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Ridilla S, Wang H, Sylvester L, Arnold S. Pain and self-pressure relief in adolescents with cerebral palsy. Assist Technol 2024:1-7. [PMID: 38289978 DOI: 10.1080/10400435.2024.2305972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Adolescents with CP classified as Gross Motor Functional Classification System Level V attend school up to 8 h daily with limited ability to self-reposition. Despite pain reported within this population, perceived pain and self-pressure relief during prolonged classroom sitting is unknown. A case series design was used with a convenience sample of six students (13-18 years) with CP. Pain assessments were taken every 30 min for 5 h. Self-relief assessments using the SensiMATTM were recorded while students were in their wheelchairs. One student self-reported pain and three students proxy reported pain movements. All students had unrelieved pressure or did not self-relieve pressure for at least 1.5 consecutive hours. Four students increased their self-pressure relief movements after 3.5 h. This study provided preliminary data regarding perceived pain and self-pressure relief during prolonged sitting and demonstrated that the SensiMATTM can capture pressure relief movements in sitting of students with severe CP. Although there was no trend of reported pain, students may either be moving enough, as demonstrated by recorded pressure relief movements, to independently relieve pressure and pain, or current pain assessments may not be sensitive enough for those with the most severe disabilities.
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Affiliation(s)
- S Ridilla
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - H Wang
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - L Sylvester
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - S Arnold
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Figueroa AA, Harmon KA, Arnold S, Xu H, Roy T, Reid RR, Tragos C. The Role of Digital Surgical Planning and Surgical Guides in the Treatment of Unilateral Condylar Hyperplasia. J Craniofac Surg 2024; 35:223-227. [PMID: 37889873 DOI: 10.1097/scs.0000000000009778] [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] [Received: 03/18/2023] [Accepted: 08/21/2023] [Indexed: 10/29/2023] Open
Abstract
Unilateral condylar hyperplasia (UCH) results in facial asymmetry, malocclusion, and temporomandibular joint dysfunction. Treatment consists of both surgical and orthodontic intervention. A review was performed for 4 patients with UCH who underwent digital surgical planning (DSP)-assisted condylectomy. All patients were female, aged 14 to 35 years at the time of operation with facial asymmetry and class III malocclusion. None of the patients had prior treatment and all had perioperative orthodontic appliances to provide fixation and postoperative elastic therapy. All patients underwent DSP-guided condylectomy, and intraoperative surgical cutting guides were used for 3 of the patients. All had significant improvement in facial symmetry and occlusion. None had recurrence, and additional intervention has not been required. If UCH is recognized before marked secondary changes in the maxilla, mandible, and occlusion, future orthognathic surgery may be potentially obviated. Craniomaxillofacial surgeons should consider using DSP and surgical guides in the treatment of UCH.
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Affiliation(s)
- Alvaro A Figueroa
- Rush Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center
| | - Kelly A Harmon
- Rush Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center
| | - Sydney Arnold
- Rush Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center
| | - Hope Xu
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL
| | - Tulsi Roy
- Rush Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center
| | - Russell R Reid
- Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL
| | - Christina Tragos
- Rush Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery, Rush University Medical Center
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Greenlund LK, Berkseth M, Shanley R, Sando N, Golden L, Wieworka J, Bergerud KB, Olin M, Pluhar GE, Arnold S, Lawrence J, Venteicher A, Chen C, Ferreira C, Neil E, Dusenbery KE, Ganguly S, Kleinberg LR, Terezakis SA, Sloan L. The Effects of Adjuvant Chemoradiotherapy (CRT) on Myeloid-Derived Suppressor Cell (MDSC) Subsets in Glioblastoma (GBM). Int J Radiat Oncol Biol Phys 2023; 117:e232. [PMID: 37784930 DOI: 10.1016/j.ijrobp.2023.06.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) GBM continues to be a diagnosis with an exceedingly low survival rate despite standard therapy of resection followed by concurrent CRT. MDSC, immunosuppressive myeloid cells that aid immune system evasion by the tumor, expand during fractionated RT. To date, little is known about the effects of CRT on MDSC subsets. The goal of our pilot study is to compare peripheral blood MDSC subset frequency in patients (pts) undergoing CRT. We hypothesize that the pro-tumor, monocytic MDSC (M-MDSC) subset increases following CRT. MATERIALS/METHODS Pts over the age of 18 yo with a new diagnosis of GBM from a single institution participated in the study between 7/2022 -1/2023. Exclusion criteria included prior history of brain RT. Baseline peripheral blood samples were collected within one week prior to CRT start and post-CRT samples were collected within the last week of CRT. Peripheral blood mononuclear cells (PBMC) were isolated from whole blood and freshly stained for intracellular flow cytometric analyses. Total MDSC (singlet, viable, non-lymphocyte, CD11b+CD33+ HLA-DR- cells) and subsets (M-MDSC, granulocytic (G-MDSC), and early MDSC (eMDSC)) were identified. Percent frequency (%fx) of total and MDSC subsets as well as MDSC activation status (n = 3) (interleukin (IL)-10, transforming growth factor-β (TGF-β), interferon gamma (IFNγ)) was compared before and after CRT. RESULTS The average age of pts receiving CRT (n = 4) was 70 yo. Fractionated RT consisted of CF RT (n = 2), 6000 cGy in 30 fractions, and HF RT (n = 2), 4005 cGy in 15 fractions. All pts received concurrent chemotherapy with temozolomide. The %fx of MDSC of non-lymphocytes started at 29.2% prior to CRT and decreased to 9.9% at the end of CRT. The fold change of %fx of total MDSC in CF RT and HF RT was 0.39 and 0.29, respectively. The mean change in %fx of MDSC subsets before and after CRT are shown in Table 1. The mean %fx of TGF-β-expressing MDSC in all GBM pts increased by 3.5% after CRT. The mean IFNγ+ MDSC %fx for all GBM pts decreased after CRT from 24.2% to 16.2% with a corresponding decrease in geometric mean fluorescence intensity (GMFI). The mean %fx of IL-10+ MDSC decreased by 1.5% at the end of CRT with a decrease in GMFI from 5550 to 1806. CONCLUSION In this limited dataset of pts with GBM receiving standard of care adjuvant therapy, we identified an expansion in the eMDSC and decrease in the M-MDSC subsets. These early results suggest HF RT may promote immunity that is more supportive of anti-tumor function, with a lesser increase in fold change of total MDSC after CRT. A more detailed understanding of the effect of RT on myeloid subpopulations is essential to addressing immune suppression in pts with GBM.
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Affiliation(s)
- L K Greenlund
- University of Minnesota Medical School, Minneapolis, MN
| | - M Berkseth
- University of Minnesota, Minneapolis, MN
| | - R Shanley
- Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - N Sando
- University of Minnesota, Minneapolis, MN
| | - L Golden
- University of Minnesota, Minneapolis, MN
| | - J Wieworka
- University of Minnesota, Minneapolis, MN
| | | | - M Olin
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - G E Pluhar
- Department of Veterinary and Clinical Sciences, University of Minnesota, Minneapolis, MN
| | - S Arnold
- Department of Neurology, University of Minnesota Veterinary Medical Center, Minneapolis, MN
| | | | - A Venteicher
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN
| | - C Chen
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN
| | - C Ferreira
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | - E Neil
- Department of Neurology, University of Minnesota Medical School, Minneapolis, MN
| | - K E Dusenbery
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | - S Ganguly
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - L R Kleinberg
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - L Sloan
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
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Hamidian Jahromi A, Arnold S, Konofaos P. APPLICATIONS OF VISCOELASTIC TESTING IN MICROSURGERY: A SYSTEMIC REVIEW AND META-ANALYSIS. Georgian Med News 2023:6-12. [PMID: 37354664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
Viscoelastic testing including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) has gained increasing popularity across many medical fields in recent years. As TEG/ROTEM testing uses whole blood sample and evaluates interactions between cellular components i.e., platelets, red blood cells and the clotting factors, these evaluations are uniquely capable of assessing coagulation in an in-vitro environment, resembling native conditions unlike those of conventual clotting tests (CCTs). While viscoelastic based protocols and applications are more commonplace in hepatic and cardiac surgery and trauma scenarios, results have attracted the attention of additional disciplines including microsurgery. TEG/ROTEM tests, with their ability to assess real-time risk of excessive bleeding or thrombosis, may be useful in the monitoring of microsurgery patients who may be at an increased risk for flap failure. The following review of TEG/ROTEM testing focuses on the most common applications of these coagulation tests and the evidence that does or does not support such uses. A systematic review and meta-analysis of the current application of TEG/ROTEM in microsurgery is reported along with an emphasis on the future that it might hold for the field.
