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Howe C, Momin MAM, Aladwani G, Strickler S, Hindle M, Longest W. Advancement of a high-dose infant air-jet dry powder inhaler (DPI) with passive cyclic loading: Performance tuning for different formulations. Int J Pharm 2023; 643:123199. [PMID: 37406945 PMCID: PMC10530264 DOI: 10.1016/j.ijpharm.2023.123199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/22/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
There is a current medical need for a dry powder aerosol delivery device that can be used to efficiently and consistently administer high dose therapeutics, such as inhaled antibiotics, surfactants and antivirals, to the lungs of infants. This study considered an infant air-jet dry powder inhaler (DPI) that could be actuated multiple times with minimal user interaction (i.e., a passive cyclic loading strategy) and focused on the development of a metering system that could be tuned for individual powder formulations to maintain high efficiency lung delivery. The metering system consisted of a powder delivery tube (PDT) connecting a powder reservoir with an aerosolization chamber and a powder supporting shelf that held a defined formulation volume. Results indicated that the metering system could administer a consistent dose per actuation after reaching a steady state condition. Modifications of the PDT diameter and shelf volume provided a controllable approach that could be tuned to maximize lung delivery efficiency for three different formulations. Using optimized metering system conditions for each formulation, the infant air-jet DPI was found to provide efficient and consistent lung delivery of aerosols (∼45% of loaded dose) based on in vitro testing with a preterm nose-throat model and limited dose/actuation to <5 mg.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 W Main Street, PO Box 843015, Richmond, VA 23284, USA.
| | - Mohammad A M Momin
- Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA 23284, USA.
| | - Ghali Aladwani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 W Main Street, PO Box 843015, Richmond, VA 23284, USA.
| | - Sarah Strickler
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 W Main Street, PO Box 843015, Richmond, VA 23284, USA.
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA 23284, USA.
| | - Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 W Main Street, PO Box 843015, Richmond, VA 23284, USA; Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA 23284, USA.
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Howe C, Momin MAM, Aladwani G, Hindle M, Longest PW. Development of a High-Dose Infant Air-Jet Dry Powder Inhaler (DPI) with Passive Cyclic Loading of the Formulation. Pharm Res 2022; 39:3317-3330. [PMID: 36253630 PMCID: PMC10561662 DOI: 10.1007/s11095-022-03409-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/29/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE The objective of this study was to incorporate a passive cyclic loading strategy into the infant air-jet dry powder inhaler (DPI) in a manner that provides high efficiency aerosol lung delivery and is insensitive to powder mass loadings and the presence of downstream pulmonary mechanics. METHODS Four unique air-jet DPIs were initially compared and the best performing passive design (PD) was selected for sensitivity analyses. A single preterm in vitro nose-throat (NT) model, air source, and nasal interface were utilized throughout. While the majority of analyses were evaluated with a model spray-dried excipient enhanced growth (EEG) formulation, performance of a Surfactant-EEG formulation was also explored for the lead DPI design. RESULTS Two devices, PD-2 and PD-3, evaluated in the preterm model achieved an estimated lung delivery efficiency of 60% with the model EEG formulation, and were not sensitive to the loaded dose (10-30 mg of powder). The PD-3 device was also unaffected by the presence of downstream pulmonary mechanics (infant lung model) and had only a minor sensitivity to tripling the volume of the powder reservoir. When using the Surfactant-EEG formulation, increasing the actuation flow rate from 1.7 to 4.0 L/min improved lung delivery by nearly 10%. CONCLUSIONS The infant air-jet DPI platform was successfully modified with a passive cyclic loading strategy and capable of providing an estimated > 60% lung delivery efficiency of a model spray-dried formulation with negligible sensitivity to powder mass loading in the range of 10-30 mg and could be scaled to deliver much higher doses.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA
| | - Mohammad A M Momin
- Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA, 23284, USA
| | - Ghali Aladwani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA, 23284, USA
| | - P Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA.
- Department of Pharmaceutics, Virginia Commonwealth University, 410 N. 12th Street, PO Box 980533, Richmond, VA, 23284, USA.
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Perger E, Baillieul S, Esteve F, Pichon A, Bilo G, Soranna D, Doutreleau S, Savina Y, Ulliel-Roche M, Brugniaux JV, Stauffer E, Oberholzer L, Howe C, Hannco I, Lombardi C, Tamisier R, Pepin JL, Verges S, Parati G. Nocturnal hypoxemia, blood pressure, vascular status and chronic mountain sickness in the highest city in the world. Ann Med 2022; 54:1884-1893. [PMID: 35786084 PMCID: PMC9258438 DOI: 10.1080/07853890.2022.2091791] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Chronic mountain sickness (CMS) is a condition characterized by excessive erythrocytosis in response to chronic hypobaric hypoxia. CMS frequently triggers cardiorespiratory diseases such as pulmonary hypertension and right or left heart failure. Ambient hypoxia might be further amplified night-time by intermittent hypoxia related to sleep-disordered breathing (SDB) so that sleep disturbance may be an important feature of CMS. Our aim was to characterize in a cross-sectional study nocturnal hypoxaemia, SDB, blood pressure (BP), arterial stiffness and carotid intima-media thickness (CIMT) in highlanders living at extreme altitude. METHODS Men aged 18 to 55 years were prospectively recruited. Home sleep apnoea test, questionnaires (short-form health survey; Montreal cognitive assessment; Pittsburgh Sleep Questionnaire Index and the Insomnia severity index), 24-h ambulatory BP monitoring, CIMT and arterial stiffness were evaluated in 3 groups: i) Andean lowlanders (sea-level); ii) highlanders living at 3,800 m and iii) highlanders living at 5,100 m. Analyses were conducted in sub-groups according to 1) CMS severity 2) healthy subjects living at the three different altitude. RESULTS Ninety-two males were evaluated at their living altitudes. Among the 54 highlanders living at 5,100 m, subjects with CMS showed lower mean nocturnal oxygen saturation (SpO2), SpO2 nadir, lower pulse wave velocity and higher nocturnal BP variability than those with no-CMS. Lower nocturnal SpO2 nadir was associated with higher CMS severity (ß= -0.14, p=.009). Among the 55 healthy subjects, healthy highlanders at 5,100 m were characterized by lower scores on quality of life and sleep quality scales and lower mean SpO2 compared to lowlanders. CONCLUSIONS Lower nocturnal SpO2 and higher nocturnal BP variability are associated with CMS severity in individuals living permanently at high altitude. The role of lower SpO2 and higher nocturnal BP variability in the cardiovascular progression of CMS and in the overall prognosis of the disease need to be evaluated in further studies.
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Affiliation(s)
- Elisa Perger
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Biostatistic Unit, University of Milano-Bicocca, Milan, Italy
| | - Sébastien Baillieul
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - François Esteve
- Inserm UA7, Rayonnement Synchrotron pour la Recherche Biomédicale, Grenoble, France
| | - Aurélien Pichon
- Faculty of Sport Sciences, Université de Poitiers, Laboratory Mobility, aging & exercise (MOVE, EA6314), Poitiers, France
| | - Gzregorz Bilo
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Biostatistic Unit, University of Milano-Bicocca, Milan, Italy
| | - Davide Soranna
- Istituto Auxologico Italiano, IRCCS, Biostatistics unit, Milan, Italy
| | - Stéphane Doutreleau
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Yann Savina
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Mathilde Ulliel-Roche
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Julien V Brugniaux
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Emeric Stauffer
- Interuniversity Laboratory of Human Movement Biology (LIBM, EA7424), "Red Blood cell and Vascular Biology" team, Univ Lyon - University Claude Bernard Lyon 1, Villeurbanne, France
| | - Laura Oberholzer
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Connor Howe
- Centre for Heart, Lung, and Vascular Health, University of British Columbia, Kelowna, Canada
| | - Ivan Hannco
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Carolina Lombardi
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Biostatistic Unit, University of Milano-Bicocca, Milan, Italy
| | - Renaud Tamisier
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Pepin
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Samuel Verges
- Univ. Grenoble Alpes, HP2 Laboratory, INSERM U1300, CHU Grenoble Alpes, Grenoble, France
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.,Biostatistic Unit, University of Milano-Bicocca, Milan, Italy
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Bass K, Momin MAM, Howe C, Aladwani G, Strickler S, Kolanjiyil AV, Hindle M, DiBlasi RM, Longest W. Characterizing the Effects of Nasal Prong Interfaces on Aerosol Deposition in a Preterm Infant Nasal Model. AAPS PharmSciTech 2022; 23:114. [PMID: 35441324 DOI: 10.1208/s12249-022-02259-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to characterize the effects of multiple nasal prong interface configurations on nasal depositional loss of pharmaceutical aerosols in a preterm infant nose-throat (NT) airway model. Benchmark in vitro experiments were performed in which a spray-dried powder formulation was delivered to a new preterm NT model with a positive-pressure infant air-jet dry powder inhaler using single- and dual-prong interfaces. These results were used to develop and validate a computational fluid dynamics (CFD) model of aerosol transport and deposition in the NT geometry. The validated CFD model was then used to explore the NT depositional characteristic of multiple prong types and configurations. The CFD model highlighted a turbulent jet effect emanating from the prong(s). Analysis of NT aerosol deposition efficiency curves for a characteristic particle size and delivery flowrate (3 µm and 1.4 L/min (LPM)) revealed little difference in NT aerosol deposition fraction (DF) across the prong insertion depths of 2-5 mm (DF = 16-24%) with the exception of a single prong with 5-mm insertion (DF = 36%). Dual prongs provided a modest reduction in deposition vs. a single aerosol delivery prong at the same flow for insertion depths < 5 mm. The presence of the prongs increased nasal depositional loss by absolute differences in the range of 20-70% compared with existing correlations for ambient aerosols. In conclusion, the use of nasal prongs was shown to have a significant impact on infant NT aerosol depositional loss prompting the need for prong design alterations to improve lung delivery efficiency.
