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Clinical Outcomes of Pulmonary Atresia With Intact Ventricular Septum (PA/IVS) Cases in Western Australia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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2
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Influence of Indexing Methodology on Interpretation of Left Ventricular Volumes in Paediatric Rheumatic Heart Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Improving diabetic patients’ outcomes in family medicine in the United Arab Emirates. EASTERN MEDITERRANEAN HEALTH JOURNAL 2021. [DOI: 10.26719/2002.8.4-5.566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We evaluated a diabetic mini-clinic by assessing adherence to American Diabetes Association guidelines and changes in glycosylated haemoglobin levels. Of 1063 patients, 721 were multiple attenders. Single and multiple attenders showed no significant differences in age, sex, time since diagnosis or body mass index. Female and male multiple attenders showed significant declines in glycosylated haemoglobin levels over the first 12 and 18 months respectively. After 2 years, these levels were similar to those at entry to the clinic. The clinic’s compliance with standard measurement guidelines was high. The diabetic mini-clinic model, which is effective in industrialized countries, was equally effective in this setting.
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Assessment of differentially methylated loci in individuals with end-stage kidney disease attributed to diabetic kidney disease: an exploratory study. Clin Epigenetics 2021; 13:99. [PMID: 33933144 PMCID: PMC8088646 DOI: 10.1186/s13148-021-01081-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/15/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND A subset of individuals with type 1 diabetes mellitus (T1DM) are predisposed to developing diabetic kidney disease (DKD), the most common cause globally of end-stage kidney disease (ESKD). Emerging evidence suggests epigenetic changes in DNA methylation may have a causal role in both T1DM and DKD. The aim of this exploratory investigation was to assess differences in blood-derived DNA methylation patterns between individuals with T1DM-ESKD and individuals with long-duration T1DM but no evidence of kidney disease upon repeated testing to identify potential blood-based biomarkers. Blood-derived DNA from individuals (107 cases, 253 controls and 14 experimental controls) were bisulphite treated before DNA methylation patterns from both groups were generated and analysed using Illumina's Infinium MethylationEPIC BeadChip arrays (n = 862,927 sites). Differentially methylated CpG sites (dmCpGs) were identified (false discovery rate adjusted p ≤ × 10-8 and fold change ± 2) by comparing methylation levels between ESKD cases and T1DM controls at single site resolution. Gene annotation and functionality was investigated to enrich and rank methylated regions associated with ESKD in T1DM. RESULTS Top-ranked genes within which several dmCpGs were located and supported by functional data with methylation look-ups in other cohorts include: AFF3, ARID5B, CUX1, ELMO1, FKBP5, HDAC4, ITGAL, LY9, PIM1, RUNX3, SEPTIN9 and UPF3A. Top-ranked enrichment pathways included pathways in cancer, TGF-β signalling and Th17 cell differentiation. CONCLUSIONS Epigenetic alterations provide a dynamic link between an individual's genetic background and their environmental exposures. This robust evaluation of DNA methylation in carefully phenotyped individuals has identified biomarkers associated with ESKD, revealing several genes and implicated key pathways associated with ESKD in individuals with T1DM.
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Combination anti-coronavirus therapies based on nonlinear mathematical models. CHAOS (WOODBURY, N.Y.) 2021; 31:023136. [PMID: 33653052 DOI: 10.1063/5.0026208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Using nonlinear mathematical models and experimental data from laboratory and clinical studies, we have designed new combination therapies against COVID-19.