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Affiliation(s)
- A Hamidian Jahromi
- 1Division of Plastic & Reconstructive Surgery, Temple University Medical Center, Philadelphia, PA, USA
| | - S Arnold
- 2Division of Plastic & Reconstructive Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - P Konofaos
- 3Department of Plastic Surgery, University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee, USA
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Ojaimi RE, Carteron M, Arnold S, Broux N, Corsia G, Zicarelli JP, Benhamou D. Neuraxial anesthesia for delivery in parturtients with Brugada syndrome: Local anesthetics revisited. J Gynecol Obstet Hum Reprod 2023; 52:102562. [PMID: 36858196 DOI: 10.1016/j.jogoh.2023.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023]
Affiliation(s)
- R El Ojaimi
- AP-HP, Département d'Anesthésie Réanimation and Médecine Péri Opératoire, Hôpital Henri, Mondor, 94000 Créteil, France
| | - M Carteron
- Service d'Anesthésie Réanimation and Médecine Péri Opératoire, Centre Hospitalier Jacques, Coeur Bourges, France
| | - S Arnold
- Département d'Anesthésie Réanimation and Médecine Péri Opératoire, Centre Hospitalier, Sud-Francilien, Corbeil-Essonnnes, France
| | - N Broux
- Service d'Anesthésie, Centre Hospitalier de Niort, France
| | - G Corsia
- AP-HP, Département d'Anesthésie Réanimation and Médecine Péri Opératoire, Hôpital La Pitié-Salpétrière, Paris, France
| | - J P Zicarelli
- AP-HM, Département d'Anesthésie Réanimation and Médecine Péri Opératoire, France
| | - D Benhamou
- AP-HP Département d'Anesthésie, Réanimation and Médecine Péri Opératoire, Université Paris-Saclay, Hôpital Universitaire Bicêtre, 94275 Le Kremlin-Bicêtre, France.
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Tarhini A, Coleman S, El Naqa I, Sukrithan V, Aakrosh R, McCarter M, Carpten J, Colman H, Ikeguchi A, Puzanov I, Arnold S, Churchman M, Hwu P, Conejo-Garcia J, Dalton W, Weiner G, Tan A. 18P Systematic evaluation of published predictive gene expression signatures in pan-cancer patient cohorts treated with immune checkpoint inhibitors in a real-world setting. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Greenlund L, Mulford K, Shanley R, Neil E, Lawrence J, Arnold S, Olin M, Pluhar G, Venteicher A, Chen C, Ferreira C, Reynolds M, Cho L, Shoo A, Yuan J, Dusenbery K, Kleinberg L, Terezakis S, Wilke C, Sloan L. Hypofractionated vs. Conventionally Fractionated Radiotherapy for Glioblastoma: Peripheral Blood Leukocyte Comparison prior to and Following Chemoradiation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2080] [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: 10/31/2022]
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Curry B, Brown R, Bhatt D, Arnold S, Lee J, Jennings L. Bentracimab demonstrates reversal of antiplatelet effects of ticagrelor: impact of hematocrit and generic versions of ticagrelor in vitro. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2720] [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: 11/13/2022] Open
Abstract
Abstract
Recent clinical studies demonstrated bentracimab provides immediate and sustained reversal of ticagrelor's antiplatelet effects in patients undergoing surgical procedures or with bleeding. Ticagrelor reversal was assessed by VerifyNow PRUTest (VN) and other platelet function testing assays in Phase I-III studies. As decreases in hematocrit (hct) may impact the VN result, it remains to be demonstrated whether this assay can detect platelet function restoration by bentracimab in bleeding patients with low hct. Additionally, bentracimab utility against generic ticagrelors is unknown. The purpose of this study was to determine the impact of decreased hct and generic forms of ticagrelor on platelet function and subsequent reversal by bentracimab, as measured by light transmission aggregometry (LTA) and VN. The hct level in blood samples collected from healthy volunteers (n=10) was sequentially lowered to 32, 30, 25, 22.5, 20 or 15% by addition of autologous platelet-rich plasma to whole blood with matching platelet counts. Prepared samples were treated with nothing, vehicle, or ticagrelor (3.0 μg/mL) followed by treatment with bentracimab (1.2 mg/mL). In a separate study, blood collected from healthy volunteers (n=10) was treated with nothing, vehicle, ticagrelor or generic ticagrelors (3.0 and 5.6 μg/mL; mean and peak plasma levels in the Phase 1 trial) prior to addition of bentracimab (0, 0.6, 1.2, 1.8 and 2.4 mg/mL; below the reported minimum to peak plasma level) to demonstrate a dose response. Reversal was assessed by either ADP-mediated LTA or VN or both assays. Results show a decrease in hct to <30% significantly increased the PRU in untreated samples (p<0.05). Ticagrelor treatment significantly decreased the PRU in all hct groups (p<0.0001). When normalized to each donor's baseline PRU values, bentracimab reversed the ticagrelor effects within 10-min, restoring the PRU value to 54–73% for all hct groups. PRU values were further restored to 85–93% of baseline PRU after 1-hr treatment. The PRU inhibition for both 10-min and 1-hr treatments were not significantly different across the hct groups, except for the 10-min treatment in the 15% hct group vs. unadjusted hct group (p<0.05), suggesting equivalent reversal by bentracimab across the hct range. In the second study, treatment with generic ticagrelor demonstrated significant platelet inhibition and was comparable to standard ticagrelor. Bentracimab (>0.6 mg/mL) immediately restored platelet function after ticagrelor treatment to 80–100% of baseline using the VN test. LTA data demonstrated similar results to VN, but as expected, reversal was less robust with 5.6 μg/mL ticagrelor + 0.6 mg/mL bentracimab combination (mean 55% of baseline values). Collectively, these data suggest the VN test can effectively measure the antiplatelet effects of ticagrelor and subsequent reversal, even at low hct, and bentracimab is also capable of reversing the antiplatelet effects of generic forms of ticagrelor.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): PhaseBio Pharmaceuticals, Inc
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Affiliation(s)
- B Curry
- MLM Medical Labs , Memphis , United States of America
| | - R Brown
- MLM Medical Labs , Memphis , United States of America
| | - D Bhatt
- Brigham and Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - S Arnold
- PhaseBio Pharmaceuticals, Inc , Malvern , United States of America
| | - J Lee
- PhaseBio Pharmaceuticals, Inc , Malvern , United States of America
| | - L Jennings
- MLM Medical Labs , Memphis , United States of America
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Bhatia A, Chen Z, Bruce J, Steuer C, Zandberg D, Riess J, Mitchell D, Davis T, Patel M, Kaur V, Arnold S, Owonikoko T. 656MO Phase I study of M6620 (VX-970, berzosertib) in combination with cisplatin and XRT in patients with locally advanced head and neck squamous cell carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.780] [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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Arnold S, Mahrhold J, Kerstein-Staehle A, Csernok E, Hellmich B, Venhoff N, Thiel J, Affeldt K, Jahnke A, Riemekasten G, Lamprecht P. POS0829 SPECTRUM OF ANCA-SPECIFICITIES IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS IN A RETROSPECTIVE MULTICENTER STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAnti-neutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCA) are found in 10-70% of the patients with eosinophilic granulomatosis with polyangiitis (EGPA) depending on disease activity, methodological aspects and cohort examined [1-3]. Recently, a higher prevalence of anti-pentraxin 3 (PTX3)-ANCA has been reported in EGPA compared to granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) [4].ObjectivesTo investigate the spectrum of ANCA specificities in a multicenter cohort of patients with EGPA and identify novel ANCA antigens.MethodsWe conducted a retrospective analysis of 73 patients with EGPA treated between 2015 and 2020 in 3 tertiary referral centers. In addition to in-house ANCA testing with indirect immunofluorescence (IFT) on fixed human granulocytes and antigen-specific enzyme-linked immunosorbent assays (ELISA), ANCA specificities were determined using a cell-based assay (CBA; Euroimmun, Lübeck, Germany). Diagnosis was based on Chapel Hill consensus conference definitions, ACR- and MIRRA-criteria for EGPA. Patient characteristics and clinical manifestations were evaluated and compared based on ANCA status. Fisher`s exact test was employed for comparison of patient groups.ResultsANCA findings are summarized in Table 1. MPO- and proteinase 3 (PR3)-ANCA positive patients (13.7%) had a higher prevalence of peripheral neuropathy (70% vs. 44.4%, p = 0.0003) and glomerulonephritis (20% vs. 14.3%, not significant). MPO- and PR3-ANCA-negative patients (86.3%) had a higher prevalence of heart (10% vs. 