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Howe C, Momin MAM, Bass K, Aladwani G, Bonasera S, Hindle M, Longest PW. In Vitro Analysis of Nasal Interface Options for High-Efficiency Aerosol Administration to Preterm Infants. J Aerosol Med Pulm Drug Deliv 2022; 35:196-211. [PMID: 35166601 PMCID: PMC9416545 DOI: 10.1089/jamp.2021.0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: An infant air-jet dry powder inhaler (DPI) platform has recently been developed that in combination with highly dispersible spray-dried powder formulations can achieve high-efficiency aerosolization with low actuation air volumes. The objective of this study was to investigate modifications to the nasal interface section of this platform to improve the aerosol delivery performance through preterm nose-throat (NT) models. Methods: Aerosol delivery performance of multiple nasal interface flow pathways and prong configurations was assessed with two in vitro preterm infant NT models. Two excipient-enhanced growth (EEG) dry powder formulations were explored containing either l-leucine or trileucine as the dispersion enhancer. Performance metrics included aerosol depositional loss in the nasal interface, deposition in the NT models, and tracheal filter deposition, which was used to estimate lung delivery efficiency. Results: The best performing nasal interface replaced the straight flexible prong of the original gradual expansion design with a rigid curved prong (∼20° curvature). The prong modification increased the lung delivery efficiency by 5%-10% (absolute difference) depending on the powder formulation. Adding a metal mesh to the flow pathway, to dissipate the turbulent jet, also improved lung delivery efficiency by ∼5%, while reducing the NT depositional loss by a factor of over twofold compared with the original nasal interface. The platform was also found to perform similarly in two different preterm NT models, with no statistically significant difference between any of the performance metrics. Conclusions: Modifications to the nasal interface of an infant air-jet DPI improved the aerosol delivery through multiple infant NT models, providing up to an additional 10% lung delivery efficiency (absolute difference) with the lead design delivering ∼57% of the loaded dose to the tracheal filter, while performance in two unique preterm airway geometries remained similar.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mohammad A M Momin
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Karl Bass
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ghali Aladwani
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Serena Bonasera
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Philip Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
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Howe C, Momin MAM, Farkas DR, Bonasera S, Hindle M, Longest PW. Advancement of the Infant Air-Jet Dry Powder Inhaler (DPI): Evaluation of Different Positive-Pressure Air Sources and Flow Rates. Pharm Res 2021; 38:1615-1632. [PMID: 34462876 DOI: 10.1007/s11095-021-03094-w] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE In order to improve the delivery of dry powder aerosol formulations to the lungs of infants, this study implemented an infant air-jet platform and explored the effects of different air sources, flow rates, and pulmonary mechanics on aerosolization performance and aerosol delivery through a preterm nose-throat (NT) in vitro model. METHODS The infant air-jet platform was actuated with a positive-pressure air source that delivered the aerosol and provided a full inhalation breath. Three different air sources were developed to provide highly controllable positive-pressure air actuations (using actuation volumes of ~10 mL for the preterm model). While providing different flow waveform shapes, the three air sources were calibrated to produce the same flow rate magnitude (Q90: 90th percentile of flow rate). Multiple air-jet DPI designs were coupled with the air sources and evaluated with a model spray-dried excipient enhanced growth formulation. RESULTS Compared to other designs, the D1-Single air-jet DPI provided improved performance with low variability across all three air sources. With the tested D1-Single air-jet and Timer air source, reducing the flow rate from 4 to 1.7 L/min marginally decreased the aerosol size and significantly increased the lung delivery efficiency above 50% of the loaded dose. These results were not impacted by the presence of downstream pulmonary mechanics (resistance and compliance model). CONCLUSIONS The selected design was capable of providing an estimated >50% lung delivery efficiency of a model spray-dried formulation and was not influenced by the air source, thereby enabling greater flexibility for platform deployment in different environments.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA
| | - Mohammad A M Momin
- Department of Pharmaceutics, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298-0533, USA
| | - Dale R Farkas
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA
| | - Serena Bonasera
- Department of Pharmaceutics, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298-0533, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298-0533, USA
| | - P Worth Longest
- Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, 401 West Main Street, P.O. Box 843015, Richmond, VA, 23284-3015, USA. .,Department of Pharmaceutics, Virginia Commonwealth University, 410 North 12th Street, P.O. Box 980533, Richmond, VA, 23298-0533, USA.
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Bland VL, Heatherington-Rauth M, Howe C, Going SB, Bea JW. Association of objectively measured physical activity and bone health in children and adolescents: a systematic review and narrative synthesis. Osteoporos Int 2020; 31:1865-1894. [PMID: 32542544 DOI: 10.1007/s00198-020-05485-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
The influence of day-to-day physical activity on bone in adolescence has not been well characterized. Forty articles were identified that assessed the relationship between accelerometry-derived physical activity and bone outcomes in adolescents. Physical activity was positively associated with bone strength in peri-pubertal males, with less consistent evidence in females. Physical activity (PA) is recommended to optimize bone development in childhood and adolescence; however, the influence of day-to-day PA on bone development is not well defined. The aim of this review was to describe the current evidence for objectively measured PA on bone outcomes in healthy children and adolescents. MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, CINAHL, PsycInfo, and ClinicalTrials.gov were searched for relevant articles up to April 2020. Studies assessing the relationship between accelerometry-derived PA and bone outcomes in adolescents (6-18 years old) were included. Two reviewers independently screened studies for eligibility, extracted data, and rated study quality. Forty articles met inclusion criteria (25 cross-sectional, 15 longitudinal). There was significant heterogeneity in accelerometry methodology and bone outcomes measured. Studies in males indicated a significant, positive relationship between moderate to vigorous PA (MVPA) and bone outcomes at the hip and femur, particularly during the peri-pubertal years. The results for MVPA and bone outcomes in females were mixed. There was a paucity of longitudinal studies using pQCT and a lack of data regarding how light PA and/or impact activity influences bone outcomes. The current evidence suggests that objectively measured MVPA is positively associated with bone outcomes in children and adolescents, especially in males. However, inconsistencies in methodology make it difficult to determine the amount and type of PA that leads to favorable bone outcomes. Given that the majority of research has been conducted in Caucasian adolescents, further research is needed in minority populations.