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R11 Digital Chest Drains After Lung Resection: An Australian Experience. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The Neuroanatomy of Autism Spectrum Disorder Symptomatology in 22q11.2 Deletion Syndrome. Cereb Cortex 2019; 29:3655-3665. [PMID: 30272146 PMCID: PMC6644859 DOI: 10.1093/cercor/bhy239] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/10/2018] [Accepted: 09/03/2018] [Indexed: 12/29/2022] Open
Abstract
22q11.2 Deletion Syndrome (22q11.2DS) is a genetic condition associated with a high prevalence of neuropsychiatric conditions that include autism spectrum disorder (ASD). While evidence suggests that clinical phenotypes represent distinct neurodevelopmental outcomes, it remains unknown whether this translates to the level of neurobiology. To fractionate the 22q11.2DS phenotype on the level of neuroanatomy, we examined differences in vertex-wise estimates of cortical volume, surface area, and cortical thickness between 1) individuals with 22q11.2DS (n = 62) and neurotypical controls (n = 57) and 2) 22q11.2DS individuals with ASD symptomatology (n = 30) and those without (n = 25). We firstly observed significant differences in surface anatomy between 22q11.2DS individuals and controls for all 3 neuroanatomical features, predominantly in parietotemporal regions, cingulate and dorsolateral prefrontal cortices. We also established that 22q11.2DS individuals with ASD symptomatology were neuroanatomically distinct from 22q11.2DS individuals without ASD symptoms, particularly in brain regions that have previously been linked to ASD (e.g., dorsolateral prefrontal cortices and the entorhinal cortex). Our findings indicate that different clinical 22q11.2DS phenotypes, including those with ASD symptomatology, may represent different neurobiological subgroups. The spatially distributed patterns of neuroanatomical differences associated with ASD symptomatology in 22q11.2DS may thus provide useful information for patient stratification and the prediction of clinical outcomes.
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Predicting Unexpected Postoperative Air Leak in Thoracic Surgery Using Digital Chest Drains. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Review of Systemic to Pulmonary Shunts: A Seventeen Year Experience at a Tertiary Paediatric Hospital. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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PO-0728: Pre-Radiation Tumor Progression Improves Prognostic Stratification In Glioblastoma Patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31038-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Anatomy and Outcomes of Patients with Right Atrial Isomerism: A West Australian Perspective. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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DEVELOPING SKILLS FOR DEVELOPMENTAL DISABILITIES: PRE-CLINICAL ELECTIVE EXPERIENCE DEMONSTRATES REPRODUCIBLE RESULTS. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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miR302 regulates SNAI1 expression to control mesangial cell plasticity. Sci Rep 2017; 7:42407. [PMID: 28195240 PMCID: PMC5307964 DOI: 10.1038/srep42407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/09/2017] [Indexed: 01/04/2023] Open
Abstract
Cell fate decisions are controlled by the interplay of transcription factors and epigenetic modifiers, which together determine cellular identity. Here we elaborate on the role of miR302 in the regulation of cell plasticity. Overexpression of miR302 effected silencing of the TGFβ type II receptor and facilitated plasticity in a manner distinct from pluripotency, characterized by increased expression of Snail. miR302 overexpressing mesangial cells also exhibited enhanced expression of EZH2 coincident with Snail upregulation. esiRNA silencing of each component suggest that Smad3 and EZH2 are part of a complex that regulates plasticity and that miR302 regulates EZH2 and Snail independently. Subsequent manipulation of miR302 overexpressing cells demonstrated the potential of using this approach for reprogramming as evidenced by de novo expression of the tight junction components ZO-1 and E-cadherin and the formation of ZO-1 containing tight junctions. Understanding the processes through which dynamic epigenetic silencing is controlled in adults cells will allow us to address the epigenetic state of acquired disease and whether original states, regenerative in nature, can be restored with therapy.
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Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, which is accompanied by differences in gray matter neuroanatomy and white matter connectivity. However, it is unknown whether these differences are linked or reflect independent aetiologies. Using a multimodal neuroimaging approach, we therefore examined 51 male adults with ASD and 48 neurotypical controls to investigate the relationship between gray matter local gyrification (lGI) and white matter diffusivity in associated fiber tracts. First, ASD individuals had a significant increase in gyrification around the left pre- and post-central gyrus. Second, white matter fiber tracts originating and/or terminating in the cluster of increased lGI had a significant increase in axial diffusivity. This increase in diffusivity was predominantly observed in tracts in close proximity to the cortical sheet. Last, we demonstrate that the increase in lGI was significantly correlated with increased diffusivity of short tracts. This relationship was not significantly modulated by a main effect of group (i.e., ASD), which was more closely associated with gray matter gyrification than white matter diffusivity. Our findings suggest that differences in gray matter neuroanatomy and white matter connectivity are closely linked, and may reflect common rather than distinct aetiological pathways.