46%, p <0.0001), central nervous system (CNS) (0% vs. 14.3%, p <0.0001) and gastrointestinal (10% vs. 22.2%, p = 0.0327) involvement. PTX3-ANCA were associated with a higher prevalence of ear-nose-throat (ENT) (100% vs. 85.3%, p <0.0001), lung (100% vs. 89.7%, p = 0.0015), gastrointestinal involvement (60% vs. 17.6%, p <0.0001) and peripheral neuropathy (100% vs. 48.5%, p <0.0001). Kidney (0% vs. 16.2%, p <0.0001) and CNS involvement (0% vs. 13.2%, p = 0.0002) occurred less frequently in PTX3-ANCA positive patients. The 2 olfactomedin 4 (OLM4)-ANCA positive patients presented with ENT, lung and kidney involvement, and polyneuropathy, respectively.Table 1.ANCA in EGPA cohort (n = 73). BPI = bactericidal permeability-increasing protein.IFT / ELISANo. of patients (%)P-ANCA11 (15.1)C-ANCA5 (6.8)MPO-ANCA8 (10.9)PR3-ANCA2 (2.7)BPI-ANCA1 (1.4)PTX3-ANCA5 (6.8)OLM4-ANCA2 (2.7)ConclusionWe report on the detection of PTX3-, BPI- and OLM4-ANCA in addition to MPO- and PR3-ANCA in EGPA. OLM4-ANCA has been reported in 2 patients with non-vasculitic inflammatory symptoms previously [5]. Herein, detection of OLM4-ANCA in EGPA is reported for the first time. Our study shows that the presence of ANCA with various specificities other than MPO and PR3 contribute to a higher prevalence of ANCA in EGPA. Moreover, clinical manifestations differ between ANCA-negative EGPA and ANCA-positive EGPA, and between patients with different ANCA-specificities.References[1]Schönermarck U, et al. Prevalence and spectrum of rheumatic diseases associated with proteinase 3-antineutrophil cytoplasmic antibodies (ANCA) and myeloperoxidase-ANCA. Rheumatology 2001;40:178-84.[2]Bremer P, et al. Getting rid of MPO-ANCA: a matter of disease subtype. Rheumatology 2013:752-4.[3]Comarmond C, et al. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): clinical characteristics and long-term followup of the 383 patients enrolled in the French Vasculitis Study Group cohort. Arthritis Rheum 2013;65:270-81.[4]Padoan R, et al. IgG anti-Pentraxin 3 antibodies are a novel biomarker of ANCA-associated vasculitis and better identify patients with eosinophilic granulomatosis with polyangiitis. J Autoimmun 2021;124:102725.[5]Amirbeagi F, et al. Olfactomedin-4 autoantibodies give unusual c-ANCA staining patterns with reactivity to a subpopulation of neutrophils. J Leukoc Biol 2015;97:181-9.Disclosure of InterestsNone declared
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Arnold S, Wallmeier P, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Iking-Konert C, Lamprecht P. AB0622 The Joint Vasculitis Registry in German-speaking countries (GeVas) – subgroup analysis of 113 GPA-patients. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundGranulomatosis with polyangiitis (GPA) is the second most frequent vasculitis in Germany with an annual incidence of 34 per million and a prevalence of 210 per million [1]. GPA is characterized by its chronic course, frequent relapses, significant overall morbidity and mortality, and substantial socio-economic impact. Multiorgan involvement affecting the respiratory tract, kidney, and other organs is common. Limited variants also occur [2]. So far, prospective long-term observational data on the disease course of GPA are missing in Germany. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to follow the course of patients recently diagnosed with vasculitis or a change of their treatment due to a relapse (inception cohort). The GeVas registry allows long-term follow-up of a substantial cohort of vasculitis patients in a multicenter setting.ObjectivesTo present the first data on the follow-up of newly diagnosed and relapsing GPA enrolled in the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and started enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon [3].ResultsBy mid-October 2021, the participating centers included 113 patients with GPA. The majority of patients were PR3-ANCA positive and affected by general symptoms, ENT, lung, renal, and neurological involvement. Patients commonly received cyclophosphamide or rituximab in combination with glucocorticoids for the induction of remission. Fewer patients received methotrexate or other immunosuppressants. Patient characteristics and therapy are summarized in Table 1.Table 1.Patient characteristics (n = 113). *Unless otherwise specified.CategoryFeaturen (%)*AgeAge (years); median [range]60 [51 - 70]GenderMale61 (54.0)Female52 (46.0)Reason for inclusion in the registryNewly diagnosed vasculitis57 (51.4)Relapse56 (49.6)ANCA statusPR3-ANCA99 (87.6)MPO-ANCA4 (3.6)ANCA negative9 (7.9)Organ manifestationGeneral symptoms86 (76.1)ENT69 (61.1)Lung/chest66 (58.4)Renal35 (31.0)Cardiovascular7 (6.2)GI3 (2.7)Neurological27 (23.9)TherapyGlucocorticoid102 (90.3)Rituximab56 (49.6)Cyclophosphamide37 (32.7)Methotrexate and other immunosuppressants, respectively26 (23.0) and 19 (16.8), respectivelyConclusionHere, we present the first interim analysis of the GeVas registry. Clinical manifestations of GPA reported herein show less frequent renal involvement in comparison with a recent report from another European registry (POLVAS) and an UK study [4, 5]. This is potentially related to the predominance of recruiting rheumatology centers thus far. By contrast, respiratory tract involvement is more frequent and PR3-ANCA less common in Japan [5]. Further data are prospectively documented and a follow up analysis is in progress.References[1]Hellmich B, et al. New insights into the epidemiology of ANCA-associated vasculitides in Germany: results from a claims data study. Rheumatology 2021;60:4868-73.[2]Kitching AR, et al. ANCA-associated vasculitis. Nat Rev Dis Primers 2020;6:71.[3]Iking-Konert C, et al. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol 2021;5:40.[4]Wójcik K, et al. Clinical characteristics of Polish patients with ANCA-asscoiated vasculitides – retrospective analysis of POLVAS registry. Clin Rheumatol 2019;38:2553-63.[5]Furuta S, et al. Comparison of the phenotype and outcome of granulomatosis with polyangiitis between UK and Japanese cohorts. J Rheumatol 2017;44:216-22.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsSabrina Arnold: None declared, Pia Wallmeier: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: VIFOR, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor: speaker honoraries, Consultant of: Roche and Vifor: advisory boards, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Christof Iking-Konert Speakers bureau: Lecture fees from: Chugai, GSK, Roche, and Vifor, Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor, Grant/research support from: Research grants for GeVas: Roche, Vifor, DGRh, John Grube Foundation, Peter Lamprecht Speakers bureau: Chugai, GSK, Roche, and Vifor, Consultant of: Chugai, GSK, Roche, and Vifor, Grant/research support from: DGRh, John Grube Foundation, Roche, and Vifor
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Wallmeier P, Arnold S, Schubach F, Ihorst G, Aries P, Bergner R, Bremer JP, Görl N, Hellmich B, Henes J, Hoyer B, Kangowski A, Kötter I, Magnus T, Metzler C, Müller-Ladner U, Schaier M, Schönermark U, Thiel J, Unger L, Venhoff N, Weinmann-Menke J, Petersen J, Lamprecht P, Iking-Konert C. POS0800 THE JOINT VASCULITIS REGISTRY IN GERMAN-SPEAKING COUNTRIES (GeVas) – SUBGROUP ANALYSIS OF 131 GCA-PATIENTS REFERENCES:. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe most frequent form of vasculitis in elderly people is giant cell arteritis (GCA) with an annual incidence rate less than 10 per 100,000 persons over the age of 50. Like most vasculitides, GCA is characterized by chronicity and relapses, leading to significant overall morbidity and higher mortality in a subset of patients with aortic involvement and dissection. Most studies carried out so far have been retrospective, used monocentric study designs and small patient cohorts. Therefore, the Joint Vasculitis Registry in German-speaking countries (GeVas) has been established to record patients, who have been recently diagnosed with vasculitis or who have changed their treatment due to a relapse (inception cohort). The GeVas-Registry allows a long-term follow-up of a substantial cohort of vasculitis patients in a prospective and multicenter manner.ObjectivesTo describe the subgroup of GCA and its characteristics within the GeVas registry.MethodsGeVas is a prospective, web-based, multicenter, clinician-driven registry for the documentation of organ manifestations, damage, long-term outcomes, and therapy regimens in various types of vasculitis. Recruitment started in June 2019. By January 2022, 17 centers in Germany were initiated and have begun enrolling patients. Meanwhile, more than 350 patients have been documented in the registry. Sites in Austria and the German-speaking cantons of Switzerland will be integrated soon (1).ResultsBy mid-October 2021, the participating centers recruited 131 GCA patients into the registry. 