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Affiliation(s)
- V L Bland
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA.
| | - M Heatherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - C Howe
- University of Arizona Health Sciences Library, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
| | - J W Bea
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
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Howe C, Hindle M, Bonasera S, Rani V, Longest PW. Initial Development of an Air-Jet Dry Powder Inhaler for Rapid Delivery of Pharmaceutical Aerosols to Infants. J Aerosol Med Pulm Drug Deliv 2020; 34:57-70. [PMID: 32758026 DOI: 10.1089/jamp.2020.1604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/12/2022] Open
Abstract
Background: Positive-pressure dry powder inhalers (DPIs) have recently been developed that in combination with highly dispersible spray-dried powder formulations can achieve high efficiency aerosolization with low actuation air-volumes (AAVs). The objective of this study was to initially develop the positive-pressure air-jet DPI platform for high efficiency aerosol delivery to newborn infants by using the nose-to-lung route. Methods: Aerosolization performance metrics of six air-jet DPIs were first assessed at AAVs that were consistent with full-term (30 mL) and preterm (10 mL) neonates. Designs of the air-jet DPIs varied based on geometry of the inlet and outlet flow passages and shape of the aerosolization chamber. Aerosolization metrics evaluated at the device outlet were emitted dose (ED) and mass median aerodynamic diameter (MMAD). Designs with the best aerosolization performance were connected to a smoothly expanding nasal interface and full-term infant (3550 g) nose-throat (NT) model with tracheal filter. Results: The three best performing devices had characteristics of a cylindrical and horizontal aerosolization chamber with a flush or protruding outlet orifice. Including multiple air inlets resulted in meeting the aerosolization targets of >80% ED (based on loaded dose) and MMAD <1.8 μm. Reducing the AAV by a factor of threefold from 30 to 10 mL had little effect on aerosol formation. The three leading devices all delivered ∼50% of the loaded dose through a full-term NT in vitro model by using an AAV of 30 mL. Conclusion: With careful selection of design attributes, the air-jet DPI platform is capable of high-efficiency aerosolization of a 10 mg powder mass by using AAVs that are consistent with infant inhalation. The associated infant air-jet DPI system, which forms a seal at the nostril(s) and delivers both the aerosol and a complete inhalation, is capable of rapid and efficient aerosol administration to infant lungs, based on initial testing in a full-term in vitro NT model.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering and Virginia Commonwealth University, Richmond, Virginia, USA
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Serena Bonasera
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Vijaya Rani
- Department of Mechanical and Nuclear Engineering and Virginia Commonwealth University, Richmond, Virginia, USA
| | - P Worth Longest
- Department of Mechanical and Nuclear Engineering and Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
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Robison K, Bevis K, Howe C, Wohlrab K, Sung V, Richter H, Lokich E, McCourt C, Glaser G, Brown A, Wethington S, Carlson M, DiSilvestro P, Lowder J, Rahn D, Occhino J, Dunivan G, Tunitsky E, Chen G, Luis C, Raker C, Clark M. Concurrent surgical treatment of urinary incontinence at the time of endometrial cancer surgery is associated with improved quality of life 6 months after cancer surgery: Cancer of the uterus and treatment of incontinence (CUTI) study. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Glassman D, Wohlrab K, Bevis K, Sung V, Richter H, Howe C, Lokich E, McCourt C, Glaser G, Brown A, Wethington S, DiSilvestro P, Lowder J, Occhino J, Dunivan G, Chen G, Luis C, Raker C, Clark M, Robison K, Carlson M, Tunitsky E. Adverse outcomes among women after concurrent surgery for endometrial cancer and pelvic floor disorders: The cancer of the uterus and treatment of incontinence (CUTI) trial. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Patrician A, Drvis I, Dawkins T, Otto B, Coombs G, Howe C, Caldwell H, Janjic N, Spajic B, Stembridge M, Dujic Z, Ainslie P. Non‐Invasive Pulmonary Gas Exchange Measurements Following Deep Breath‐Hold Diving. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.838.27] [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: 11/11/2022]
Affiliation(s)
| | | | - Tony Dawkins
- Cardiff Metropolitan UniversityCardiffUnited Kingdom
| | | | - Geoff Coombs
- University British Columbia OkanaganKelownaBCCanada
| | - Connor Howe
- University British Columbia OkanaganKelownaBCCanada
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Stevenson J, Howe C, Alexander G. A Cross-Sectional Study on MyPlate Awareness in Children 7-13 Years of Age. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.125] [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: 11/15/2022]
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Howe C, Mishra S, Kim YS, Chen Y, Ye SH, Wagner WR, Jeong JW, Byun HS, Kim JH, Chun Y, Yeo WH. Stretchable, Implantable, Nanostructured Flow-Diverter System for Quantification of Intra-aneurysmal Hemodynamics. ACS Nano 2018; 12:8706-8716. [PMID: 30021063 DOI: 10.1021/acsnano.8b04689] [Citation(s) in RCA: 7] [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] [Indexed: 06/08/2023]
Abstract
Random weakening of an intracranial blood vessel results in abnormal blood flow into an aneurysmal sac. Recent advancements show that an implantable flow diverter, integrated with a medical stent, enables a highly effective treatment of cerebral aneurysms by guiding blood flow into the normal vessel path. None of such treatment systems, however, offers post-treatment monitoring to assess the progress of sac occlusion. Therefore, physicians rely heavily on either angiography or magnetic resonance imaging. Both methods require a dedicated facility with sophisticated equipment settings and time-consuming, cumbersome procedures. In this paper, we introduce an implantable, stretchable, nanostructured flow-sensor system for quantification of intra-aneurysmal hemodynamics. The open-mesh membrane device is capable of effective implantation in complex neurovascular vessels with extreme stretchability (500% radial stretching) and bendability (180° with 0.75 mm radius of curvature) for monitoring of the treatment progress. A collection of quantitative mechanics, fluid dynamics, and experimental studies establish the fundamental aspects of design criteria for a highly compliant, implantable device. Hemocompatibility study using fresh ovine blood captures the device feasibility for long-term insertion in a blood vessel, showing less platelet deposition compared to that in existing implantable materials. In vitro demonstrations of three types of flow sensors show quantification of intra-aneurysmal blood flow in a pig aorta and the capability of observation of aneurysm treatment with a great sensitivity (detection limit as small as 0.032 m/s). Overall, this work describes a mechanically soft flow-diverter system that offers an effective treatment of aneurysms with an active monitoring of intra-aneurysmal hemodynamics.
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Affiliation(s)
- Connor Howe
- Department of Mechanical and Nuclear Engineering, Institute for Engineering and Medicine, Center for Rehabilitation Science and Engineering , Virginia Commonwealth University , Richmond , Virginia 23284 , United States
| | - Saswat Mishra
- George W. Woodruff School of Mechanical Engineering, College of Engineering , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
| | - Yun-Soung Kim
- George W. Woodruff School of Mechanical Engineering, College of Engineering , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
| | - Yanfei Chen
- Department of Industrial Engineering , University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Sang-Ho Ye
- Department of Bioengineering , University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - William R Wagner
- Department of Bioengineering , University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Jae-Woong Jeong
- School of Electrical Engineering , Korea Advanced Institute of Science and Technology , Daejeon , Republic of Korea 34141
| | - Hun-Soo Byun
- Department of Chemical and Biomolecular Engineering , Chonnam National University , Yeosu , Jeonnam 59626 , South Korea
| | - Jong-Hoon Kim
- School of Engineering and Computer Science , Washington State University , Vancouver , Washington 98686 , United States
| | - Youngjae Chun
- Department of Industrial Engineering , University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
- Department of Bioengineering , University of Pittsburgh , Pittsburgh , Pennsylvania 15261 , United States
| | - Woon-Hong Yeo
- Department of Mechanical and Nuclear Engineering, Institute for Engineering and Medicine, Center for Rehabilitation Science and Engineering , Virginia Commonwealth University , Richmond , Virginia 23284 , United States
- George W. Woodruff School of Mechanical Engineering, College of Engineering , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
- Institute for Electronics and Nanotechnology, Bioengineering Interdisciplinary Program, Petit Institute for Bioengineering & Bioscience, and Center for Flexible Electronics , Georgia Institute of Technology , Atlanta , Georgia 30332 , United States
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Robison K, Bevis K, Howe C, Wohlrab K, Sung V, Richter H, Lokich E, McCourt C, Glaser G, Brown A, Wethington S, Carlson M, Rahn D, Lowder J, Occhino J, Dunivan G, Tunitsky E, Chen G, Luis C, Raker C, DiSilvestro P, Clark M. Characteristics of women with endometrial cancer and stress urinary incontinence (SUI) that desire concurrent cancer and SUI surgery: Cancer of the uterus and treatment of incontinence (CUTI) study. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.372] [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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Lee Y, Howe C, Mishra S, Lee DS, Mahmood M, Piper M, Kim Y, Tieu K, Byun HS, Coffey JP, Shayan M, Chun Y, Costanzo RM, Yeo WH. Wireless, intraoral hybrid electronics for real-time quantification of sodium intake toward hypertension management. Proc Natl Acad Sci U S A 2018; 115:5377-5382. [PMID: 29735689 PMCID: PMC6003521 DOI: 10.1073/pnas.1719573115] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Recent wearable devices offer portable monitoring of biopotentials, heart rate, or physical activity, allowing for active management of human health and wellness. Such systems can be inserted in the oral cavity for measuring food intake in regard to controlling eating behavior, directly related to diseases such as hypertension, diabetes, and obesity. However, existing devices using plastic circuit boards and rigid sensors are not ideal for oral insertion. A user-comfortable system for the oral cavity requires an ultrathin, low-profile, and soft electronic platform along with miniaturized sensors. Here, we introduce a stretchable hybrid electronic system that has an exceptionally small form factor, enabling a long-range wireless monitoring of sodium intake. Computational study of flexible mechanics and soft materials provides fundamental aspects of key design factors for a tissue-friendly configuration, incorporating a stretchable circuit and sensor. Analytical calculation and experimental study enables reliable wireless circuitry that accommodates dynamic mechanical stress. Systematic in vitro modeling characterizes the functionality of a sodium sensor in the electronics. In vivo demonstration with human subjects captures the device feasibility for real-time quantification of sodium intake, which can be used to manage hypertension.
