the highest HPI and softest texture. Thus, selecting cows with a more health-promoting milk fatty acid composition and feeding supplemental RSB can be used in combination to produce butter that has a consumer-friendly texture and a healthful fatty acid profile.
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Affiliation(s)
- G Bobe
- Department of Animal Science, Iowa State University, Ames 50011, USA
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Dowling NF, Beckman MG, Manco-Johnson M, Hassell K, Philipp CS, Michaels LA, Moll S, Heit JA, Penner J, Kulkarni R, Pipe S, Bockenstedt P, Andersen J, Crudder S, James AH, Zimmerman S, Ortel TL. The U.S. Thrombosis and Hemostasis Centers pilot sites program. J Thromb Thrombolysis 2006; 23:1-7. [PMID: 17111206 DOI: 10.1007/s11239-006-9002-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Venous thromboembolism (VTE) is a common disorder associated with significant morbidity and mortality. Despite important advances in understanding the etiology of VTE, delivery of care to patients with thrombosis and thrombophilia is frequently incomplete and highly variable. A comprehensive model of health care has been used successfully to treat and prevent complications for people with hemophilia and other chronic disorders. The effectiveness of an integrated healthcare model for patients with all coagulation disorders has yet to be evaluated. The Division of Hereditary Blood Disorders of the Centers for Disease Control and Prevention (CDC) is collaborating with eight Thrombosis and Hemostasis Centers (pilot sites) to provide health-related services and conduct research directed toward the reduction or prevention of complications of thrombosis and thrombophilia. The initial objectives of the collaboration are to (1) determine the efficacy of integrated multidisciplinary care and prevention services for people with hemostatic disorders, (2) assess unmet needs for service delivery and identify outreach strategies to improve access to care, (3) develop effective messages aimed at disease management and prevention, and (4) foster the development of training programs to enhance provider skills for the delivery of patient care. To address these objectives, the investigators and CDC have developed and implemented a web-based patient registry to follow prospectively service allocation and patient outcomes. Funding for the program began in October 2001. All eight funded centers are affiliated with U.S. medical schools. Principal investigators at the centers are hematologists (five adult, two pediatric) or cardiologists. Faculty in obstetrics-gynecology, surgery, and multiple other specialties are integral to the model of care at the centers. Other critical components at the centers are clinical laboratory services, training programs, research networks, and education and outreach programs. From August 2003 to March 2006, over 2,600 patients were enrolled in the registry, accounting for a total of more than 5,000 visits to the centers. Immediate goals of the data collection at the centers are to characterize patients receiving care at centers and document the state of health services provided. Long-term goals are to evaluate prospectively clinical outcomes for patients receiving multidisciplinary care and prevention services at centers. The network of data collection across centers will facilitate future collaborative clinical and epidemiologic investigations and enhance collective expertise in hemostasis and coagulation disorders.
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Affiliation(s)
- N F Dowling
- Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Imbach P, Kühne T, Müller D, Berchtold W, Zimmerman S, Elalfy M, Buchanan GR. Childhood ITP: 12 months follow-up data from the prospective registry I of the Intercontinental Childhood ITP Study Group (ICIS). Pediatr Blood Cancer 2006; 46:351-6. [PMID: 16086422 DOI: 10.1002/pbc.20453] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Acute and chronic idiopathic thrombocytopenic purpura (ITP) is traditionally based on the duration of thrombocytopenia at the cut-off point of 6 months after diagnosis. Registry I evaluated the diagnosis, definition, management, and follow-up of childhood ITP. This report focuses on children with thrombocytopenia persisting more than 6 months. PROCEDURE Data were collected by questionnaires to the physicians caring for children with ITP, at diagnosis, 6, and 12 months later. Data were compared regarding initial features and follow-up with emphasis on children with persistent thrombocytopenia, and those with ITP who recovered their platelet counts between 7 and 12 months from diagnosis. RESULTS At 12 months from diagnosis, 79 of 308 (25.6%) evaluable children recovered from ITP and 229 had ongoing ITP. Children with recovered ITP were younger than children with ongoing ITP (P = 0.043) and exhibited a lower frequency of bleeding symptoms during the first 6 months after diagnosis (P = 0.018). Frequency of hospitalization, bone marrow aspiration, and drug treatment differed regionally. CONCLUSIONS The high rate of recovery from ITP between 7 to 12 months demonstrates, that the cut-off point of 6 months for the definition of chronic ITP does not adequately differentiate chronic from acute ITP. The majority of children with ITP have variable time to recovery with gradual improvement of platelet counts and disappearance of bleeding signs. ITP is a heterogeneous disorder with a diverse natural history and diverse pattern of treatment response.
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Affiliation(s)
- P Imbach
- University Children's Hospital Basel UKBB, Basel, Switzerland.
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