21.7% of patients (n=28) were enrolled in the registry due to relapse, and 78.3% (n=101) due to a first-time diagnosis. In accordance with long-standing epidemiology data, the majority of patients (67,2%), were female (n=88), and 32.8% (n=43) were male. Mean age was 74 years (max. 92y, min. 52y). The most frequently recorded organ manifestations in GCA patients addressed cranial and ophthalmic symptoms, and the cardiovascular system. However, vascular lung/chest involvement was also observed in 3% of cases (n=4). Out of the 131 patients, 97.7% (n=128) received immunosuppressive therapy, three refused to take any medication. An equal number of patients were treated with glucocorticoid (GC) therapy. While about two equal parts were treated by stable long term oral GC therapy (47,7%, n=62) or by i.v. pulse therapy followed by tapering (49,2%, n=64), only about 2.3% (n=3) were treated by oral GC therapy with intermittent i.v. pulses. 48.5% (n=63) of patients received tocilizumab as additional immunosuppressive therapy, 19.2% (n=25) methotrexate, and 18.5% (n=24) cyclophosphamide i.v. pulses.ConclusionIn June 2019, we successfully established the prospective multicenter vasculitis registry GeVAS. It describes the first systematically recorded prospective GCA cohort in German-speaking countries. Its characteristics correspond to those that can be expected from the literature, with some unexpected finding e.g. the high proportion of patients treated with cyclosphosphamid, probably reflecting a sicker patient population with e.g. aortic or central nervous involvement. After 2.5 years of follow-up documentation, the first long-term results will be systematically evaluated and interpreted. The newly acquired data on disease manifestation, diagnostics and therapy regimens will provide important insights into the treatment of GCA patients in Germany and may generate further research goals.ReferencesTrial registration: German Clinical Trials Register (Deutsches Register Klinischer Studien): DRKS00011866. Registered 10 May 2019. 3[1]C Iking-Konert; P Wallmeier; S Arnold; S Adler; K de Groot; B Hellmich; B Hoyer; K Holl-Ulrich; Ihorst; M Kaufmann; I Kötter; U Müller-Ladner; T Magnus; J. Rech; H. Schulze-Koops; N. Venhoff; T. Wiech; P. Villiger; F. Schubach; P. Lamprecht. The Joint Vasculitis Registry in German-speaking countries (GeVas) – a prospective, multicenter registry for the follow-up of long-term outcomes in vasculitis. BMC Rheumatol. 2021 Jul 31;5(1):40. doi: 10.1186/s41927-021-00206-2.AcknowledgementsGeVas was supported by unrestricted grants by: DGRh, John Grube Foundation, Vifor and Roche PharmaDisclosure of InterestsPia Wallmeier: None declared, Sabrina Arnold: None declared, Fabian Schubach: None declared, Gabriele Ihorst: None declared, Peer Aries: None declared, Raoul Bergner Consultant of: Advisory Board VIFOR, Grant/research support from: John-Grube Research Award 2021, Jan Philip Bremer: None declared, Norman Görl: None declared, Bernhard Hellmich: None declared, Jörg Henes: None declared, Bimba Hoyer: None declared, Antje Kangowski: None declared, Ina Kötter: None declared, Tim Magnus: None declared, Claudia Metzler: None declared, Ulf Müller-Ladner: None declared, Matthias Schaier: None declared, Ulf Schönermark: None declared, Jens Thiel: None declared, Leonore Unger: None declared, Nils Venhoff Speakers bureau: Roche and Vifor, Consultant of: Roche and Vifor, Grant/research support from: John-Grube Research Award 2021, Julia Weinmann-Menke: None declared, Jana Petersen: None declared, Peter Lamprecht Speakers bureau: Lecture fees from: Chugai, GSK, Roche, Consultant of: Consulting & lecture fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor, Christof Iking-Konert Speakers bureau: lecture fees from: Chugai, GSK, Roche, and Vifor., Consultant of: Consulting fees from: Chugai, GSK, Roche, and Vifor., Grant/research support from: Research grants for GeVas: DGRh, John Grube Foundation, Roche, and Vifor;
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Spiegel J, Arnold S, Salbach H, Gotti EG, Pfeiffer E, Lehmkuhl U, Correll CU, Jaite C. Emotional abuse interacts with borderline personality in adolescent inpatients with binge-purging eating disorders. Eat Weight Disord 2022; 27:131-138. [PMID: 33677816 PMCID: PMC8860808 DOI: 10.1007/s40519-021-01142-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/01/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Childhood abuse is associated with an increased risk of developing eating disorders (EDs) as well as personality disorders (PDs). However, their interaction is still uncertain, particularly in adolescents. This study investigates the correlations between childhood emotional neglect (CEN), childhood emotional abuse (CEA), and obsessive-compulsive and borderline personality styles in female adolescent inpatients with eating disorders (EDs). METHODS One hundred and twenty-eight inpatients (ages 14-18) were assessed, 54 were diagnosed with restricting-type anorexia nervosa (AN-R) and 33 with a binge-purging ED [BP-ED; comprising patients with binge-purging type anorexia nervosa (AN-BP), n = 15, and bulimia nervosa (BN), n = 18]. Fifty healthy participants made up the control group (CG). CEN and CEA were assessed with the Childhood Trauma Questionnaire, while the Personality Style and Disorder Inventory was implemented to determine personality styles. RESULTS A MANOVA revealed a significant main effect of CEA on spontaneous-borderline personality style [F(8,119) = 17.1, p < 0.001, η2 = 0.126], as well as a main effect of ED group on spontaneous-borderline [F(2,119) = 3.1, p = 0.048, η2 = 0.050]. A significant interaction between ED group, CEA, and spontaneous-borderline was found [F(2,119) = 3.5, p = 0.034, η2 = 0.055] with BP-ED showing significantly higher scores in CEA (9.3 ± 4.0) and in spontaneous-borderline (14.2 ± 6.2). CONCLUSIONS Considering CEA and borderline personality style in adolescent inpatients with BN or AN-BP may help improve the understanding of the etiology and maintenance of BP-ED and provide more effective treatment targets. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- J Spiegel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Hospital Urban, Berlin, Germany
| | - S Arnold
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - H Salbach
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - E G Gotti
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E Pfeiffer
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Lehmkuhl
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - C U Correll
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - C Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
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Bradley DT, Murphy S, McWilliams P, Arnold S, Lavery S, Murphy J, de Lusignan S, Hobbs R, Tsang RSM, Akbari A, Torabi F, Beggs J, Chuter A, Shi T, Vasileiou E, Robertson C, Sheikh A, Reid H, O'Reilly D. Investigating the association between COVID-19 vaccination and care home outbreak frequency and duration. Public Health 2022; 203:110-115. [PMID: 35038629 PMCID: PMC8683272 DOI: 10.1016/j.puhe.2021.12.010] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES At the end of 2020, many countries commenced a vaccination programme against SARS-CoV-2. Public health authorities aim to prevent and interrupt outbreaks of infectious disease in social care settings. We aimed to investigate the association between the introduction of the vaccination programme and the frequency and duration of COVID-19 outbreaks in Northern Ireland (NI). STUDY DESIGN We undertook an ecological study using routinely available national data. METHODS We used Poisson regression to measure the relationship between the number of RT-PCR confirmed COVID-19 outbreaks in care homes, and as a measure of community COVID-19 prevalence, the Office for National Statistics COVID-19 Infection Survey estimated the number of people testing positive for COVID-19 in NI. We estimated the change in this relationship and estimated the expected number of care home outbreaks in the absence of the vaccination programme. A Cox proportional hazards model estimated the hazard ratio of a confirmed COVID-19 care home outbreak closure. RESULTS Care home outbreaks reduced by two-thirds compared to expected following the introduction of the vaccination programme, from a projected 1625 COVID-19 outbreaks (95% prediction interval 1553-1694) between 7 December 2020 and 28 October 2021 to an observed 501. We estimated an adjusted hazard ratio of 2.53 of the outbreak closure assuming a 21-day lag for immunity. CONCLUSIONS These findings describe the association of the vaccination with a reduction in outbreak frequency and duration across NI care homes. This indicates probable reduced harm and disruption from COVID-19 in social care settings following vaccination. Future research using individual level data from care home residents will be needed to investigate the effectiveness of the vaccines and the duration of their effects.