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Affiliation(s)
- Yongkuk Lee
- George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332
| | - Connor Howe
- Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Saswat Mishra
- George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332
| | - Dong Sup Lee
- Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Musa Mahmood
- George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332
| | - Matthew Piper
- Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Youngbin Kim
- Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Katie Tieu
- Department of Mechanical and Nuclear Engineering, School of Engineering, Virginia Commonwealth University, Richmond, VA 23284
| | - Hun-Soo Byun
- Department of Chemical and Biomolecular Engineering, Chonnam National University, 59626 Jeonnam, South Korea
| | - James P Coffey
- Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298
| | - Mahdis Shayan
- Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15261
| | - Youngjae Chun
- Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15261
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261
| | - Richard M Costanzo
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298
| | - Woon-Hong Yeo
- George W. Woodruff School of Mechanical Engineering, College of Engineering, Georgia Institute of Technology, Atlanta, GA 30332;
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332
- Petit Institute for Bioengineering & Bioscience, Georgia Institute of Technology, Atlanta, GA 30332
- Center for Flexible Electronics, Georgia Institute of Technology, Atlanta, GA 30332
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Shah A, Callahan K, Usiak C, Sauvigne K, Leipzig R, Marshall N, Howe C. CREATION AND USE OF A NATIONAL, COMPETENCY BASED GERIATRICS EDUCATION CURRICULUM: WEBGEMS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.778] [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)
- A. Shah
- Community Internal Medicine, Mayo Clinic, Phoenix, Arizona,
| | | | - C. Usiak
- Mount Sinai, New York, New York,
| | | | | | | | - C. Howe
- University of Arizona, Tucson, Arizona
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Fleming SL, Jones SE, Green S, Clark AL, Howe C, Kon SSC, Dickson M, Godden J, Bell D, Haselden BM, Man WDC. P43 Patients’ experiences of early post-hospitalisation pulmonary rehabilitation: A quality improvement initiative. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.193] [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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Zwygart KA, Howe C, Moir HJ. THE ACUTE EFFECTS OF EXERCISE ON POST-EXERCISE INFLAMMATION AND IRON REGULATION: A COMPARISON BETWEEN TRAINED AND UNTRAINED MEN. Br J Sports Med 2013. [DOI: 10.1136/bjsports-2013-093073.38] [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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Affiliation(s)
- C. Howe
- Department of Genetics; Evolution and Environment; University College London; London; UK
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Musgrave H, Howe C, Green S, Lennox L, Elkin S, Wilson S, Mann B, Lai D. P286 Implementing a COPD Discharge Care Bundle: The Challenges and Facilitators Revealed: Abstract P286 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.378] [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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Jones SE, Green SA, Clark AL, Dickson MJ, Nolan AM, Moloney C, Kon SSC, Godden J, Howe C, Haselden BM, Fleming S, Man WDC. P102 Post-Hospitalisation Outpatient Pulmonary Rehabilitation: A Translational Gap? Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sanger C, Hayward J, Patel G, Poots A, Howe C, Green J. O9 Is HIV and blood borne virus testing acceptable and indicated in psychiatric settings? Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601a.9] [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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Affiliation(s)
- C. Howe
- Department of Life Sciences and Centre for Environmental Policy; Imperial College London; London; UK
| | - E. J. Milner-Gulland
- Department of Life Sciences and Centre for Environmental Policy; Imperial College London; London; UK
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Affiliation(s)
- C. Howe
- Department of Life Sciences and Centre for Environmental Policy; Imperial College London; London; UK
| | - E. J. Milner-Gulland
- Department of Life Sciences and Centre for Environmental Policy; Imperial College London; Silwood Park Campus, Ascot; Berks; UK
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Fisher A, Howe C, Smith A, Bombelli P, Cameron P, Bendall D. Biological electrochemical devices for production of current and hydrogen. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.08.070] [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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Morgan C, Howe C, Rose HM, Moore DH. STRUCTURE AND DEVELOPMENT OF VIRUSES OBSERVED IN THE ELECTRON MICROSCOPE : IV. VIRUSES OF THE RI-APC GROUP. J Biophys Biochem Cytol 2010; 2:351-60. [PMID: 19866554 PMCID: PMC2223972 DOI: 10.1083/jcb.2.3.351] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Representative viruses of the RI-APC group were observed with the electron microscope in thin sections of infected HeLa cells. The viral particles varied in density, were approximately 60 mµ in diameter and had a center to center spacing when close packed of about 65 mµ. Many of the less dense particles exhibited an internal body averaging 24 mµ in diameter. It was suggested that within the nucleus the virus differentiated from dense granular and reticular material and formed crystals. Disintegration of the crystals and disruption of the nuclear membrane with release of virus into the cytoplasm appeared to occur at any stage. No evidence to suggest development of the virus in the cytoplasm was obtained. It was possible to deduce the structure of the viral crystal from the electron micrographs. The viral particles are packed in a cubic body—centered lattice. Correlative histochemical observations in the light microscope which are now in progress revealed that the crystals and non-crystalline aggregates of virus were strongly Feulgen-positive.
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Affiliation(s)
- C Morgan
- (From the Departments of Microbiology and of Medicine, College of Physicians and Surgeons, Columbia University, New York)
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Abstract
Methods have been described for the extraction and purification of an agent inhibiting the hemagglutination of red cells by influenza (PR8) and mumps viruses. Human red cells have served as the chief source of the inhibitor but the latter has also been found in human lung. The active extracts have been purified to the extent that 0.1 gamma of material suffices to inhibit one hemagglutinating dose of virus. Incomplete chemical characterization of the most highly purified fractions available indicates the presence of 2.6 per cent nitrogen, at least 50 per cent of polysaccharide, and no phosphorus. In the ultracentrifuge the purified preparation behaves as a polydisperse macromolecular substance. The active material can be obtained from red cell stroma in an ether- and chloroform-soluble form which, on further treatment, can be converted into chloroform-insoluble material. It is possible that the former represents more closely the virus receptor as it exists in the red cell. The purified inhibitor is inactivated on incubation with the virus at 37 degrees C. The nature of this effect is being investigated.