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SU-F-J-42: Comparison of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac X-Ray for Cranial Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4955950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Developmental Delay? Graduating Medical Students’ Knowledge of Child Development. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e65b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Knowledge of child development is fundamental to medical practice. Previous studies have demonstrated gaps in knowledge and training among trainees and practicing physicians. We conducted a longitudinal study of medical students’ knowledge of child development. Previously, we reported that students’ knowledge of developmental milestones was poor at baseline, did not improve after preclinical teaching and improved marginally after pediatrics clerkship. Here, we report the report the data on graduating medical students.
OBJECTIVES: The present study aimed to describe graduating medical students’ knowledge of developmental milestones in comparison to their baseline knowledge. A secondary aim was to compare graduating students' knowledge to that of the general population.
DESIGN/METHODS: We assessed medical students' knowledge of developmental milestones using a previously published 17-item questionnaire. Milestones were categorized as motor or non-motor. Students were surveyed at the start of medical school in Year 1 and prior to graduation in Year 4. Changes in students' scores were assessed using paired t-tests. Graduating medical students were compared to a published general population sample using t-tests.
RESULTS: 56 students completed the survey in both Years 1 and 4 (33% of entering class). Overall, students’ percentage of correct answers increased from 24% at baseline to 32% at graduation (p<0.001). Knowledge of motor milestones did not change significantly between Years 1 and 4. Knowledge of non-motor milestones improved significantly between Years 1 and 4 (p<0.001). 85 medical students completed the questionnaire in Year 4 (50% of entering class). Compared to a sample of the general population (n=1198), graduating medical students answered 1.0 more questions correctly out of 17 (p<0.001). Students’ knowledge of non-motor milestones was greater than that of the general population (p<0.001). Knowledge of motor milestones did not differ significantly.
CONCLUSION: Medical students' knowledge of developmental milestones improved only modestly over the course of their undergraduate medical education. At graduation, their knowledge of developmental milestones was marginally better than that of the general population. This level of knowledge is likely insufficient for generalist practice. At the undergraduate level, curricular improvements including innovative teaching strategies and greater student engagement are likely necessary to remediate this knowledge gap. Pediatricians supervising medical students and residents should not assume that trainees have an adequate knowledge of normal child development and may wish to highlight the developmental achievements of typically developing children as part of their clinical teaching.
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Developing Skills for Developmental Disabilities: Assessing Efficacy in An Innovative Preclinical Elective. Paediatr Child Health 2016. [DOI: 10.1093/pch/21.supp5.e65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Many medical students feel they are not trained with adequate skills and knowledge regarding cognitive and physical disability. Because of this, students may have poor clinical skills in assessing developmental delays and discomfort when interacting with these patients. “Developing Skills for Developmental Disabilities (DSDD)” is a 12-hour preclinical (years 1 and 2) elective developed collaboratively by a group of medical students and developmental pedi-atric faculty. This elective provides training in disability, behaviour, family challenges, and available interventions via faculty presentations, peer teaching, simulation sessions, and observation of a clinical developmental intervention program.
OBJECTIVES: Our objective is to assess the efficacy of this new elective-which aims to assist students in correctly and comfortably identifying pediatric patients with, or at risk for, developmental delays and ininterac-tions withfamily members.
DESIGN/METHODS: Participating students completed a 10-question survey (responses administered on a 5 point Likert scale) at the start and end of the elective, whereby they self-assessed confidence and knowledge when engagingchildren with developmental disabilities. This questionnaire was adapted from confidence surveys used for other curriculum assessments.
RESULTS: 22 preclinical students enrolled in DSDD. Of these, 20 completed the elective and both surveys. Out ofthe 20 participants, 8 (40%) had previous work experience with disability, and 11 (55%) had personal experience (family or friend related). A significant (p0.001, CI 95%) increase in self-reported confidence was seen in 8 of10 survey questions.
CONCLUSION: Overall, DSSD increased preclinical students' self-reported confidence and knowledge regarding pediatric patients with developmental disabilities. Future plans include arepeatsurveycomparing students who opt to take the elective with a control group, randomly selected from the remainder of the class. This willaddress any potential self-selection bias. Because this brief form of intervention was significant in increasing student confidence and skill, aspects of this approach may be adapted into teaching tools for office practice (e.g. assessing development and/ordiscussing care with parents) when medical students are working alongside general pediatricians seeing children with chronic developmental disabilities.