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Affiliation(s)
- D T Bradley
- Public Health Agency, Belfast, UK; Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - S Murphy
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
| | | | - S Arnold
- Public Health Agency, Belfast, UK
| | - S Lavery
- Public Health Agency, Belfast, UK
| | - J Murphy
- Public Health Agency, Belfast, UK
| | - S de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - R Hobbs
- Nuffield Department of Health Care Sciences, University of Oxford, Oxford, UK
| | - R S M Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A Akbari
- Population Data Science and Health Data Research UK, Swansea University, Swansea, UK
| | - F Torabi
- Population Data Science, Swansea University Medical School, UK
| | - J Beggs
- BREATHE- The Health Data Research Hub For Respiratory Health, UK
| | - A Chuter
- BREATHE- The Health Data Research Hub For Respiratory Health, UK
| | - T Shi
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - E Vasileiou
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - C Robertson
- Public Health Scotland, UK; University of Strathclyde, Glasgow, UK
| | - A Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK; BREATHE- The Health Data Research Hub For Respiratory Health, UK
| | - H Reid
- Public Health Agency, Belfast, UK
| | - D O'Reilly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Sahmel J, Arnold S, Ramachandran G. Influence of repeated contacts on the transfer of elemental metallic lead between compartments in an integrated conceptual model for dermal exposure assessment. J Toxicol Environ Health A 2022; 85:89-109. [PMID: 34569450 DOI: 10.1080/15287394.2021.1979435] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Transfer of contaminants to and from the skin surface has been postulated to occur through a number of different pathways and compartments including: object(s)-to-skin, skin-to-skin, skin-to-clothing, skin-to-gloves, air-to-skin, skin-to-lips, and skin-to-saliva. However, many identified transfer pathways have been only minimally examined to determine the potential for measurable transfer. The purpose of this study was to quantitatively evaluate repeated transfer between different compartments using elemental metallic lead (Pb) in the solid form using a series of systematic measurements in human subjects. The results demonstrated that some transfer pathways and compartments are significantly more important than others. Transfer of Pb could not be measured from skin to cotton clothing or skin to laminate countertop surfaces. However, transfer was consistently measured for skin-to-skin and between the skin and the surface of nitrile gloves, suggesting the potential for significant transfer to or from these compartments in real-world exposure scenarios, and the importance of these pathways. With repeated contacts, transfer increased non-linearly between 1 and 5 contacts, but appeared to approach a steady state distribution among the compartments within 10 contacts. Consistent with other studies, relative to 100% transfer for a single contact, the quantitative transfer efficiency decreased with repeated contacts to 29% after 5 contacts and 11-12% after 10 contacts; for skin-to-skin transfer measurements, transfer efficiency after either 5 or 10 contacts was approximately 50% of the single contact transfer. These data are likely to be useful for refining current approaches to modeling of repeated contacts for dermal exposure and risk assessment.
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Affiliation(s)
- J Sahmel
- Insight Exposure and Risk Sciences, Boulder, Colorado, USA
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - S Arnold
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - G Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Jassim T, Sheng T, Zhang S, Wei S, Arnold S, Kejner A, Bocklage T, Dueber J. Novel fusion KTN1-PRKD1 in cribriform adenocarcinoma of salivary glands located in the parotid gland: Case report including cytologic findings. Human Pathology: Case Reports 2021. [DOI: 10.1016/j.ehpc.2021.200496] [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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Rao S, Arnold S, Carbone D, Salgia R, Tsao A, Niu J, Aggarwal C, Dragnev K, Awad M, Gainor J, Gubens M, Velcheti V, Telliho L, Akala O, Chartash E, Stevenson J. P75.03 KEYNOTE-U01: A Phase 2 Umbrella Study of Investigational Agents Plus Pembrolizumab-Based Therapy for Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Speakman A, Harwood S, Jukes A, Hewett R, Arnold S, Dodington S. Are we providing adequate vitamin K to patients receiving parenteral nutrition? Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Christian WJ, Walker CJ, Huang B, Levy JE, Durbin E, Arnold S. Using residential histories in case-control analysis of lung cancer and mountaintop removal coal mining in Central Appalachia. Spat Spatiotemporal Epidemiol 2020; 35:100364. [PMID: 33138948 DOI: 10.1016/j.sste.2020.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/19/2020] [Accepted: 07/20/2020] [Indexed: 01/09/2023]
Abstract
Population-based ecological and cross-sectional studies have observed high risk for several cancers in areas of Central Appalachia where mountaintop removal coal mines operate. Case-control studies could provide stronger evidence of such relationships, but misclassification of exposure is likely when based on current residence, since individuals could have inhabited several residences with varying environmental exposures over many years. To address this, we used residential histories for individuals enrolled in a previous case-control study of lung cancer to assess residential proximity to mountaintop removal coal mining over a 30-year period, using both survey data and proprietary data from LexisNexis, Inc. Supplementing the survey data with LexisNexis data improved precision and completeness of geographic coordinates. Final logistic regression models revealed higher odds of high exposure among cases. These findings suggest that living in close proximity to mountaintop removal coal mining sites could increase risk for lung cancer, after adjusting for other relevant factors.
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Affiliation(s)
- W J Christian
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
| | - C J Walker
- Dept. of Epidemiology College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - B Huang
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - J E Levy
- Dept. of Geography College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - E Durbin
- Kentucky Cancer Registry, Lexington, Kentucky, USA
| | - S Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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Malik A, Chen H, Cooper A, Gomes M, Hejjaji V, Ji L, Khunti K, Kosiborod M, Nicolucci A, Peri-Okonny P, Shestakova M, Tang F, Vora J, Watada H, Arnold S. Relationship between country income, socioeconomic factors and control of cardiovascular disease risk factors in patients with type 2 Diabetes: insights from the global DISCOVER registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2832] [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: 11/13/2022] Open
Abstract
Abstract
Background
In patients with type 2 diabetes (T2D), optimal management of cardiovascular (CV) risk factors is critical for primary prevention of CV disease.
Purpose
To describe the association of country income and patient socioeconomic factors with risk factor control in patients with T2D.
Methods
DISCOVER is a 37-country, prospective, observational study of 15,983 patients with T2D enrolled between January 2016 and December 2018 at initiation of 2nd-line glucose-lowering therapy and followed for 3 years. In patients without known CV disease with sub-optimally controlled risk factors at baseline, we examined achievement of risk factor control (HbA1c <7%, BP <140/90 mmHg, appropriate statin) at the 3 year follow-up. Countries were stratified by gross national income (GNI)/capita, per World Bank report. We explored variability across countries in risk factor control achievement using hierarchical logistic regression models and examined the association of country- and patient-level economic factors with risk factor control.