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Affiliation(s)
- P M Deburgh
- Department of Bacteriology and Immunology, Harvard Medical School, Boston
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Howe C, Barbrook A. The remarkable chloroplast genome of dinoflagellates. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.466] [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]
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Har-Shai Y, Glickman YA, Siller G, McLeod R, Topaz M, Howe C, Ginzburg A, Zamir B, Filo O, Kenan G, Ullmann Y. Electrical impedance scanning for melanoma diagnosis: a validation study. Plast Reconstr Surg 2006; 116:782-90. [PMID: 16141816 DOI: 10.1097/01.prs.0000176258.52201.22] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A multicenter study was conducted to test the ability of electrical impedance scanning to differentiate between benign and malignant skin lesions. The performance of a dual electrical impedance scanning/image analysis device was also assessed. METHODS Electrical impedance scanning measurements of 449 preoperative lesions found on 382 patients and including 53 melanomas from the trunk and extremities were performed. Results were correlated with histopathologic findings. In addition, ABCD parameters for the lesions were automatically calculated by the system. RESULTS Electrical impedance scanning detected melanomas of the trunk and extremities with 91 percent sensitivity and 64 percent specificity. Moreover, sensitivity of electrical impedance scanning was increased to 100 percent for in situ and thin melanomas of smaller size (n = 27). Visual examination identified as malignant only 67 percent of these early tumors (p = 0.002). Clinical examination detected 96 percent of the larger or thicker melanomas (n = 26), whereas electrical impedance scanning detected only 81 percent of them. Combined electrical impedance scanning and image analysis detected 100 percent of the melanomas, independent of their thickness, and with no significant decrease of specificity. Because of electrical differences between the head/neck and the rest of the body, the assessed electrical impedance scanning parameters were not adequate for the diagnosis of melanomas from the head and neck. CONCLUSIONS A validation study proved the value of electrical impedance scanning as a noninvasive technique for detection of melanoma lesions of the trunk and extremities, specifically, of in situ and thin type. In addition, image analysis was shown to be a valuable, complementary procedure. New parameters should be designed to optimize the performance of electrical impedance scanning for melanomas of the head and neck.
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Affiliation(s)
- Y Har-Shai
- Department of Plastic Surgery, Linn Medical Center, TransScan Medical Ltd., Haifa, Israel.
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Abidov A, Hachamovitch R, Friedman JD, Hayes SW, Kang X, Cohen I, Germano G, Berman DS, Kjaer A, Cortsen A, Federspiel M, Hesse B, Holm S, O’Connor M, Dhalla AK, Wong MY, Wang WQ, Belardinelli L, Therapeutics CV, Epps A, Dave S, Brewer K, Chiaramida S, Gordon L, Hendrix GH, Feng B, Pretorius PH, Bruyant PP, Boening G, Beach RD, Gifford HC, King MA, Fessler JA, Hsu BL, Case JA, Gegen LL, Hertenstein GK, Cullom SJ, Bateman TM, Akincioglu C, Abidov A, Nishina H, Kavanagh P, Kang X, Aboul-Enein F, Yang L, Hayes S, Friedman J, Berman D, Germano G, Santana CA, Rivero A, Folks RD, Grossman GB, Cooke CD, Hunsche A, Faber TL, Halkar R, Garcia EV, Hansen CL, Silver S, Kaplan A, Rasalingam R, Awar M, Shirato S, Reist K, Htay T, Mehta D, Cho JH, Heo J, Dubovsky E, Calnon DA, Grewal KS, George PB, Richards DR, Hsi DH, Singh N, Meszaros Z, Thomas JL, Reyes E, Loong CY, Latus K, Anagnostopoulos C, Underwood SR, Kostacos EJ, Araujo LI, Kostacos EJ, Araujo LI, Lewin HC, Hyun MC, DePuey EG, Tanaka H, Chikamori T, Igarashi Y, Harafuji K, Usui Y, Yanagisawa H, Hida S, Yamashina A, Nasr HA, Mahmoud SA, Dalipaj MM, Golanowski LN, Kemp RAD, Chow BJ, Beanlands RS, Ruddy TD, Michelena HI, Mikolich BM, McNelis P, Decker WAV, Stathopoulos I, Duncan SA, Isasi C, Travin MI, Kritzman JN, Ficaro EP, Corbett JR, Allison JS, Weinsaft JW, Wong FJ, Szulc M, Okin PM, Kligfield P, Harafuji K, Chikamori T, Igarashi Y, Tanaka H, Usui Y, Yanagisawa H, Hida S, Ishimaru S, Yamashima A, Giedd KN, Bergmann SR, Shah S, Emmett L, Allman KC, Magee M, Van Gaal W, Kritharides L, Freedman B, Abidov A, Gerlach J, Akincioglu C, Friedman J, Kavanagh P, Miranda R, Germano G, Berman DS, Hayes SW, Damera N, Lone B, Singh R, Shah A, Yeturi S, Prasad Y, Blum S, Heller EN, Bhalodkar NC, Koutelou M, Kollaros N, Theodorakos A, Manginas A, Leontiadis E, Kouzoumi A, Cokkinos D, Mazzanti M, Marini M, Cianci G, Perna GP, Pai M, Greenberg MD, Liu F, Frankenberger O, Kokkinos P, Hanumara D, Goheen E, Wu C, Panagiotakos D, Fletcher R, Greenberg MD, Liu F, Frankenberger O, Kokkinos P, Hanumara D, Goheen E, Rodriguez OJ, Iyer VN, Lue M, Hickey KT, Blood DK, Bergmann SR, Bokhari S, Chareonthaitawee P, Christensen SD, Allen JL, Kemp BJ, Hodge DO, Ritman EL, Gibbons RJ, Smanio P, Riva G, Rodriquez F, Tricoti A, Nakhlawi A, Thom A, Pretorius PH, King MA, Dahlberg S, Leppo J, Slomka PJ, Nishina H, Berman DS, Akincioglu C, Abidov A, Friedman JD, Hayes SW, Germano G, Petrovici R, Husain M, Lee DS, Nanthakumar K, Iwanochko RM, Brunken RC, DiFilippo F, Neumann DR, Bybel B, Herrington B, Bruckbauer T, Howe C, Lohmann K, Hayden C, Chatterjee C, Lathrop B, Brunken RC, Chen MS, Lohmann KA, Howe WC, Bruckbauer T, Kaczur T, Bybel B, DiFilippo FP, Druz RS, Akinboboye OA, Grimson R, Nichols KJ, Reichek N, Ngai K, Dim R, Ho KT, Pary S, Ahmed SU, Ahlberg A, Cyr G, Vitols PJ, Mann A, Alexander L, Rosenblatt J, Mieres J, Heller GV, Ahmed SU, Ahlberg AW, Cyr G, Navare S, O’Sullivan D, Heller GV, Chiadika S, Lue M, Blood DK, Bergmann SR, Bokhari S, Heston TF, Heller GV, Cerqueira MD, Jones PG, Bryngelson JR, Moutray KL, Gegen LL, Hertenstein GK, Moser K, Case JA, Zellweger MJ, Burger PC, Pfisterer ME, Mueller-Brand J, Kang WJ, Lee BI, Lee DS, Paeng JC, Lee JS, Chung JK, Lee MC, To BN, O’Connell WJ, Botvinick EH, Duvall WL, Croft LB, Einstein AJ, Fisher JE, Haynes PS, Rose RK, Henzlova MJ, Prasad Y, Vashist A, Blum S, Sagar P, Heller EN, Kuwabara Y, Nakayama K, Tsuru Y, Nakaya J, Shindo S, Hasegawa M, Komuro I, Liu YH, Wackers F, Natale D, DePuey G, Taillefer R, Araujo L, Kostacos E, Allen S, Delbeke D, Anstett F, Kansal P, Calvin JE, Hendel RC, Gulati M, Pratap P, Takalkar A, Kostacos E, Alavi A, Araujo L, Melduni RM, Duncan SA, Travin MI, Isasi CR, Rivero A, Santana C, Esiashvili S, Grossman G, Halkar R, Folks RD, Garcia EV, Su H, Dobrucki LW, Chow C, Hu X, Bourke BN, Cavaliere P, Hua J, Sinusas AJ, Spinale FG, Sweterlitsch S, Azure M, Edwards DS, Sudhakar S, Chyun DA, Young LH, Inzucchi SE, Davey JA, Wackers FJ, Noble GL, Navare SM, Calvert J, Hussain SA, Ahlberg AM, Katten DM, Boden WE, Heller GV, Shaw LJ, Yang Y, Antunes A, Botelho MF, Gomes C, de Lima JJP, Silva ML, Moreira JN, Simões S, GonÇalves L, Providência LA, Elhendy A, Bax JJ, Schinkel AF, Valkema R, van Domburg RT, Poldermans D, Arrighi J, Lampert R, Burg M, Soufer R, Veress AI, Weiss JA, Huesman RH, Gullberg GT, Moser K, Case JA, Loong CY, Prvulovich EM, Reyes E, Aswegen AV, Anagnostopoulos C, Underwood SR, Htay T, Mehta D, Sun L, Lacy J, Heo J, Brunken RC, Kaczur T, Jaber W, Ramakrishna G, Miller TD, O’connor MK, Gibbons RJ, Bural GG, Mavi A, Kumar R, El-Haddad G, Srinivas SM, A Alavi, El-Haddad G, Alavi A, Araujo L, Thomas GS, Johnson CM, Miyamoto MI, Thomas JJ, Majmundar H, Ryals LA, Ip ZTK, Shaw LJ, Bishop HA, Carmody JP, Greathouse WG, Yanagisawa H, Chikamori T, Tanaka H, Usui Y, Igarashi U, Hida S, Morishima T, Tanaka N, Takazawa K, Yamashina A, Diedrichs H, Weber M, Koulousakis A, Voth E, Schwinger RHG, Mohan HK, Livieratos L, Gallagher S, Bailey DL, Chambers J, Fogelman I, Sobol I, Barst RJ, Nichols K, Widlitz A, Horn E, Bergmann SR, Chen J, Galt JR, Durbin MK, Ye J, Shao L, Garcia EV, Mahenthiran J, Elliott JC, Jacob S, Stricker S, Kalaria VG, Sawada S, Scott JA, Aziz K, Yasuda T, Gewirtz