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Abstract
Coupling between the lower and upper atmosphere, combined with loss of gas from the upper atmosphere to space, likely contributed to the thin, cold, dry atmosphere of modern Mars. To help understand ongoing ion loss to space, the Mars Atmosphere and Volatile Evolution (MAVEN) spacecraft made comprehensive measurements of the Mars upper atmosphere, ionosphere, and interactions with the Sun and solar wind during an interplanetary coronal mass ejection impact in March 2015. Responses include changes in the bow shock and magnetosheath, formation of widespread diffuse aurora, and enhancement of pick-up ions. Observations and models both show an enhancement in escape rate of ions to space during the event. Ion loss during solar events early in Mars history may have been a major contributor to the long-term evolution of the Mars atmosphere.
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Abstract
The Mars Atmosphere and Volatile Evolution (MAVEN) mission, during the second of its Deep Dip campaigns, made comprehensive measurements of martian thermosphere and ionosphere composition, structure, and variability at altitudes down to ~130 kilometers in the subsolar region. This altitude range contains the diffusively separated upper atmosphere just above the well-mixed atmosphere, the layer of peak extreme ultraviolet heating and primary reservoir for atmospheric escape. In situ measurements of the upper atmosphere reveal previously unmeasured populations of neutral and charged particles, the homopause altitude at approximately 130 kilometers, and an unexpected level of variability both on an orbit-to-orbit basis and within individual orbits. These observations help constrain volatile escape processes controlled by thermosphere and ionosphere structure and variability.
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SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems. Med Phys 2015. [DOI: 10.1118/1.4924134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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RT-31 * SURVIVAL OUTCOMES IN PATIENTS RECEIVING BOTH FRACTIONATED STEREOTACTIC RADIOTHERAPY AND BEVACIZUMAB FOR RECURRENT HIGH GRADE GLIOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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AT-51 * PHASE I STUDY OF PANOBINOSTAT AND FRACTIONATED STEREOTACTIC RE-IRRADIATION THERAPY (FSRT) FOR RECURRENT HIGH GRADE GLIOMAS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou237.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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RT-26 * RE-RESECTION FOR RECURRENT HIGH GRADE GLIOMA IN THE SETTING OF RE-IRRADIATION: SURVIVAL OUTCOMES UPDATE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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CN-21 * RISK MODELING FOR TEMOZOLOMIDE (TMZ)-MYELOTOXICITY IN PATIENTS WITH GLIOBLASTOMA TREATED ON RTOG 0825. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou243.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Essential versus accessory aspects of cell death: recommendations of the NCCD 2015. Cell Death Differ 2014; 22:58-73. [PMID: 25236395 PMCID: PMC4262782 DOI: 10.1038/cdd.2014.137] [Citation(s) in RCA: 668] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 07/30/2014] [Indexed: 02/07/2023] Open
Abstract
Cells exposed to extreme physicochemical or mechanical stimuli die in an uncontrollable manner, as a result of their immediate structural breakdown. Such an unavoidable variant of cellular demise is generally referred to as ‘accidental cell death' (ACD). In most settings, however, cell death is initiated by a genetically encoded apparatus, correlating with the fact that its course can be altered by pharmacologic or genetic interventions. ‘Regulated cell death' (RCD) can occur as part of physiologic programs or can be activated once adaptive responses to perturbations of the extracellular or intracellular microenvironment fail. The biochemical phenomena that accompany RCD may be harnessed to classify it into a few subtypes, which often (but not always) exhibit stereotyped morphologic features. Nonetheless, efficiently inhibiting the processes that are commonly thought to cause RCD, such as the activation of executioner caspases in the course of apoptosis, does not exert true cytoprotective effects in the mammalian system, but simply alters the kinetics of cellular demise as it shifts its morphologic and biochemical correlates. Conversely, bona fide cytoprotection can be achieved by inhibiting the transduction of lethal signals in the early phases of the process, when adaptive responses are still operational. Thus, the mechanisms that truly execute RCD may be less understood, less inhibitable and perhaps more homogeneous than previously thought. Here, the Nomenclature Committee on Cell Death formulates a set of recommendations to help scientists and researchers to discriminate between essential and accessory aspects of cell death.