Results
Among 9,613 patients with T2D but without CV disease (mean age 57.2 years, 47.9% women), 83.1%, 37.5%, and 66.3% did not have optimal control of glucose, BP, and statins, respectively, at baseline. Of these, 40.8%, 55.5%, and 28.6% achieved optimal control at 3 years of follow-up. There was substantial variability in achievement of risk factor control across countries (Figure) but no association of country GNI/capita on achievement of risk factor control (Table). Insurance status, which differed substantially by GNI group, was strongly associated with glycemic control, with no insurance and public insurance associated with lower odds of patients achieving HbA1c <7%.
Conclusions
In a global cohort of patients with T2D, a substantial proportion do not achieve risk factor control even after 3 years of follow-up. The variability across countries in risk factor control is not explained by the GNI/capita of the country.
Proportion of patients at goal
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): The DISCOVER study is funded by AstraZeneca
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Affiliation(s)
- A Malik
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - H Chen
- AstraZeneca, Gaithersburg, United States of America
| | - A Cooper
- AstraZeneca, Cambridge, United Kingdom
| | - M Gomes
- Rio de Janeiro State University UERJ, Rio de Janeiro, Brazil
| | - V Hejjaji
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - L Ji
- Peking University, Beijing, China
| | - K Khunti
- University of Leicester, Leicester, United Kingdom
| | - M Kosiborod
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - A Nicolucci
- Center of Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - P Peri-Okonny
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - M Shestakova
- Endocrinology Research Center, Diabetes Institute, Moscow, Russian Federation
| | - F Tang
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - J Vora
- Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - H Watada
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Arnold
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
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Abstract
Large vessel vasculitides comprise two distinct entities, giant cell arteritis (GCA) and Takayasu arteritis (TAK). GCA is the most common vasculitis in central Europe, becoming manifested at an age over 50 years. In contrast, the much rarer TAK affects almost exclusively young adults and mostly women. Both vasculitides are granulomatous arteritides affecting mainly the aorta and its major arterial branches. GCA and TAK are associated with different major histocompatibility complex genes. Infections possibly play a role in the initiation of large vessel vasculitides. Activation of dendritic cells in the adventitia induces chemokine and cytokine-mediated recruitment and maturation of T‑helper (Th)1 and Th17 cells and macrophages producing cytokines, growth factors and matrix metalloproteinases. In GCA, CD4+ T‑helper cells and macrophages are predominantly found in the inflammatory infiltrate. In TAK, the infiltrate also contains cytotoxic CD8+ T‑cells and γδ T‑cells. This could indicate different antigenic triggers in GCA and TAK. Inflammatory infiltration with T‑cells and macrophages and activation of myofibroblasts and smooth muscular cells induce vascular remodeling with intimal hyperplasia and destruction of the media. Remodeling is histologically characterized by progressive arterial wall fibrosis, vascular stenosis and obstruction. In summary, GCA and TAK represent two different entities with a distinct human leukocyte antigen (HLA) and potentially etiopathogenetic background. Clinically, inflammation-related general symptoms and signs of ischemia are encountered, accompanied by increased levels of serological markers of inflammation.
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Affiliation(s)
- S Arnold
- Klinik für Rheumatologie und klinische Immunologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland
| | - K Holl Ulrich
- Pathologie - Hamburg, Labor Lademannbogen MVZ GmbH, Hamburg, Deutschland
| | - P Lamprecht
- Klinik für Rheumatologie und klinische Immunologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
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Jukes A, Hewett R, Speakman A, Harwood S, Lewis H, Arnold S, Jones R, Marini S. Palliative Home Parenteral Nutrition – a review in adult patients in Wales over a 5-year period. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2019.12.067] [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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Cherney D, Wheeler D, Kosiborod M, Arnold S, MacLachlan S, Hunt P, Chen H, Repetto E, Vora J. SAT-221 CARDIO-RENAL-METABOLIC COMORBIDITIES AND ASSOCIATION WITH CARDIOVASCULAR OUTCOMES AND MORTALITY IN NEWLY DIAGNOSED PATIENTS WITH T2DM. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.256] [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: 11/30/2022] Open
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Studts J, Burris J, Andrykowski M, Schapmire T, Head B, Rigney M, Criswell A, Arnold S, Yates A, Blair C, Christian A. MA17.02 Early Accrual to a Precision Lung Cancer Survivorship Intervention: The Kentucky LEADS Collaborative Lung Cancer Survivorship Care Program. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.457] [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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Chauhan A, Mynt Z, Arnold S, Grant B, Anthony L. P2.07-051 Immune Checkpoint Associated Cardiotoxicity: An Update. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1307] [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: 10/18/2022]
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Myint Z, Chauhan A, Arnold S, Anthony L. P3.15-010 Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH): Natural History of the Disease Progression and Management. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chauhan A, Burkeen G, Houranieh J, Arnold S, Anthony L. Immune checkpoint-associated cardiotoxicity: case report with systematic review of literature. Ann Oncol 2017; 28:2034-2038. [DOI: 10.1093/annonc/mdx213] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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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Amison R, Arnold S, O'Shaughnessy B, Cleary S, Ofoedu J, Idzko M, Page C, Pitchford S. Lipopolysaccharide (LPS) induced pulmonary neutrophil recruitment and platelet activation is mediated via the P2Y1 and P2Y14 receptors in mice. Pulm Pharmacol Ther 2017; 45:62-68. [DOI: 10.1016/j.pupt.2017.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 11/29/2022]
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Devore E, Fong T, Marcantonio E, Schmitt E, Arnold S, Dickerson B, Jones R, Inouye S. PREDICTION OF LONG-TERM COGNITIVE DECLINE FOLLOWING DELIRIUM IN OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4861] [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)
- E. Devore
- Brigham and Women’s Hospital, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
| | - T. Fong
- Hebrew SeniorLife, Boston, Massachusetts,
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
| | - E.R. Marcantonio
- Hebrew SeniorLife, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
| | | | - S. Arnold
- Harvard Medical School, Boston, Massachusetts,
- Massachusetts General Hospital, Boston, Massachusetts,
| | - B. Dickerson
- Massachusetts General Hospital, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
| | - R.N. Jones
- Hebrew SeniorLife, Boston, Massachusetts,
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - S.K. Inouye
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
- Hebrew SeniorLife, Boston, Massachusetts,
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Marcantonio E, Vasunilashorn S, Dillon S, Ngo L, Jones R, Arnold S, Inouye S, Libermann T. THE ROLE OF INFLAMMATION IN POSTOPERATIVE DELIRIUM. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4859] [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)
- E.R. Marcantonio
- Hebrew SeniorLife, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
| | - S. Vasunilashorn
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
- Hebrew SeniorLife, Boston, Massachusetts,
| | - S. Dillon
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
| | - L. Ngo
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
| | - R.N. Jones
- Hebrew SeniorLife, Boston, Massachusetts,
- Warren Alpert Medical School of Brown University, Providence, Rhode Island,
| | - S. Arnold
- Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts,
| | - S.K. Inouye
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
- Hebrew SeniorLife, Boston, Massachusetts,
| | - T. Libermann
- Beth Israel Deaconess Medical Center, Boston, Massachusetts,
- Harvard Medical School, Boston, Massachusetts,
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Carter O, Bennett D, Nash T, Arnold S, Brown L, Cai RY, Allan Z, Dluzniak A, McAnally K, Burr D, Sundram S. Sensory integration deficits support a dimensional view of psychosis and are not limited to schizophrenia. Transl Psychiatry 2017; 7:e1118. [PMID: 28485725 PMCID: PMC5534945 DOI: 10.1038/tp.2017.69] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/26/2017] [Accepted: 02/23/2017] [Indexed: 12/16/2022] Open
Abstract
Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Psychophysical evidence suggests that this dysfunction results from impairments in the integration of low-level neural signals into complex cortical representations, which may also be associated with symptom formation. Despite the symptoms of schizophrenia occurring in a range of disorders, the integration deficit has not been tested in broader patient populations. Moreover, it remains unclear whether such deficits generalize across other sensory modalities. The present study assessed patients with a range of psychotic and nonpsychotic disorders and healthy controls on visual contrast detection, visual motion integration, auditory tone detection and auditory tone integration. The sample comprised a total of 249 participants (schizophrenia spectrum disorder n=98; bipolar affective disorder n=35; major depression n=31; other psychiatric conditions n=31; and healthy controls n=54), of whom 178 completed one or more visual task and 71 completed auditory tasks. Compared with healthy controls and nonpsychotic patients, psychotic patients trans-diagnostically were impaired on both visual and auditory integration, but unimpaired in simple visual or auditory detection. Impairment in visual motion integration was correlated with the severity of positive symptoms, and could not be accounted for by a reduction in processing speed, inattention or medication effects. Our results demonstrate that impaired sensory integration is not specific to schizophrenia, as has previously been assumed. Instead, sensory deficits are closely related to the presence of positive symptoms independent of diagnosis. The finding that equivalent integrative sensory processing is impaired in audition is consistent with hypotheses that propose a generalized deficit of neural integration in psychotic disorders.