H, Hsu BL, Moutray K, Udelson JE, Barrett RJ, Johnson JR, Menenghetti C, Taillefer R, Ruddy T, Hachamovitch R, Jenkins SA, Massaro J, Haught H, Lim CS, Underwood R, Rosman J, Hanon S, Shapiro M, Schweitzer P, VanTosh A, Jones S, Harafuji K, Giedd KN, Johnson NP, Berliner JI, Sciacca RR, Chou RL, Hickey KT, Bokhari SS, Rodriguez O, Bokhari S, Moser KW, Moutray KL, Koutelou M, Theodorakos A, Kollaros N, Manginas A, Leontiadis E, Cokkinos D, Mazzanti M, Marini M, Cianci G, Perna GP, Nanasato M, Fujita H, Toba M, Nishimura T, Nikpour M, Urowitz M, Gladman D, Ibanez D, Harvey P, Floras J, Rouleau J, Iwanochko R, Pai M, Guglin ME, Ginsberg FL, Reinig M, Parrillo JE, Cha R, Merhige ME, Watson GM, Oliverio JG, Shelton V, Frank SN, Perna AF, Ferreira MJ, Ferrer-Antunes AI, Rodrigues V, Santos F, Lima J, Cerqueira MD, Magram MY, Lodge MA, Babich JW, Dilsizian V, Line BR, Bhalodkar NC, Lone B, Singh R, Prasad Y, Yeturi S, Blum S, Heller EN, Rodriguez OJ, Skerrett D, Charles C, Shuster MD, Itescu S, Wang TS, Bruyant PP, Pretorius PH, Dahlberg S, King MA, Petrovici R, Iwanochko RM, Lee DS, Emmett L, Husain M, Hosokawa R, Ohba M, Kambara N, Tadamura E, Kubo S, Nohara R, Kita T, Thompson RC, McGhie AI, O’Keefe JH, Christenson SD, Chareonthaitawee P, Kemp BJ, Jerome S, Russell TJ, Lowry DR, Coombs VJ, Moses A, Gottlieb SO, Heiba SI, Yee G, Coppola J, Elmquist T, Braff R, Youssef I, Ambrose JA, Abdel-Dayem HM, Canto J, Dubovsky E, Scott J, Terndrup TE, Faber TL, Folks RD, Dim UR, Mclaughlin J, Pollepalle D, Schapiro W, Wang Y, Akinboboye O, Ngai K, Druz RS, Polepalle D, Phippen-Nater B, Leonardis J, Druz R. Abstracts of original contributions ASNC 2004 9th annual scientific session September 3-–October 3, 2004 New York, New York. J Nucl Cardiol 2004. [DOI: 10.1007/bf02974964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
OBJECTIVE Testosterone pellets are a highly effective subdermal depot administered at regular intervals with the timing individualized depending upon return of the patient's characteristic androgen deficiency symptoms. Yet the in vivo testosterone release rate and effective duration of action of these pellets has been little studied systematically. DESIGN Analysis of prospectively collected data from three randomized controlled clinical trials. Collection of extruded pellets. PATIENTS Androgen-deficient men (n = 136) undergoing long-term androgen replacement therapy with a standard dose (800 mg) of testosterone pellets implanted subdermally at intervals from 5 to 7 months. MEASUREMENTS Testosterone release rate of pellets, consisting of pure crystalline testosterone without excipients, is estimated by measuring the dry weight lost by pellets (n = 179) over their time in situ. The effective duration of the standard regimen, and the influence of extrusion and patient or procedural characteristics on it, was estimated by timing of return for re-implantation due to recurrence of the patient's familiar androgen deficiency symptoms. RESULTS The loss of dry weight of intact (n = 112) pellets was strongly correlated with time in situ (r2 = 0.969) providing an estimate of daily testosterone release rate per 200 mg pellet of 1.34 +/- 0.02 mg/pellet/day (95% CI 1.30-1.37 mg/day) for the first 3 months. After 756 implantations of the standard dose, men return for re-implantation at 5.8 calendar months following no or only a single pellet extrusion, but the time to return was significantly shorter after multiple extrusions. No patient or procedural features influenced the timing of return. Among men with primary hypogonadism, increases in plasma LH and FSH were more sensitive than plasma total or free testosterone to changes in testosterone delivery following an extrusion. CONCLUSION Testosterone pellet implants release testosterone at a steady rate of 1.3 mg/200 mg implant/day (95% CI). The duration of action is about 6 months in an uncomplicated cycle with timing of return shortened by extrusions only in the 3.6% of procedures followed by multiple extrusions. No other patient or procedural features influenced duration of action. Among men with an intact hypothalamo-pituitary unit, plasma gonadotropins are more sensitive than blood total or free testosterone to reduced testosterone delivery following an extrusion.
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Affiliation(s)
- S Kelleher
- Department of Andrology, Concord Hospital and ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia
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Jones BA, Kasl SV, Soler H, Van Ness P, Howe C, Lachman M, Beeghly A, Dallal C, Duan F. #11 Race / ethnic differences in breast cancer survival. Ann Epidemiol 2002. [DOI: 10.1016/s1047-2797(02)00299-5] [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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Howe C, Vasanthan N, MacClamrock C, Sankar S, Shin ID, Simonsen IK, Tonelli AE. Inclusion Compound Formed between Poly(L-lactic acid) and Urea. Macromolecules 2002. [DOI: 10.1021/ma00103a028] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tart E, Wood G, Wernsman D, Sangwatanaroj U, Howe C, Zhou Q, Zhang S, Tonelli AE. Carbon-13 NMR spectroscopy as a means to probe the local microstructures and conformations of ethylene-vinyl acetate copolymers. Macromolecules 2002. [DOI: 10.1021/ma00068a032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fullerton JT, Lowe NK, Howe C. A common misunderstanding about the relationship between the core competencies promulgated by the American College of Nurse-Midwives. J Midwifery Womens Health 2001; 46:118-9. [PMID: 11370688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Parisotto R, Wu M, Ashenden MJ, Emslie KR, Gore CJ, Howe C, Kazlauskas R, Sharpe K, Trout GJ, Xie M. Detection of recombinant human erythropoietin abuse in athletes utilizing markers of altered erythropoiesis. Haematologica 2001; 86:128-37. [PMID: 11224480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The detection of recombinant human erythropoietin (r-HuEPO) abuse by athletes remains problematic. The main aim of this study was to demonstrate that the five indirect markers of altered erythropoiesis identified in our earlier work were reliable evidence of current or recently discontinued r-HuEPO use. A subsidiary aim was to refine weightings of the five markers in the initial model using a much larger data set than in the pilot study. A final aim was to verify that the hematologic response to r-HuEPO did not differ between Caucasian and Asiatic subjects. DESIGN AND METHODS Recreational athletes resident in Sydney, Australia (Sydney, n = 49; 16 women, 33 men) or Beijing, China (Beijing, n=24; 12 women, 12 men) were randomly assigned to r-HuEPO or placebo groups prior to a 25 day administration phase. Injections of r-HuEPO (or saline) were administered double-blind at a dose of 50 IU/kg three times per week, with oral iron (105 mg) or placebo supplements taken daily by all subjects. Blood profiles were monitored during and for 4 weeks after drug administration for hematocrit (Hct), reticulocyte hematocrit (RetHct), percent macrocytes (%Macro), serum erythropoietin (EPO) and soluble transferrin receptor (sTfr), since we had previously shown that these five variables were indicative of r-HuEPO use. RESULTS The changes in Hct, RetHct, %Macro, EPO and sTfr in the Sydney trial were qualitatively very similar to the changes noted in our previous administration trial involving recreational athletes of similar genetic origin. Statistical models developed from Fisher's discriminant analysis were able to categorize the user and placebo groups correctly. The same hematologic response was demonstrated in Beijing athletes also administered r-HuEPO. INTERPRETATION AND CONCLUSIONS This paper confirms that r-HuEPO administration causes a predictable and reproducible hematologic response. These markers are disturbed both during and for several weeks following r-HuEPO administration. This work establishes an indirect blood test which offers a useful means of detecting and deterring r-HuEPO abuse. Ethnicity did not influence the markers identified as being able to detect athletes who abuse r-HuEPO.