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THU0480 Candidate Gene Discovery in Autoimmunity by Using Extreme Phenotypes and Whole Exome Capture. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Prevalence and penetrance of ZFPM2 mutations and deletions causing congenital diaphragmatic hernia. Clin Genet 2014; 87:362-7. [PMID: 24702427 DOI: 10.1111/cge.12395] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/24/2014] [Accepted: 04/02/2014] [Indexed: 01/18/2023]
Abstract
Zinc finger protein, FOG2 family member 2 (ZFPM2) (previously named FOG2) gene defects result in the highly morbid congenital diaphragmatic hernia (CDH) in humans and animal models. In a cohort of 275 CDH patient exomes, we estimated the prevalence of damaging ZFPM2 mutations to be almost 5%. Genetic analysis of a multigenerational family identified a heritable intragenic ZFPM2 deletion with an estimated penetrance of 37.5%, which has important implications for genetic counseling. Similarly, a low penetrance ZFPM2 frameshift mutation was observed in a second multiplex family. Isolated CDH was the predominant phenotype observed in our ZFPM2 mutation patients. Findings from the patients described herein indicate that ZFPM2 point mutations or deletions are a recurring cause of CDH.
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MOLECULAR EPIDEMIOLGOY. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozone induces glucose intolerance and systemic metabolic effects in young and aged Brown Norway rats. Toxicol Appl Pharmacol 2013; 273:551-60. [PMID: 24103449 DOI: 10.1016/j.taap.2013.09.029] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 09/24/2013] [Accepted: 09/27/2013] [Indexed: 12/27/2022]
Abstract
Air pollutants have been associated with increased diabetes in humans. We hypothesized that ozone would impair glucose homeostasis by altering insulin signaling and/or endoplasmic reticular (ER) stress in young and aged rats. One, 4, 12, and 24 month old Brown Norway (BN) rats were exposed to air or ozone, 0.25 or 1.0 ppm, 6 h/day for 2 days (acute) or 2 d/week for 13 weeks (subchronic). Additionally, 4 month old rats were exposed to air or 1.0 ppm ozone, 6 h/day for 1 or 2 days (time-course). Glucose tolerance tests (GTT) were performed immediately after exposure. Serum and tissue biomarkers were analyzed 18 h after final ozone for acute and subchronic studies, and immediately after each day of exposure in the time-course study. Age-related glucose intolerance and increases in metabolic biomarkers were apparent at baseline. Acute ozone caused hyperglycemia and glucose intolerance in rats of all ages. Ozone-induced glucose intolerance was reduced in rats exposed for 13 weeks. Acute, but not subchronic ozone increased α2-macroglobulin, adiponectin and osteopontin. Time-course analysis indicated glucose intolerance at days 1 and 2 (2>1), and a recovery 18 h post ozone. Leptin increased day 1 and epinephrine at all times after ozone. Ozone tended to decrease phosphorylated insulin receptor substrate-1 in liver and adipose tissues. ER stress appeared to be the consequence of ozone induced acute metabolic impairment since transcriptional markers of ER stress increased only after 2 days of ozone. In conclusion, acute ozone exposure induces marked systemic metabolic impairments in BN rats of all ages, likely through sympathetic stimulation.