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Affiliation(s)
- O Carter
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia,Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3010, Australia. E-mail:
| | - D Bennett
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - T Nash
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - S Arnold
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - L Brown
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - R Y Cai
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Z Allan
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - A Dluzniak
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - K McAnally
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - D Burr
- Department of Psychology, University of Florence, Florence, Italy
| | - S Sundram
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia,The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia,Northern Psychiatry Research Centre, North Western Mental Health, Parkville, VIC, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University and Monash Health, Clayton, VIC, Australia
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Kolicheski A, Barnes Heller HL, Arnold S, Schnabel RD, Taylor JF, Knox CA, Mhlanga-Mutangadura T, O'Brien DP, Johnson GS, Dreyfus J, Katz ML. Homozygous PPT1 Splice Donor Mutation in a Cane Corso Dog With Neuronal Ceroid Lipofuscinosis. J Vet Intern Med 2016; 31:149-157. [PMID: 28008682 PMCID: PMC5259623 DOI: 10.1111/jvim.14632] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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] [Received: 08/03/2016] [Revised: 10/05/2016] [Accepted: 11/10/2016] [Indexed: 12/23/2022] Open
Abstract
A 10‐month‐old spayed female Cane Corso dog was evaluated after a 2‐month history of progressive blindness, ataxia, and lethargy. Neurologic examination abnormalities indicated a multifocal lesion with primarily cerebral and cerebellar signs. Clinical worsening resulted in humane euthanasia. On necropsy, there was marked astrogliosis throughout white matter tracts of the cerebrum, most prominently in the corpus callosum. In the cerebral cortex and midbrain, most neurons contained large amounts of autofluorescent storage material in the perinuclear area of the cells. Cerebellar storage material was present in the Purkinje cells, granular cell layer, and perinuclear regions of neurons in the deep nuclei. Neuronal ceroid lipofuscinosis (NCL) was diagnosed. Whole genome sequencing identified a PPT1c.124 + 1G>A splice donor mutation. This nonreference assembly allele was homozygous in the affected dog, has not previously been reported in dbSNP, and was absent from the whole genome sequences of 45 control dogs and 31 unaffected Cane Corsos. Our findings indicate a novel mutation causing the CLN1 form of NCL in a previously unreported dog breed. A canine model for CLN1 disease could provide an opportunity for therapeutic advancement, benefiting both humans and dogs with this disorder.
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Affiliation(s)
- A Kolicheski
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO
| | - H L Barnes Heller
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - S Arnold
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - R D Schnabel
- Division of Animal Sciences and Informatics Institute, University of Missouri, Columbia, MO
| | - J F Taylor
- Division of Animal Sciences, University of Missouri, Columbia, MO
| | | | | | - D P O'Brien
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO
| | - G S Johnson
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO
| | - J Dreyfus
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
| | - M L Katz
- Mason Eye Institute, University of Missouri, Columbia, MO
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Rafei-Shamsabadi D, Kunz S, Martin S, Klose C, Tanriver Y, Arnold S, Diefenbach A, Halim T, McKenzie A, Jakob T, van de Poel S, Ebert K. 395 Lack of type 2 innate lymphoid cells promotes a type I driven enhanced immune response in TNCB contact hypersensitivity. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.415] [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]
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Arnold S, Attinger S, Frank K, Hildebrandt A. Assessing the structural adequacy of alternative ecohydrological models using a pattern-oriented approach. Ecol Modell 2015. [DOI: 10.1016/j.ecolmodel.2015.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moran B, Cecil T, Chandrakumaran K, Arnold S, Mohamed F, Venkatasubramaniam A. The results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1200 patients with peritoneal malignancy. Colorectal Dis 2015; 17:772-8. [PMID: 25880479 DOI: 10.1111/codi.12975] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [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: 09/17/2014] [Accepted: 12/31/2014] [Indexed: 12/12/2022]
Abstract
AIM The study determined the outcome of 1200 consecutive patients treated for peritoneal malignancy in one surgical unit over a 20-year period. METHOD A retrospective analysis was conducted of a custom designed prospective database of patients undergoing surgery for peritoneal malignancy since 1994. Patient demographics, tumour type, extent of surgery and outcome were recorded. RESULTS Between 1994 and January 2014 (when the 1200th case had undergone surgery) 2956 patients were referred with a diagnosis of peritoneal malignancy. Pseudomyxoma peritonei of appendiceal origin was the pathology in 956/1200 (79.7%) patients. Other aetiologies included colorectal peritoneal metastases [89/1200 (7.4%)], abdominal mesothelioma [65/1200 (5.4%)] and miscellaneous [90/1200 (7.5%)]. Overall 863/1200 (71.9%) had complete cytoreduction, 294 (24.5%) had maximal tumour debulking and 43 (3.6%) had laparotomy only. The proportion undergoing complete cytoreduction per quartile of 300 patients was 60.7%, 65.0%, 77.0% and 80.3%. Laparotomy and biopsy fell from 6.4% in the first quartile to 2.7%, 1.7% and 1.3% in subsequent quartiles. The 30-day mortality in the four quartiles was 3.0%, 1.0%, 0.7% and 0.7%. The 5-year survival was 84% in the 636 patients with appendix tumours who had complete cytoreduction, 76% in the 38 with abdominal mesothelioma and 44% in the 60 with colorectal peritoneal metastases. CONCLUSION A centralized approach facilitated high volume experience in a single centre with an increase in the completeness of surgical excision rates and a reduction in mortality and morbidity over time.
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Affiliation(s)
- B Moran
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
| | - T Cecil
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
| | - K Chandrakumaran
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
| | - S Arnold
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
| | - F Mohamed
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
| | - A Venkatasubramaniam
- Peritoneal Malignancy Institute, North Hampshire Hospital, Hampshire Hospital Foundation Trust, Basingstoke, UK
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Lord AC, Hompes R, Venkatasubramaniam A, Arnold S. Successful management of abdominal wound dehiscence using a vacuum assisted closure system combined with mesh-mediated medial traction. Ann R Coll Surg Engl 2015; 97:e3-5. [PMID: 25519257 DOI: 10.1308/003588414x14055925059237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Management of the open abdomen has advanced significantly in recent years with the increasing use of vacuum assisted closure (VAC) techniques leading to increased rates of fascial closure. We present the case of a patient who suffered two complete abdominal wall dehiscences after an elective laparotomy, meaning primary closure was no longer possible. She was treated successfully with a VAC system combined with continuous medial traction using a Prolene(®) mesh. This technique has not been described before in the management of patients following wound dehiscence.
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Affiliation(s)
- A C Lord
- Hampshire Hospitals NHS Foundation Trust, UK
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Segrave R, Thomson C, Arnold S, Hoy K, Fitzgerald P. Retraining the brain to beat depression: tDCS and cognitive control training. Brain Stimul 2015. [DOI: 10.1016/j.brs.2015.01.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Lord A, Hompes R, Arnold S, Venkatasubramaniam A. Ultra-low anterior resection with coloanal anastomosis for recurrent rectal prolapse in a young woman with colitis cystica profunda. Ann R Coll Surg Engl 2015; 97:e32-3. [PMID: 25723681 DOI: 10.1308/003588414x14055925061351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This case demonstrates the successful treatment of a young female patient with colitis cystica profunda causing rectal prolapse, after primary treatment with a Delorme procedure had failed. An ultra-low anterior resection with a temporary defunctioning ileostomy was carried out with good postoperative results. This case illustrates the possibility of carrying out sphincter preserving surgery rather than an abdominoperineal resection in the treatment of this condition, which may be preferable for patients.