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Affiliation(s)
- R Parisotto
- Department of Physiology, Australian Institute of Sport, P.O. Box 176, Belconnen ACT 2616, Australia.
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Parisotto R, Gore CJ, Emslie KR, Ashenden MJ, Brugnara C, Howe C, Martin DT, Trout GJ, Hahn AG. A novel method utilising markers of altered erythropoiesis for the detection of recombinant human erythropoietin abuse in athletes. Haematologica 2000; 85:564-72. [PMID: 10870111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The use of recombinant human erythropoietin (r-HuEPO) to enhance athletic performance is prohibited. Existing tests cannot readily differentiate between exogenous and endogenous EPO. Therefore the aim of our study was to investigate possible indirect detection of r-HuEPO use via blood markers of altered erythropoiesis. DESIGN AND METHODS Twenty-seven recreational athletes were assigned to three groups prior to a 25 day drug administration phase, with the following protocols: EPO+IM group (n = 10), 50 Ukg(-1) r-HuEPO at a frequency of 3wk(-1), 100 mg intramuscular (IM) iron 1wk(-1) and a sham iron tablet daily; EPO+OR group (n = 8), 50 U.kg(-1) r-HuEPO 3wk(-1), sham iron injection 1wk(-1) and 105 mg of oral elemental iron daily; placebo group (n = 9), sham r-HuEPO injections 3wk(-1), sham iron injections 1wk(-1) and sham iron tablets daily. Each group was monitored during and for 4 weeks after drug administration. RESULTS Models incorporating combinations of the variables reticulocyte hematocrit (RetHct), serum EPO, soluble transferrin receptor, hematocrit (Hct) and % macrocytes were analyzed by logistic regression. One model (ON-model) repeatedly identified 94-100% of r-HuEPO group members during the final 2 wk of the r-HuEPO administration phase. One false positive was recorded from a possible 189. Another model (OFF-model) incorporating RetHct, EPO and Hct was applied during the wash-out phase and, during the period of 12-21 days after the last r-HuEPO injection, it repeatedly identified 67-72% of recent users with no false positives. INTERPRETATION AND CONCLUSIONS Multiple indirect hematologic and biochemical markers used simultaneously are potentially effective for identifying current or recent users of r-HuEPO.
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Affiliation(s)
- R Parisotto
- Department of Physiology, Australian Institute of Sport, P.O. Box 176, Belconnen ACT 2616, Australia.
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Abstract
Most subunits of the alphabeta deltaepsilon gammaepsilon zetazeta T cell antigen receptor (TCR) complex associate with the molecular chaperone calnexin shortly after their synthesis in the endoplasmic reticulum, including clonotypic TCRalpha,beta molecules and invariant CD3gamma,delta,epsilon chains. While calnexin interaction is suggested to be important for the stability of newly synthesized TCRalpha subunits, the role of calnexin in the survival and assembly of remaining TCR components is unknown. Here we evaluated the expression of TCR proteins in CEM T cells and the calnexin-deficient CEM variant CEM.NK(R). We found that CEM and CEM.NK(R) cells constitutively synthesized all TCR subunits except for TCRalpha and that CD3gamma,delta,epsilon components and CD3-beta complexes were effectively assembled together in both cell types. The stability and folding of core CD3epsilon chains were similar in CEM and CEM.NK(R) cells. Interestingly, TCRalpha synthesis was differentially induced by phorbol myristate acetate treatment in CEM and CEM.NK(R) cells and TCRalpha proteins synthesized in CEM.NK(R) cells showed reduced survival compared to those made in CEM cells. Importantly, these data show that TCR complexes were inducibly expressed on CEM.NK(R) cells in the absence of calnexin synthesis. These results demonstrate that TCR complexes can be expressed in the absence of calnexin and suggest that the role of calnexin in the quality control of TCR assembly is primarily restricted to the stabilization of newly synthesized TCRalpha proteins.
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Affiliation(s)
- T G Gardner
- Department of Microbiology & Immunology, East Carolina University, School of Medicine, Greenville, North Carolina 27858-4354, USA
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Abstract
The purpose of this study was to replicate a national study of physician knowledge, experience, and attitudes about breastfeeding. All family, pediatric, and women's health care nurse practitioners and nurse-midwives in a northwestern state were surveyed using a mail questionnaire; the response rate was 60.4%. Respondents were nearly unanimous in believing that "breast is best" and in recommending breastfeeding to expectant mothers as a part of their role. In general, 70% of respondents considered themselves effective or very effective in meeting the needs of breastfeeding patients. Although respondents were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. There were differences in attitudes among nursing specialties and with years of experience. Overall, this statewide sample of nurse practitioners and nurse-midwives had a better understanding of the benefits of breastfeeding and an increased sense of effectiveness in managing breastfeeding problems than the physician participants in the national study. A national sample of nurse practitioners and nurse-midwives is needed to verify and expand on the results from this single jurisdiction, where 40% of the respondents were graduates of the home institution of the co-investigators.
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Affiliation(s)
- P Hellings
- OHSU School of Nursing, Portland, OR 97201, USA
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Delany AM, Amling M, Priemel M, Howe C, Baron R, Canalis E. Osteopenia and decreased bone formation in osteonectin-deficient mice. J Clin Invest 2000; 105:1325. [PMID: 10792008 PMCID: PMC378207 DOI: 10.1172/jci7039c1] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Bone continuously remodels in response to mechanical and physiological stresses, allowing vertebrates to renew bone as adults. Bone remodeling consists of the cycled synthesis and resorption of collagenous and noncollagenous extracellular matrix proteins, and an imbalance in this process can lead to disease states such as osteoporosis, or more rarely, osteopetrosis. There is evidence that the extracellular matrix glycoprotein osteonectin or secreted protein acidic and rich in cysteine (BM-40) may be important in bone remodeling. Osteonectin is abundant in bone and is expressed in areas of active remodeling outside the skeleton. In vitro studies indicate that osteonectin can bind collagen and regulate angiogenesis, metalloproteinase expression, cell proliferation, and cell-matrix interactions. In some osteopenic states, such as osteogenesis imperfecta and selected animal models for bone fragility, osteonectin expression is decreased. To determine the function of osteonectin in bone, we used contact x-ray, histomorphometry, and Northern blot analysis to characterize the skeletal phenotype of osteonectin-null mice. We found that osteonectin-null mice have decreased bone formation and decreased osteoblast and osteoclast surface and number, leading to decreased bone remodeling with a negative bone balance and causing profound osteopenia. These data indicate that osteonectin supports bone remodeling and the maintenance of bone mass in vertebrates.