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A Pilot Study on Spine Stereotactic Body Radiation Therapy Residual Setup Errors and Intrafraction Motion Using Stereotactic X-ray Image Guidance Verification System. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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SU-E-T-678: Normal Tissue Dose-Volume Constrains for Inverse Planning of Acoustic Neuroma Stereotactic Radiosurgery (SRS). Med Phys 2013. [DOI: 10.1118/1.4815105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
Antiphospholipid syndrome (APS) is a distinct autoimmune prothrombotic disorder due to pathogenic autoantibodies directed against proteins that bind to phospholipids. APS is characterized by arterial and venous thrombosis and their clinical sequelae. Catastrophic antiphospholipid syndrome (CAPS) is a rare and often fatal form of APS characterized by disseminated intravascular thrombosis and ischemic injury resulting in multiorgan failure. Rarely, intravascular thrombosis in CAPS is accompanied by hemorrhagic manifestations such as diffuse alveolar hemorrhage. Here, we report a 43-year-old woman who presented with anemia, acute gastroenteritis, abnormal liver function tests, bilateral pulmonary infiltrates, and a systemic inflammatory response syndrome. The patient developed respiratory failure as a result of diffuse alveolar hemorrhage followed by acute renal failure. Laboratory tests disclosed hematuria, proteinuria, and reduced platelet count. Microbiologic tests were negative. A renal biopsy demonstrated acute thrombotic microangiopathy and extensive interstitial hemorrhage. Serologic tests disclosed antinuclear antibodies and reduced serum complement C4 concentration. Coagulation studies revealed the lupus anticoagulant and autoantibodies against cardiolipin, beta 2-glycoprotein I, and prothrombin. High-dose glucocorticoids and plasma exchange resulted in rapid resolution of pulmonary, renal, and hematological manifestations. This rare case emphasizes that CAPS can present with concurrent thrombotic and hemorrhagic manifestations. Rapid diagnosis and treatment may result in complete recovery.
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Transcriptional activation of inflammasome components by Libby amphibole and the role of iron. Inhal Toxicol 2011; 24:60-9. [PMID: 22168577 DOI: 10.3109/08958378.2011.633942] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The induction of the NALP3 inflammasome complex is shown to be necessary for the development of fibrosis after asbestos exposure. Libby amphibole (LA) induces lung inflammation and fibrosis, while complexation of iron (Fe) on fibers inhibits inflammation. In this study we examined the ability of LA to induce the inflammasome cascade and the role of Fe in modulating inflammasome activity. Spontaneously hypertensive rats were exposed intratracheally to either saline (300 μl), deferoxamine (Def) (1 mg), FeCl(3) (21 μg), LA (0.5 mg), Fe-loaded LA (Fe + LA), or LA + Def. Activities of oxidative stress-sensitive enzymes, expression of inflammasome-specific genes, and cytokine proteins in bronchoalveolar lavage fluid were analyzed. Lung enzymes at 4 h and 24 h post-exposure were unchanged. LA increased lung expression of genes including interleukin-1β (IL-1β), cathepsin-B, ASC, NALP3, interleukin (IL)-6 and NFκB. LA+Fe significantly reduced IL-1β and NFκB with a trend of reduction in ASC, NALP3, cathepsin-B and IL-6 expression. Def treatment did not reverse the inhibitory effect of Fe on IL-1β and ASC but reversed IL-6 expression. CCL-7, CCL-12, CXCL-3 and COX-2 were induced by LA while LA+Fe tended to reduce these responses. Phosphorylation of ERK but not MEK was increased at 4 h after LA but not LA+Fe exposure. In conclusion, components of the NALP3 inflammasome are transcriptionally activated acutely during LA-induced inflammation. The key inflammatory regulators IL-1β and NFκB were inhibited in the presence of surface-complexed Fe possibly through decreased ERK signaling upstream of the NALP3 inflammasome. The inflammasome activation by LA may contribute to fibrosis, and Fe may reduce this response and alter compensatory mechanisms in individuals exposed to LA.