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Affiliation(s)
- A Lord
- Hampshire Hospitals NHS Foundation Trust, UK
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Koch DA, Rosaspina M, Wiestner T, Arnold S, Montavon PM. Comparative investigations on the upper respiratory tract in Norwich terriers, brachycephalic and mesaticephalic dogs. SCHWEIZ ARCH TIERH 2015; 156:119-24. [PMID: 24568805 DOI: 10.1024/0036-7281/a000561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 11/19/2022]
Abstract
For some time Norwich terriers have been known to suffer from respiratory problems. In order to assign this weakness to a pathophysiology, 23 terriers were examined clinically, with laryngoscope and with rhinomanometry. In addition their skulls were dimensioned on radiographs. Widened nostrils, overlong soft palates and the everted laryngeal pouches were consistent with brachycephalic syndrome. Resistance values in the nasal passage corresponded to the appearance in brachycephalic dogs. Skull measurements gave inconsistent results, because length to width ratios and craniofacial angles denoted mesaticephaly, whereas the facial to cranial length ratios (S-index = 0.65) lay in the brachycephalic sector. It can be concluded, that the Norwich terrier breed is in transition towards brachycephaly with some individual dogs already suffering from the brachycephalic syndrome. Breeders are requested to introduce necessary counter measures.
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Affiliation(s)
- D A Koch
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich
| | - M Rosaspina
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich
| | - T Wiestner
- Equine Clinic, Vetsuisse Faculty, University of Zurich
| | - S Arnold
- Clinic for Small Animal Reproduction, Vetsuisse Faculty, University of Zurich
| | - P M Montavon
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich
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Abstract
Joint punctures and injections are a widely used approach to obtain a differential diagnostic assessment for the formation of a treatment concept for recurrent joint effusions, to exclude a periprosthetic infection in painful and loosened endoprostheses before a planned revision, to assign the origin of pain symptoms to a specific joint or to provide a treatment for arthritis of any kind. In all medical fields the standardization of processes has progressed. Therefore, for joint punctures there are standards relating to the implementation and hygiene of intra-articular punctures or injections in order to prevent the occurrence of complications, such as joint infections.
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Affiliation(s)
- S Arnold
- Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland,
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Yaroslawitz SL, DeGrace BW, Sloop J, Arnold S, Hamilton TB. A study of family health in Chareidi second and third generation survivors of the Holocaust. Work 2014; 50:501-10. [PMID: 25248538 DOI: 10.3233/wor-141961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Intergenerational transmission of survivor syndrome places the health of family occupation of Chareidi second and third generation survivors of the Holocaust at risk. OBJECTIVE The purpose of this phenomenological study was to describe the lived experience and capture the essence of family health from the perspective of this cultural group. METHODS Guided by phenomenological research design, 5 participants were interviewed. They described their perception of the health of their families and how experiences in Nazi death camps impacted their families' health. RESULTS Family health is an experience of being together and doing together. Generational transmission of family health was disrupted by the Holocaust. Dysfunction exists in generations that were produced by the survivors. Daily effort is required to reverse the effects of the Holocaust and establish connections with subsequent generations. CONCLUSION The essence of occupational therapy is described as "being before doing", which is the cornerstone of individual health and well-being; and in this case family health. This study investigates a cultural group who is experiencing intergenerational transmission of trauma that disrupts family health. Opportunities to examine family health in all settings and consider implications for interventions should be explored.
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Affiliation(s)
- S L Yaroslawitz
- University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - B W DeGrace
- University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - J Sloop
- University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - S Arnold
- University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| | - T B Hamilton
- University of Oklahoma Health Sciences, Oklahoma City, OK, USA
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Glenn M, Mace L, Shaw L, Arnold S, Wolk D, Moelter S. A-79 * Primacy-Weighted Retrieval Differences in Healthy Older Adults with Pathological or Normal Cerebrospinal Fluid Markers of Alzheimer's Disease. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.79] [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: 11/12/2022] Open
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Hompes R, Arnold S, Warusavitarne J. Towards the safe introduction of transanal total mesorectal excision: the role of a clinical registry. Colorectal Dis 2014; 16:498-501. [PMID: 24806149 DOI: 10.1111/codi.12661] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 02/06/2023]
Affiliation(s)
- R Hompes
- Oxford University Hospitals NHS Trust, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LE, UK
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Arnold S, Bailey H, Bates G, Bell V, Brumbelow R, Chunn M, Coxon A, Crouse C, Djafari, Duke J, Ganeshram. Improvement Strategies to Reduce 30-Day Heart Failure Readmissions. Heart Lung 2013. [DOI: 10.1016/j.hrtlng.2013.10.009] [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: 12/01/2022]
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Wong MYL, Medina A, Uppaluri C, Arnold S, Seymour JR, Buston PM. Consistent behavioural traits and behavioural syndromes in pairs of the false clown anemonefish Amphiprion ocellaris. J Fish Biol 2013; 83:207-213. [PMID: 23808701 DOI: 10.1111/jfb.12133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [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: 01/03/2013] [Accepted: 03/20/2013] [Indexed: 06/02/2023]
Abstract
Using the social clown anemonefish Amphiprion ocellaris, whether individuals exhibited consistency in activity levels, boldness and sociability in a paired context, and whether these three behavioural traits were positively correlated within a single behavioural syndrome, was investigated. The results highlight that consistent individual differences in behaviour are expressed in a social fish and suggest that consistent behavioural traits and behavioural syndromes could influence the structure and functioning of their societies.
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Affiliation(s)
- M Y L Wong
- School of Biological Sciences, University of Wollongong, Northfields Avenue, NSW 2518, Australia.
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Youngblood B, del Rio C, Yeh S, Georgopoulos L, Arnold S, Hamlin R. Acute pulmonary artery hypertension in closed-chest anesthetized rats and the sustained pulmonary artery vaso-relaxation following treatment with a novel vasoactive intestinal peptide. J Pharmacol Toxicol Methods 2013. [DOI: 10.1016/j.vascn.2013.01.155] [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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Krausslach O, Malysheva O, Arnold S, Baerwald CGO. AB0423 Impact of fibromyalgia on perceived pain in patients with systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Malysheva O, Ivanov P, Arnold S, Liebert U, Baerwald C. SAT0540 Monitoring of Vaccination Status in Patients with Rheumatic Diseases. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2264] [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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Müntinga H, Ahlers H, Krutzik M, Wenzlawski A, Arnold S, Becker D, Bongs K, Dittus H, Duncker H, Gaaloul N, Gherasim C, Giese E, Grzeschik C, Hänsch TW, Hellmig O, Herr W, Herrmann S, Kajari E, Kleinert S, Lämmerzahl C, Lewoczko-Adamczyk W, Malcolm J, Meyer N, Nolte R, Peters A, Popp M, Reichel J, Roura A, Rudolph J, Schiemangk M, Schneider M, Seidel ST, Sengstock K, Tamma V, Valenzuela T, Vogel A, Walser R, Wendrich T, Windpassinger P, Zeller W, van Zoest T, Ertmer W, Schleich WP, Rasel EM. Interferometry with Bose-Einstein condensates in microgravity. Phys Rev Lett 2013; 110:093602. [PMID: 23496709 DOI: 10.1103/physrevlett.110.093602] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Indexed: 06/01/2023]
Abstract
Atom interferometers covering macroscopic domains of space-time are a spectacular manifestation of the wave nature of matter. Because of their unique coherence properties, Bose-Einstein condensates are ideal sources for an atom interferometer in extended free fall. In this Letter we report on the realization of an asymmetric Mach-Zehnder interferometer operated with a Bose-Einstein condensate in microgravity. The resulting interference pattern is similar to the one in the far field of a double slit and shows a linear scaling with the time the wave packets expand. We employ delta-kick cooling in order to enhance the signal and extend our atom interferometer. Our experiments demonstrate the high potential of interferometers operated with quantum gases for probing the fundamental concepts of quantum mechanics and general relativity.
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Affiliation(s)
- H Müntinga
- ZARM, Universität Bremen, Am Fallturm, 28359 Bremen, Germany
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Goetzenich A, Röhl AB, Moza AK, Hein M, Beyer C, Arnold S. The differenzial role of mitochondria in hypoxia – compared to isoflurane-induced late phase preconditioning. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332656] [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: 10/27/2022]
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