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Affiliation(s)
- A M Delany
- Department of Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105, USA
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Farrell MP, Gehring LL, Howe C. Child and family nursing international consulting. The Web way. J Child Fam Nurs 2000; 3:71-6. [PMID: 11022484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Karaivanova V, Suzuki C, Howe C, Kearse KP. Characterization of the epitope on murine T-cell receptor (TCR) alpha proteins recognized by H28-710 monoclonal antibody. Hybridoma (Larchmt) 1999; 18:497-503. [PMID: 10626678 DOI: 10.1089/hyb.1999.18.497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Antigen recognition by alphabeta T lymphocytes is mediated via the multisubunit T-cell receptor (TCR) complex consisting of invariant CD3-gamma,delta,epsilon, and zeta chains associated with clonotypic TCRalpha,beta molecules. In the current report, we evaluated the molecular basis for recognition of murine TCRalpha proteins by H28-710 monoclonal antibody (MAb), specific for the constant region of murine TCRalpha chains. H28-710 is widely used in the study of the TCR complex as it is the only reagent currently available that recognizes all murine TCRalpha proteins, regardless of their clonotype. These data show that H28-710 is useful for the immunoprecipitation of TCRalpha proteins not associated with CD3 subunits, and that H28-710 effectively recognizes denatured TCRalpha proteins synthesized in several different cell types. Most importantly, these results demonstrate that H28 binding involves a serine/threonine-rich region between amino acids 150-177 on murine TCRalpha polypeptides.
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MESH Headings
- Amino Acids/chemistry
- Animals
- Antibodies, Monoclonal/immunology
- Antibody Specificity
- CD3 Complex/genetics
- CD3 Complex/immunology
- CD3 Complex/metabolism
- COS Cells
- Epitopes/chemistry
- Epitopes/immunology
- Glycosylation
- Hybridomas
- Immunoblotting
- L Cells
- Mice
- Oligosaccharides
- Precipitin Tests
- Receptors, Antigen, T-Cell, alpha-beta/chemistry
- Receptors, Antigen, T-Cell, alpha-beta/genetics
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, alpha-beta/metabolism
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Affiliation(s)
- V Karaivanova
- Department of Microbiology & Immunology, East Carolina University, School of Medicine, Greenville, NC 27858-4354, USA
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Abstract
BACKGROUND It has previously been shown that testosterone implantation is an effective and well accepted form of androgen replacement therapy, but that pellet extrusion was the most frequent side-effect. The present study aimed to reduce the extrusion rate. OBJECTIVE To determine whether the washing of testosterone pellets to remove potentially surface-adherent particles decreased the rate of extrusion of pellet implants. DESIGN Prospective, randomized parallel group design in a single centre with consecutive procedures to be randomized (1 : 1) into a wash or control group. PATIENTS The study included 251 testosterone implantation procedures in men with known androgen deficiency. MEASUREMENTS The primary endpoint, extrusion rate per procedure, was evaluated prospectively by telephone contact at 1 week and then 3 and 6 month intervals. Secondary end-points included peri-procedure adverse events (bleeding, skin reaction, excessive discomfort) noted at the time of implant. Bruising, bleeding and infection were also evaluated as later adverse events by telephone and personal follow-up. Explanatory variables recorded as possible covariables included the number of implants used, production batch number of the implants, the operator, as well as other demographic and medical factors. RESULTS In the wash group, the extrusion rate was 12% per procedure (19 pellets from 15 subjects) whereas in the control group, the extrusion rate was 11.1% per procedure (18 pellets from 14 subjects), indicating no evidence of any benefit of the wash procedure (OR = 1. 09 [95% CI 0.47-2.6] per procedure). There was no evidence of benefit in secondary endpoints including total adverse events (7.1%, OR 1.28 [0.44-3.9], bleeding/bruising (8.8%, 1.23 [0.47-3.3]) and infection (4.0%, 1.54 [0.35-7.6]) per procedure. Among men reporting an infection requiring antibiotic treatment according to their own general practitioners, six/ten (60%) subsequently experienced an extrusion. There were no significant differences in extrusion rate between four different operators (P = 0.24) nor among 12 different batches of pellets used during the course of the study (P = 0.77). CONCLUSIONS The pellet washing procedure used during implantation does not reduce the subsequent extrusion rate. The higher rate of both primary and secondary adverse events in this prospective study compared with the previous retrospective survey may reflect either more rigorous follow-up or a secular trend.
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Affiliation(s)
- S Kelleher
- Andrology Unit, Royal Prince Alfred Hospital &, Department of Medicine, University of Sydney, Australia
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Deeg HJ, Seidel K, Casper J, Anasetti C, Davies S, Gajeweski JL, Territo M, Ramsay N, Harris RE, Catro-Malaspina H, Collins R, Champlin R, Schoch G, King R, Howe C. Marrow transplantation from unrelated donors for patients with severe aplastic anemia who have failed immunosuppressive therapy. Biol Blood Marrow Transplant 1999; 5:243-52. [PMID: 10465104 DOI: 10.1053/bbmt.1999.v5.pm10465104] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Allogeneic marrow transplantation offers curative therapy for patients with aplastic anemia. We analyzed retrospective results in 141 patients with severe aplastic anemia who received transplants between 1988 and 1995 from an unrelated volunteer donor identified through the National Marrow Donor Program (NMDP). All patients had failed one or more courses of immunosuppressive therapy. Of the patients, 121 (86%) received a radiation-containing conditioning regimen, and 20 (14%) were given chemotherapy only. Based on serologic human leukocyte antigen (HLA) typing (class I and II), 105 patients (74%) received HLA-matched marrow, and 36 (26%) received marrow mismatched for at least one HLA-A, -B, or -DR antigen. Allele-level (molecular) typing for HLA-DRB1 was available in 108 donor-recipient pairs; 77 patients received DRB -matched and 31 DRB1-mismatched transplants. All but 13% of patients were given a cyclosporine-containing regimen for graft-vs.-host disease (GVHD) prophylaxis, and 45 patients (32%) received marrow that was T cell-depleted. Among 131 evaluable patients, 116 (89%) achieved sustained engraftment and 15 (11%) did not. Among patients with engraftment, acute GVHD of grades II-IV developed in 60 patients (52%) and extensive chronic GVHD in 24 patients at risk (31%). Currently, 51 patients (36%) are surviving at 11-94 months (median 36) after transplantation. All but five have Karnofsky scores > or =80. Patients who received a serologically matched transplant fared somewhat better than did patients given a serologically mismatched transplant p = 0.03). Patients with donors matched by both serology and allele-level DRB1 typing had significantly better survival than DRB1-mismatched patients with 56 vs. 15% surviving at 3 years p = 0.001). Outcome in patients transplanted within 3 years of diagnosis was superior to that among patients transplanted with greater delay. Major causes of death were graft failure, GVHD, and infections. These data suggest that unrelated marrow transplantation offers successful therapy for a proportion of patients who have failed immunosuppressive therapy.
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Affiliation(s)
- H J Deeg
- Fred Hutchinson Cancer Research Center, the Department of Medicine, University of Washington, Seattle, USA
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Howe C, Tolmie A, Sofroniou N. Experimental appraisal of personal beliefs in science: constraints on performance in the 9 to 14 age group. Br J Educ Psychol 1999; 69 ( Pt 2):243-74. [PMID: 10405619 DOI: 10.1348/000709999157707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Recent curricula initiatives have promoted experimentation as a means by which relatively young children can appraise their personal beliefs and thereby modify these beliefs towards received scientific ideas. However, key psychological theories signal problems, and the enterprise is not in any event securely grounded in empirical research. AIMS As a consequence, the study reported here aimed to provide comprehensive information about children's abilities to use experimentation to appraise their beliefs, while allowing full exploration of theorized constraints. SAMPLES The study involved 24 children at each of three age levels within the 9 to 14 range. METHODS The children were first interviewed to establish their beliefs about influences on outcome in four educationally significant topic areas: flotation, pressure, motion and shadows. Subsequently, they were asked to conduct investigations to determine whether selected beliefs were correct. RESULTS The results showed that, regardless of age or topic, very few children appreciated that to explore whether some variable is influencing outcome it is necessary to manipulate that variable experimentally and that variable only. There was a strong tendency to manipulate other variables, a tendency attributed to the intrusion of everyday reasoning practices into the experimental context. Once extraneous variables had been introduced, the children experienced great difficulties with subsequent stages in the experimental process, e.g., predicting, observing and drawing conclusions. CONCLUSIONS It is concluded that experimentation as a means of appraising beliefs is not straightforward in the 9 to 14 age group, and that the pattern of difficulties has psychological significance given the background theories. Nevertheless, while not straightforward, experimental appraisal remains possible given appropriate teacher support, and proposals are made as to the form which the support should take.
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Affiliation(s)
- C Howe
- Department of Psychology, University of Strathclyde, Scotland, UK
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