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Can the Volume of Irradiated Normal Tissue Be Decreased in Patients with High Grade Gliomas? A Prospective Study Evaluating Changes in Radiation Treatment Volumes from Post-Operative to Same-Day Planning MRI. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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SU-E-J-163: Tracking Interfractional Patient Positioning Consistency When a Robotic Couch Is in Use. Med Phys 2011. [DOI: 10.1118/1.3611931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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The Surgical Perspective in Infective Endocarditis: A 10-Year Review of Surgically Treated Infective Endocarditis in a Major Cardiac Surgical Centre. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2010.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bentall's Procedure for Ascending Aortic Disease: A 10-Year Review. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2010.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Regionalization Of Care For The Critically Ill In Post-Earthquake Haiti: The Value Of Teamwork. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Surgical Therapies. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Radiation Therapy. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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PL3-3 Silencing of Irf7 expression in breast cancer cells promotes bone metastases. Cytokine 2010. [DOI: 10.1016/j.cyto.2010.07.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
We examined the effectiveness of self-managed individual and group contingency procedures in improving the completion and accuracy rates of daily mathematics homework assignments. A group of sixth-grade students having homework difficulties in mathematics were selected for the study. There was substantial improvement in the amount of homework completed over baseline for a majority of the students, whereas the results for accuracy were mixed. Students who participated in the self-management training made significant gains on standardized measures of academic achievement and curriculum-based measures of classroom performance. Parents also reported significantly fewer problems associated with homework completion following the intervention. Students who were allowed to select their own performance goals made superior improvements in the number of homework assignments returned compared to students who were given a specified goal by the classroom teacher. Parents, subjects, and the classroom teacher responded positively on consumer satisfaction measures following termination of the study.
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Teaching Clinical Skill Assessment of Normal Child Development to Medical Students: An in tegrated, Evidence-Based Approach. Paediatr Child Health 2010. [DOI: 10.1093/pch/15.suppl_a.58a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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rFV11a and paediatric open-heart surgery: thrombosis in the cardiopulmonary bypass circuit in spite of adequate markers of anticoagulation. Anaesthesia 2009; 64:683-6. [DOI: 10.1111/j.1365-2044.2009.05897.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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A phase I trial using patupilone (epothilone B) and concurrent radiotherapy for CNS malignancies. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e14504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14504 Background: Based on pre-clinical data indicating the radiosensitizing potential of Epothilone B, this study was designed to evaluate the toxicity and response rate of patupilone (EPO906), an anti-microtubule stabilizing agent, with concurrent radiotherapy in the treatment of patients with CNS malignancies. Methods: This phase I study evaluated the toxicities associated with patupilone in combination with radiotherapy for the treatment of CNS malignancies in order to establish maximum tolerated dose (MTD). Eligible patients had recurrent gliomas (10), primary (5), or metastatic (17) brain tumors. Dose escalation occurred if no dose limiting toxicities (DLT) defined as any Grade 4–5 toxicity or Grade 3 toxicity requiring hospitalization or interruption of radiation therapy. Results: A total of 32 patients were enrolled. Five patients were treated with weekly patupilone at 1.5 mg/m2, 4 patients at 2.0 mg/m2, 4 patients at 2.5 mg/m2 and one patient at 4mg/m2. Based on sponsor recommendations, the protocol was changed to a q-3 week dosing schedule with a starting dose of 6 mg/m2. Seven patients were treated in the 6 mg/m2 group, 6 patients in the 8 mg/m2 cohort and 5 patients in the 10 mg/m2 group. Radiation treatment was determined by the patient's diagnosis. Primary CNS malignancies received a median dose of 60 Gy in 1.8–2.0 Gy fractions. CNS metastases received whole brain radiation with a median dose of 37.4 Gy in 1.8–2.5 Gy fractions and patients with recurrent gliomas received stereotactic radiotherapy with a median dose of 37.5 Gy in 2.0–3.5 Gy fractions. No DLTs were observed in patients who received weekly patupilone or in the 6 mg/m2 q3wk cohort. One DLT (pneumonia/infection without neutropenia) was observed at the 8 mg/m2 q3wk group. In the subsequent dose level (10 mg/m2), two grade 4 DLTs occurred (renal failure and pulmonary hemorrhage) making 8 mg/m2 q3wk the MTD and recommended phase II dose. Median overall survival was 12 months for recurrent gliomas, 15 months for primary brain tumors and 4 months for CNS metastasis. Conclusions: Combined with a variety of radiation doses and fractionation schedules, concurrent patupilone is well tolerated and safe with a MTD of 8 mg/m2 q3wk. A phase II study to characterize efficacy should be considered. No significant financial relationships to disclose.
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Effects of leptin replacement on risk factors for cardiovascular disease in genetically leptin-deficient subjects. Horm Metab Res 2009; 41:164-7. [PMID: 18726825 DOI: 10.1055/s-0028-1082037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The pediatric doctor mom blues. CMAJ 2008. [DOI: 10.1503/cmaj.081471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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